Worth fighting for is made possible by AARP.

And these United States of America and our great state of Arkansas.

Our tomorrow's have always been better than our yesterdays.

We have so much to be thankful for and to Leo for.

The soldiers, Airmen, Marines, sailors, coast Guardsmen's National Guardsmen, and our reserves.

Our job is to get the mission done.

It's a tough job completed by smart tough men and women.

Once the mission is over and our time and service comes to an end.

We take those experiences with us for the rest of our lives.

The good and the bad.

The UPS and the Downs.

They stay with us and that's why it's so important that whenever one of our veterans find themselves in a position where they need help, we are there for them.

Tonight we're talking to veterans to their families and their friends to everyone who has a veteran in their life to ensure that no one is left behind because our veterans and their mental health is worth fighting for.

That heartfelt introduction from Colonel Nate Todd, Secretary of Arkansas Department of Veterans Affairs.

Hi everybody, I'm Donna Terrell and tonight I'll be leading a discussion on preventing deaths by suicide in the veteran community.

Our guests.

Argina Chandler, assistant director for veteran services and Arkansas Department of Veterans Affairs Laura Watlington suicide prevention program manager at Central Arkansas Veterans Healthcare Systems retired Colonel Don Berry of the Arkansas Veterans Coalition.

Dr Mandy Maccorkindale, chief psychologist at Central Arkansas Veterans Healthcare Systems and retired Marine core staff.

Sergeant Dan hall.

I want to thank you all for being here.

Really appreciate it.

You know one of the things I've been wondering is let's talk about statistics here and how deaths among veterans compared to deaths among civilians.

So we usually are about two years behind on statistics to make sure that they're accurate.

In 2019 there were approximately 47,000 people who died by suicide in the United States veterans make up.

8 to 9% of the population, but they make up 20% of the deaths by suicide, so that's a significant number that is significant 20%, but they only make up 8 to 9% of the population.

So why is this happening?

Why are so many veterans committing suicide?

Veterans are a special population.

They have been through experiences that the rest of us have not been through.

They firearms is the number one way that people die by suicide and veterans are very well versed in firearms and so they tend to have more in their homes and they're again comfortable with the weapon.

And so with firearms being the number one way that people die by suicide veterans are well.

They do well with the firearms.

OK, so they're not afraid to commit suicide, so when times get tough and they feel like they need to end it all, they're not afraid to do it.

So means by which they can feel like they're in control as well too, and that recognizing that they're in and out of control situation and having the thought of suicidology the the idea that you would do this, it actually puts them back in control because they are now taking control of their.

Of their dilemma that they have that they're dealing with OK and I fully understand that.

I guess what I'm trying to get to is, is there and certainly people want to take their lives for a number of reasons.

We know this, but is there an underlying issue that veterans are facing that the rest of the population does not readjustment?

Readjustment back into society readjustment coming from a controlled environment from the military and there were told when to eat.

You know what to eat when to go to bed, when to get a hour day is so structured that coming back to the civilian world there's no structure there.

There's no continuity of what they were used to in the military.

How often do families put pressure on them?

Because when you say you know they're in this structured environment.

And then they come back home where there is no structure.

There's an issue of control.

I've been called a control freak.

I like to call myself a control enthusiast.

In a lot of cases, when they come back home, they're not in control of the household been run by somebody else, and they're kind of a visitor for the first few months.

In addition to that, they're pretty proud people used to be expected to take care of themselves, and they don't readily ask for help we have.

About 80% of veterans aren't in what we call the veterans community.

They don't join the American Legion or join the Disabled American Veterans.

They compartmentalize that and go on with our lives, and consequently, when they end up with a situation where they feel that nobody really understands, I'm kind of in this alone, and when it's no longer something that they can tolerate, then suicide enters the picture.

And I'm glad you mentioned that, because generally when people die by suicide, they don't want to end their life.

They want to end the pain.

Weather and the physical emotional.

Turmoil that they might be facing.

They see no other way to end that pain, and so they think suicide is the only way out.

Rather than seeing an alternative to how they're currently feeling, seeing other ways to get through the crisis.

So I think it's very important to have veterans who have peers you know we have a peer support program at the VA, but they they are able to relate to one another in ways that I, as a non veteran can never relate to a veteran.

And that's really what they need.

They they need the support from their community when they're in crisis, especially them into the community into the resources away from that.

To their brothers and sisters, I mean that the people that understand them the most understand the language, understand why something triggers them the way that it does.

And that's.

Well, we've been bringing him into the community if their fellow brother and sisters in arms.

So how do you reach them?

You know, I mean, obviously I think the onus falls on the people closest to them.

They recognize one with think if something is wrong, but how do you reach a veteran who's in crisis before they get to the point where they want to end it all?

That's the real trick is to deal with them before they're in crisis, and that takes a public health community networking.

For example, in my community when we broke this down, you look at the community at large.

Well, the community at large is made up of a dozen.

Or more smaller communities within the community, the veterans community, which we think of as the veteran service organizations and VA and sits on the law enforcement community, the education community, the healthcare community, and when you look at, for example, in my county, we've got 40,000 people.

Roughly census tells us it's about 5060 veterans live in that community.

Then you go around and you count how many are members of the different organizations.

Come up with less than 1000 because most of us belong to two or three of those organizations.

OK, so that's 20%.

Where are the other 80% of those veterans?

Yeah, where are they?

Well, we do some surveys when we find out the chief of police is astounded to find the 20% of his workforce.

Are veterans.

The sheriff has 33 veterans on on his department.

One of the national initiatives and one that we're adopting here in Arkansas has asked the question.

We will see more and you'll hear more about that from other programs.

Roll out, but simply asking, did you or us for service of family members serve in the military and not asking that their veterans asking if they served in the military and the family member because the families are as essential at risk and part of the solution as are the service members.

So it, that's why we deal with service members, veterans and their families and.

Asking the question, did you serve or have you served?

It's going to be a very common theme that you're going to see an awful lot of.

OK, you know one of the things I want to touch on before we get too far into this discussion is National Guard.

National Guard members have a higher rate of suicide.

Then veterans in general.

Correct, and hopefully I'm saying that right?

Yes, absolutely, that that's correct.

So when you think about the challenge of deploying.

To an austere environment.

For an active duty service member who goes with their own unit, goes with their teammates, they deploy together and then they return together.

But for the National Guard, oftentimes there's it's it's disjointed.

They're returning to their local communities, maybe to rural areas that don't have good access to mental health.

They also don't have direct access to their teammates.

So they may drill one weekend out of a month and that's when they see.

Maybe they see the people that they deployed with and they have that camaraderie and that they're able to engage in that kind of have that cohesiveness.

But then they go back to their regular lives.

And so.

So that's just an added complication to overcoming that sense of isolation.

That often goes hand in hand with suicidal behavior.

It's interesting when you bring that up.

Where were you going to say?

I'm sorry.

Our outreach program runs into this and for years I'm commander of the local Disabled American Veterans chapter and involved with all of the organization and they've all from time to time said we need to go outreach to these National Guard.

We have a post right there.

Well, what you find out when you really dig into it is the reason they're not involved is they don't live there.

The people that come to our Armory for drill once a week they live in Missouri.

And over in Oklahoma and southern Arkansas, they don't live in Mountain Home AR, so that's why it's very difficult for our organizations to outreach to them.

It took to reach them.

That's interesting.

Let's talk to about, you know, we talk about veterans.

Obviously they're no longer in service, but the ones who.

Are currently in listed and they have several tours that they do with little breaks and then maybe a long tour.

Another break along tour if they're struggling trying to readjust when they get back home, and then they're back in it again.

There's no one really to help them, so I guess my question is.

Is are there any services being offered to them that they're actually taking advantage of while they're in listed as opposed to waiting for them to get home?

Well, it wasn't until recently that they could receive help while in service, why couldn't they before?

Because if they've received help to up until recently, and we're talking probably last five years, you would be kicked out of the service if you sought mental health help, because if you were diagnosed with a mental health illness, you were not considered worldwide qualified, meaning you couldn't deploy to wherever you needed to deploy to or do your job, and therefore you were no longer needed in service.

I don't have to tell you this.

You know how horrible that sound?

It sounds very bad.

Colleges who practice them as an active and active duty in the Air Force.

I just want to say, oh wait, that's cringe worthy for me because because that's a myth.

That's that's a perception that's part of what contributes to stigma, and so not all mental health diagnosis create discharge from the military ones do, right?

So it's complicated.

I mean, so if you're, if you're afraid of being diagnosed.

OK, so I'm going to get diagnosed and mine may fall in this one.

Category versus the other one, right?

I'm not gonna even go exact right.

So So what we say is.

Is access treatment early when there when it's easier to intervene?

OK, so if we let mental health problems, mental health illnesses escalate to the point of something like a hospitalization that can create problems.

But we have service members who are currently serving who have been hospitalized for suicidal behavior.

So it's it historically probably so.

And the tip of the iceberg that you see.

Is the people who get discharged but there are a lot of service members who are receiving mental health services and are continuing to serve.

I'm glad we're clarifying that I'm glad you brought it up, because that's that's more to it than that.

Also, having to do with concurrent pay if and one of the reasons that people in the guard don't seek help or file benefits with the VA, I have one that I'm working with now who's a member of the Coast Guard Reserve?

He's very close to retirement, but he has a 10% disability service connected.

OK, once he accepted that he goes to drill on a weekend instead of getting paid, they take his money.

That's true because he cannot get paid from department of Fence and from VA at the same time.

Now that only applies in the military and if he went to work for the post office he can work full time and get a VA pension and a full check.

But if he if he's trying to serve in the military then you have this concurrent pay problem yet.

But you have to have a disability of more than 50% before you have concurrent.

Receiver, but you can't drill and receive benefits at the same time, and that and a lot of our guards and this effects a lot of the guard because the guard are still drilling.

They're still in it once you leave active duty, and some leave active duty and go into the guard.

You cannot receive VA benefits, compensation and drill at the same time, so when they're going for their two weeks out of the year every other weekend, they they receive money or compensation from that.

They can't receive both at the same time.

So a lot of times in dealing with veterans and Guardsmen I hear.

Well, I don't want to file for this disability because I'm close to retirement or it's going to affect my status in the guard and so they may not be getting the help they need if they're still continuing to drill and be in the guard.

And I would just like to point out I've joined the VA approximately 10 years ago.

Service connection, status and benefits.

It was a foreign language to me and so for viewers, you know this might sound like a foreign language, but.

Yes, you can become compensated for aggravated or injured and acquired injury while you're in service.

You can be compensated for that up to a percentage up to 100%, but then you know if you're on active duty and you get paid on guard duty then that does affect your other income and so it's just a very complicated system that isn't easy to navigate which I want to plug in.

Please please contact the Arkansas Department of Veterans Affairs.

That is what we are trained to do to help veterans file their benefits.

Understand the pay system.

I understand all of that and also point him in the direction of receiving help.

Just because you receive compensation doesn't mean they're going to come to the other side of the VA, which is the healthcare side, which is the most important side in receiving the treatment that they need for help.

So I guess that just leads me to the question is how well?

First of all, let's just kind of identify what civilians can do to help their loved one, and then I want to talk about what the VA can do once once.

Someone is able to guide this person or help them understand that you know there's support out there.

That brings me to two different topics.

For one thing, I think a lot of people think that you have to be a trained professional to intervene with somebody who might be suicidal.

They think, well, I don't have the training for that.

What can I do?

That's completely untrue.

You know?

As Colonel Berry pointed out, about six of the 20 veterans who died by suicide per day are not enrolled in VA health care.

Do I have that backwards backwards?

14 are not enrolled in VA healthcare.

Give that number again.

I'm OK. Out of we we average now about 20 veterans who die by suicide per day.

Again, we don't really like to call it by number per day, but of those only six are enrolled in VA Healthcare and so the others are getting care in the community and so we want to arm our community providers but also not getting care at all.

Or not.

That's probably the biggest point, right?

So we need our family members, friends, acquaintances.

We need them to be able to recognize signs, signs of suicidal thinking.

Which can vary from person to person significantly, but you know, if you've got somebody who's seeming very hopeless, somebody's engaging in risky behaviors.

You know a lot of mood changes, different things, different things that we all experience at times.

But if you seem kind of adding up, then you might be prompted to, as Don was saying earlier, asked the question about have you served?

But in in my world, for suicide prevention it's about.

Are you thinking about suicide?

That's one of our big things, and people don't feel comfortable with that.

It's a.

It's a scary conversation.

People think if I asked them that, what am I going to do?

What if they say yes?

So are you saying that family members, friends loved ones should ask?

Yes, are you thinking about suicide?

Should just put that out there?

Yes, absolutely.

But I always encourage people when I'm when I'm talking about this.

Know what you're going to do if they say yes.

Don't be all prepared, because if they say yes, that can be terrifying.

OK, So what do I do to do?

You can call 911.

You can call the Veterans crisis line.

We will be putting that information up.

You can take them to your doctor.

You know you can go to your primary care doctor.

You can come as a walk in at the VA.

I think I think one of the fears because I am thinking of myself.

If I were to do that to someone and then you know, we go to the doctor, we get help or whatever.

And then now that person is mad at me.

We what we did in our community and asking the questions we took on what they call QPR, which is question persuade and refer.

The question is, are you considering suicide?

The persuasion is, you know, that's pretty much a permanent solution to a temporary problem.

There are resources and then have resources to refer them to.

When I started this about six years ago, I think we only had about two QPR instructors in the state.

I have 10 in my community now.

We have two in the Police Department, two in the Sheriff's Department.

Two and DAV we have two of them that are home health improvement nurses and that's the way we've approached it.

But once you've asked the question and I got into this back door, I was at a gun show one Saturday and somebody I knew called me and he said the commander I got a problem.

I need to talk to you.

And then he heard the background noise.

He said he started to apologize for interfering with my day.

And I said, well, give me an hour to get out of here and give me a call.

He didn't and I forgot about it.

But four hours later, I wondered what did he want and when I tried to reach him, he had a bottle of pills.

And you beat yourself up for a long time, like had I been able to take that call.

Could I have done something?

Well that led me when I talked about it.

The awareness situation.

Many people who knew him so well.

I'm not really surprised he's talked about that so well.

What did you do?

Well, what do you do?

And that's when we decided we needed the training programs in the schools, in the Community and the Police Department to where people do know that there are resources and how to ask that question.

Do we have those training programs now?

We do and QPR II kind of like into the old concept of CPR, you know years ago we lost 10s of thousands of people to heart failure until we taught laypeople to do CPR.

QPR is kind of similar.

It doesn't take a psychologist or.

Psychiatrist to discuss a problem with a person and took the closer you are to them in their community, the more likely, or it can bite.

Confide in you as opposed to calling some 800 number when they don't know who or what's going to answer.

So when do we get to the point where we have QPR offer to everyone, myself included.

Well that you mentioned that because VA has a very similar program to QPR we do save but they're the steps lined up precisely.

I would just hope that anybody who wants this training can contact the station.

Contact the VA contact Mr Hall.

I mean, we could just we are available to offer it, we can do in small groups, large groups, businesses, schools.

What does the training include and how?

How quickly can you get through it?

I'll tell you what I have been through eight hour trainings and these resilience programs and and dealing with suicide.

I've been with the first one of the QPR sessions was about 2 hours and I got more out of the two hour one than I did the whole 8 hour day.

It was very.

Very concise, very easy for anybody to follow and we have lots of good instructors now in this state.

I know we have in our community.

I know the Health Department offers it out of Little Rock.

Used to be Mandy Thomas.

I think she's Jacob Smith and now there's a new person coming.

All Arkansans, I mean you know we're a subset of the population, right?

But everybody needs to learn this and to say their son or daughter's life that's being bullied in school.

Or, you know, an elderly person that doesn't want to live with their like CPR like, OK, hold that thought, now we want to have a message from AARP Arkansas volunteer President Colonel Charlie Wagner.

I am Charlie Wagner, the AARP Arkansas Volunteer state president and a proud army veteran.

As a nonprofit and nonpartisan membership organization with over 270,000 members in Arkansas, we worked to empower people 50 plus to choose how they live with respect and dignity as they age.

That includes helping veterans and their families.

We also want to help veterans and military families better navigate other resources so they get the most from their earned and deserved service benefits.

Two of the many AARP resources you'll find include a military caregiving guide for Veterans service members and their families, as well as they recently created AARP Veterans Health Benefits Navigator, which is a one stop resource on healthcare information from EU S Department of Veterans Affairs, military Tricare, Medicare, private insurance, and even Medicaid.

These two informational resources and many more can be found at AARP.

Dot org slash veterans.

Check it out for yourself.

I might add that all of these resources are free and you do not need to be an AARP member to access them.

Thank you for your tireless and relentless service to our great nation.

And that of course was Colonel Wagner.

We appreciate that I do want to talk about resources with this panel, but before we get into that, and I had a quick thought, we need to talk about COVID and the effect that COVID had or is having on suicides among veterans military professionals.

Per national reports out of, you know the Office of Mental Health and Suicide Prevention.

It did not have an impact on veteran suicide.

It did not.

It did not have an impact, but I I just.

I'm not quite sure I I don't necessarily agree with that.

I could speak kind of locali.

In the state of Arkansas.

FY20, or you know, 2021, since we've been dealing with the pandemic, we have seen an increase in suicide rates among veterans and among civilians, and it's taken a toll on everybody because the things that people could access before for resources.

Even just you know, visiting with friends and whatnot.

All of those resources disappeared with COVID, and so the support systems were gone.

And so I believe that it did have a significant impact and I would add to that that we were talking about suicide suicide as the tip of the iceberg.

That is what we see.

That's what we're counting.

But underneath that is mental health.

Crisis is distress is problems and that that we need to help get people connected to resources before it becomes a statistic that we're counting right?

So so it's, you know it's also about reaching people who are feeling isolated who are experiencing the difficulties and before it gets to that point.

And during covert there were a lot of people isolated.

Yes, we.

We anticipated that with our program since we are in the outreach business and and contacting people buddy checks all the time, we anticipated that increased isolation would be a problem.

We were able.

Fortunately, besides the small grant that we got from Disabled American Veterans National Service Foundation, we got some money from the Cares Act and really accelerated that outreach over the winter time.

Through Christmas and and whatnot of last year and we actually had a downturn.

We started our program.

Baxter County was the highest suicide rate in the state.

We had two a month, 24 in one year.

The High year was 2016.

As we began our program, we cut that rate by a third.

And that's when we started to apply for the grants to help us a little bit.

So, well, you know, one year does not a trend set, but we might be on to something.

That trend continued this year as of the third quarter, we've had a total of three suicides in our county.

Now I don't wait two years for Villiers 2019 statistics part of our.

Organization or partnership is the county coroner so I can get actual numbers, not statistics every month, and we're at the point now for this entire year, we've had three suicides, 2 veterans and one not, certainly three or too many, but that's that's compared to compare.

That is pretty incredible, so you're doing something right.

That's good.

One thing I've failed to mention is that suicide is related to loss, and so if you think about loss of a loved one, whether it's death or you know, a divorce, loss of a child, and whether that's just angsting separation of ways that kind of loss, loss of job, loss of income, loss of independence as you get older, and loss of physical ability, all of these things are real triggers for suicide.

And so I think that anytime you see somebody facing.

One or more losses, particularly if they're they're big.

You know somebody getting older, unable to care for themselves.

That's a really difficult thing for one to accept in face and ask for that kind of help.

And so I just really want people to think about loss as the major risk factor for suicide, and also to be aware of that, it's normal as a human to feel a great deal of emotional pain when you are faced with with loss like that, especially com, pounding loss and so you know, recognizing.

As humans we are designed to avoid pain, right?

I mean if we go to touch if we put our hand out on a hot stove, what's going to happen?

We we don't even think about it.

We're we're avoiding it.

We're pulling away from it.

So with loss like Laura has described it is, there's a degree of normalcy to think about.

Not wanting to live anymore to not wanting to live like this and and then the way that people think about that is what also then contributes to them feeling odd or different, or what's wrong with me.

They question themselves like question, meaning you know what that says about them and when, when there is no one intervening where people can get really lost in their own thoughts and this is.

I have to commend you all because this is a great conversation.

I think we're making some really good headway.

Arnold Wagner would be upset if we don't talk about resources definitely, so let's let's get that in what's available first of all, to veterans, I'm going to ask about families as well, but what's available?

We have the vet Center for.

the VA has a vet Center for counseling and readjustment, and obviously the VA health benefits with the VA mental health program in the Central Arkansas Healthcare system or whatever VA system you use because 55 medical.

Centers touch Arkansas, so it could be Memphis, Poplar Bluff, Fayetteville, Shreveport or Central Arkansas health care system.

Arkansas Department of Veterans Affairs.

It's it's reaching out to somebody so we can pull the resources around it because it may be mental health, but it also may be a financial situation.

It may be other tide into it.

It's not just here.

We're going to ship you offer mental health and that's it.

It's going to solve everything because they're going through something so they need help with whatever it is.

The catalyst that's creating this emotion.

One of the navigators now that we have, that's emerging.

Since last fall, locally developed in Northwest Arkansas is a resource called Camp Connect.

Those who visit the DMV.

The revenue offices in Northwest Arkansas or even Hearts is now over.

In Jonesboro, they've rolled out 65 kiosks to this point in time that you'll see in these public places that basically that asked the question and then through an iPad that's located there, you can actually navigate to resources that deal with education or housing or employment, but also connecting with the VA so that resource list.

Is expanding we're seeing really significant interest?

Not only here in Arkansas, but as Giannetti indicated to us that Oklahoma is very much interested in adopting the program as well too.

So it's a kiosk space that you'll see in public places, so there's no stigma attached to going to it and taking a look at what's there.

And you can also shoot the QR code on your phone so you can take it away from you.

And then you have on your phone.

You have all those resources.

Designed here in Arkansas and Cares Act funding supported its deployment.

Don, you brought up something that's important to talk about to stigma.

When you talk about mental health, there are many communities.

African American community is one of them, where you know a lot of people are opposed to getting mental health help.

How do you convince someone even once you've identified that they're suicidal?

How do you convince them that it's OK, right?

You can do this.

I wish we had more time.

One of the things VA has done is we've created a program which we could talk more about, but it's called primary care, behavioral health and so one can go to their primary care doctor and then they can see mental health while they're in just the primary care appointment so that you know allows them to be seen without having to go to a mental health clinic or to, you know, without the stigma, I would think because stigma is a huge factor.

Did you want to?

Yeah, so just increases the availability and access.

So whether it's within the VA system or even.

Non VA going and seeing your primary care doctor.

That's the first that can be the first.

Let me just it and I'd rather someone see a primary care doctor then.

No one at all, but is that primary care doctor really able to help them in the way that?

You would be able to.

Oftentimes they can help get people connected to mental health services, so they may have someone that they refer to.

They can assist you know.

Ideally they would have someone right there in their office that they could hand the patient off to to see.

But yeah, I will say this.

Many people will listen to their primary care dogs and I'm not trying to dismiss that.

I'm just bringing it up shows, you know.

Generally people who die by suicide they have seen.

Their primary care doctor within 30 days of their deaths, not mental health, but they've seen primary care.

That's what we've seen over the past six years that I've studied, veteran suicide and so VA has.

Armed our primary care doctors and their staff to assess for suicide in a deeper way than they did previously.

And as many said, if they get that assessment and evaluation, then they can be referred to a kind of a higher level or more specialized care.

Also, for the veterans in Arkansas, we have 12 community based outpatient clinics from Mountain Home all the way to El Dorado and across the state Nina where Helena West Helena.

There are twelve of these community based out.

Patient clinics operated by the VA and it becomes as Laura would indicate you do.

There you go there for your primary or care, but a part of that primary care services just like dermatology.

Its primary care is behavioral health, not.

We would like to call that behavioral health because it's part of the overall spirit and so that one building encompasses all of those specialties, so there isn't, so there isn't the stigma attached with parking in front of some building that has a.

Mental health facility.

Yeah, I do want to say one thing in the last two three years now, mental health help with the VA has been opened up to veterans with other than honorable discharges.

That's key, glad you brought that up, and that was something I wanted to discuss because before if you were, if you get a dishonorable discharge then you're cut off, correct and sometimes even knowing that you were discharged dishonorably.

You need help.

You need in addition to everything else you're dealing with, bring their full circle to resources and what happened when we started our program locally in our more rural, isolated area when I first wrote this.

Proposal, which became our grant.

My logic was, well, you know, they can turn down hall down pretty easy, but maybe they think twice about Senator Bozeman.

So I got to Senator John Bozeman to give us a letter of support.

Lieutenant Governor Tim Griffin.

Congressman Crawford and we had all these letters of support this and and.

Senator Bozeman took that any in DC kind of nationalized our program and said, look at Mountain Home AR is doing with very little funding.

And he introduced Senate Bill 1906 and then 785, which became the Colonel John Hammond Veterans Mental Health Improvement Act.

Which requires the VA then to provide resources in the community to programs like ours.

Bottom up instead of top down.

We're currently involved with a together with Veterans Grant from the VA that helps with some of our expenses, so the whole thing is come full cycle.

We now have a full mental health service at the Community based Outreach clinic at the same time, Baxter Regional Medical Center.

Because of the Mission Act has really come on.

Forward to be the primary provider for veterans in our community and they now have a full behavioral, health and substance abuse team so it it gets also back to the question of stigma when one person goes to this facility that says mental health, you've got a stigma.

But when the whole community is involved with this and they understand the gravity of the thing and how it is that we can deal with it as a community, a lot of that stigma goes away.

Talk a little bit about it off.

Focus on the individual treatment programs such as these, but a larger measure in the direction that we're approaching nationally is a public health approach that treats communities.

And when you consider and I've shared this with Colonel Tide, if I had out of 100.

If we could spend $0.50 of every dollar in our communities for Community Wellness so that we can ensure that our communities are resilient and strong, and then we do have relationships with our neighbors, that's worth a half investment and then 30%.

Perhaps as being spent on the treatment programs we've talked about, the clinical treatment programs and then still save 20% or so 15% towards crisis intervention.

But when we focus all of our efforts on crisis intervention, you'll never be able to save.

Everybody and if you try to treat everybody that is at risk, you will always be in that ketchup.

So what we have to do is recognize a three prong approach and find ways to treat our communities.

Colonel Tide and I've talked about this a number of occasions that the health of the Community may be best identified by the attendance at Friday Night Football games.

And when you think about the fact that if attendance is high, that community is strong, they're there to beat there together with their friends and their neighbors.

That's a very resilient community.

So one of the metrics that we'd like to watch would be what's our attendance at Friday Night Football games and a well attended communities where or Little League or parades, or those events where we can as a Community relate to one another when we see good turn out and good performance and involvement of our Community members.

Together, that is a defense measure that prevents those somewhat loss of hopefulness and alone incidences occurring that drive people over down down the path.

I'm going to ask a question this.

I don't think this will science sound odd, but.

I have been in places where.

You know, a veteran may be there and people feel like he's odd or afraid to talk to him because.

He's odd, I hope you follow what I'm saying here.

How do communities?

Because when you talk about bringing people together at a football game.

And you have someone who is just kind of different than everyone else.

And I'm specifically talking about a veteran.

How does the community embrace?

How does the community help that person?

Because you don't know what's going on with them.

You have to socialize him there.

You have to recognize that because.

You may see this, they're they're off or some like.

Well, chances are there.

Companion fare fare associate their colleague there.

There are people who they are around normally all the time.

They will note that change, so there's a.

That's a that's a reason for an alert, but the best way to to to recognize is that if someone's off, let's discover what's what's off, what's driven them because you've recognized Aunt Mary isn't the way.

Not quite something not quite right.

Versation with them.

I mean you don't want to isolate them more by, you know, looking away or being afraid of the behavior is, you know, talking to them and and finding out what is wrong with them.

Or you know my dad used to always drink and I didn't understand why he was self medicating and I just thought.

OK well Dad comes home from work he drinks and he was numbing the pain.

So it may be that person that's off.

It may be that person that's numbing the pain.

But talk to them and see.

Not and I.

One thing I want to make sure we make clear not every veteran as a combat veteran.

We're not focusing just on combat veterans.

You know my service in the military.

2 1/2 years changed me forever, so going through basic training, they tear you down to build you up and or into the soldier airman, you are that changes your trajectory, your life forever, the way you handle stress.

The way you handle conflict so.

You know, basically it's every veteran.

That's why we asked the question.

Did you serve?

Ask them how they're doing.

Did you serve and how are you doing and and the the person you know this this person that I'm describing?

It sounds to me what you're saying is get to know that person reach out to know them, reach out because they may be just fine, right?

But they may not be and the only way you're going to be able to discern is to have that conversation, and I think even before you get to that point, inclusiveness accept them as they are.

They might seem a little different, but oh hey, come on out to the football game, everybody will be there or.

Some sort of community food, food event or something like that be inclusive and try to get them to at least attend.

If not, talk at that point because they may not be ready to share what's going on with them, but to just have them feel a part of something could be a significant impact in their life.

Yeah, and family members are going to notice the change before this service member or the veteran, and you know veterans think they're fine.

You know it's just a drink or two.

They don't realize they're going down this rabbit, so and I'll give you a perfect example of veteran.

A father yesterday said you need to call my son.

My son needs help.

You need to call my son and I called him and he says, you know I haven't been getting treatment at the VA.

I haven't done anything since 2012 and I went through a substance peace program but I need help and I said OK, we're going to get you help.

So it was a father member.

Father realized or recognizing the son needed help you know and I said are you in crisis right now?

Because if you're in crisis we need to take care of you right now, he said.

I'm not in crisis right now and I gave him the steps.

For if he is in crisis, what he needs to do so it's family members recognizing it before service veterans, let me just throw this out here because we do talk about family members and I, I think you mentioned something a little earlier about someone who committed suicide and family recognized that this person was suicidal.

So now I want to talk about how do survivors deal with guilt?

When they've missed something.

I think that.

You can never blame yourself for somebody dying by suicide, and I don't know if you've noticed, but in in the world of preventing suicide or trying to prevent, we don't.

We don't ever say commit suicide.

I'm sorry.

Oh no, Oh no.

It's a very common thing.

Most people say that, but there's a negative connotation with that.

We tend to say die by suicide.

Some people even say suicided, which I haven't gotten on board with that some might say they died from depression.

Again, you know the word suicide itself has a lot of stigma to it, but you know, as professionals you know I mean.

We are bound by ethical duty to do right by our patients in a patient can walk out of your office and immediately go die by suicide.

And you know the guilt that that could put on you.

The same with any family member is that you you can only work with what you have and people have the right to not tell everything to not admit to having suicidal thoughts, to not admit feeling so poorly that they would like to end their life.

And so while family members can beat themselves up as well as professionals.

We are not miracle workers.

We can lift the community and try to prevent somebody from getting to the point where they would rather end it all.

Then try to find a way out of it.

But we we.

I would actually just hope nobody ever feels that much guilt because it's it's not bearable.

There's nothing you can do to stop somebody if somebody is going to do it and commit the act, they're going to do it even if you get them help.

I mean, we're talking about getting them help.

Yes, even if you get them help, they can leave the next day and go and.

Follow through with their plan.

In the end, they're responsible for their own decisions and all you do is have your input and help, but at tying in with someone with Don said and what we're saying, I look at the thing of the three things having to do with suicide community faith and resilience.

You get your resilience by being part of the community joining your veteran service.

Organizations have people that you can deal with and talk to and have the whole community involved in this, I guess.

I'm a little proud of my community, so unique, but I was elected county judge in Baxter County.

I'm a Marine chief of police was a retired marine.

Many of my appointments to different commissions and so on were people who I knew had vast military experience.

We were retirement community people like Don, who were colonels and Lieutenant colonels in the military and have a variety of different talents that can go to work in your community.

And that whole thing creates the resilience and veterans.

That they're part of it, and I've dealt with this before.

It it's not unique to veterans I mentioned in a previous discussion that one of the highest suicide rates as far as professions is law enforcement.

For very similar reasons, law enforcement officers go to work every day.

It isn't what I do, it's who I am.

I am a police officer.

I am a public safety officer and all the decisions I make everyday impact a whole lot of people in the Community.

I worked shift work all these years.

I've been through two or three wives.

The kids are off at college, and now it's retirement age and they retire and they go home and suddenly every decision they make only affects themselves.

And they begin to feel completely irrelevant and alone.

That's when is very similar to retired military.

I know people came back from Vietnam.

There was no such thing as poster Matic stress, or Americans with Disabilities Act.

You went on with your life and what did they do?

Well, you first of all, you weren't going to seek mental health because you want to succeed in the civilian community, which means you're going to be a policeman or fireman, a school teacher or whatever.

Mental health you're not coming into this here.

And so then they get to retirement age and all these things.

They compartmentalized all these years.

When they're sitting at home on the recliner, come back and bite them.

That's when we need to be there for them.

One of our.

New and ongoing efforts is called the Governor's challenge, and I wanted to see if I could bring it back.

Laura, Gina, Dan and I, or monks, to probably 30 or more were part of the Arkansas team.

The Arkansas team is one of eight teams in our current cohort.

The substance abuse, Mental health services agencies of DHS, in partnership with the VA a number of years ago.

Established mayors challenges and governors challenges where you put a cross government team together, including the private sector and and veteran organizations and military Department of Defense as well in establishing programs within your state.

Sometimes policy adjustments may be engagement of different initiatives and we have a team here in Arkansas.

We've been working for about six months, divided up into three segments policy.

Areas.

Identification of SMF service member veteran and their families and screen for suicide risk, connectedness and care transitions, lethal means, safety and and safety planning.

In fact, that segment Laura runs is the is the team leader for lethal means safety and safety planning, which is very significant and in fact this week the White House released its plan for addressing suicide within the veteran and military community.

And their emphasis is on lethal means safety, so that's very much key.

We talked about it earlier about the incidence of firearms use, and in this case here the main theme of the White House is effort.

Going forward is addressing the lethal means safety.

That's a critical component.

We talk about firearms.

I mean the number one method for dying by suicide.

If you can get a little bit of space between the firearm and the person who might die, die with it.

Whether it's a gun lock.

They can keep their gun in their ammo separate.

We have people that sometimes give their guns to family members or friends even to law enforcement at times.

Law enforcement will hold onto the gun.

There's a big misconception that people have that if I say I'm suicidal, they're going to take my firearm.

That is absolutely false.

That Second Amendment rights stands very firmly.

There are very, very very few incidents where you might have to give up your gun rights, but that's such a common myth.

We also have people say, why would I want to have?

What good is?

My gun going to do if it's unlocked.

You know what?

If I have an intruder you can say you know how often has your home been broken into that you've actually needed to use an armed weapon to defend your home?

Probably not very many times.

And so when you're having suicidal thoughts, it would be safer for you and your family to possibly have that separated or it locked in some way.

We also like to frame it as a child safety issue.

We've all seen news stories where children.

Have died with, you know.

Open accessible firearms and so it's just very important to keep them safe.

Because if I wanted to shoot myself and I don't have a gun then I can't.

I simply cannot do it and it gives you time to think about it.

It gives you time for someone to come and help you.

It just gives you time.

You need time, you know that makes me think of this slide.

I've actually submitted this, but there's.

There's a slide we have at VA and I had to get the paper out, but the time from decision of saying I'm going to die by suicide.

I'm going to kill myself to actually taking action is less than an hour.

So statistically, if someone decides to die by suicide when they actually take action, it's less than one hour, so it's going to happen within an hour.

Generally, yes, OK, so if you can give them a moment a little, I gotta go get the key to my gun lock.

OK wait, I need to go call someone.

I need to go call the crisis line and I know it's not ideal to have an 800 number, but I would like to make sure that we do discuss the veteran crisis line as a resource.

Let me not jump ahead, but it's very critical.

Sometimes it's even less than five minutes that somebody decides to take their life and then takes the action, and so it's just very critical to put space between whatever method and we talk a lot about firearms that if somebody is going to overdose, you know you can use pill counters.

You can ask your family, hey, I just need seven days worth of medication at a time.

A lot of pharmacies will put them into blister packs.

In that way.

You know it takes a lot more effort than just to open a bottle knives.

I mean, there's so many different ways.

Of lethal means safety, but we do focus on firearms.

OK, I, I just want to just briefly.

We have about 3 minutes left.

I want to just talk about addiction, talk about alcoholism.

Some of these things come into play with alcoholism.

Is it OK?

Do you suggest a veteran?

Go to AA meetings?

Or should they really reach out to to the veterans to the VA?

I believe EA has been a long standing program that's been very successful for many people.

I don't think it's the the program for everyone, and so I think absolutely if EA suits your needs.

Their AA meetings online you can look them up for your community all over the place, but there's other ways to reach out for help with addiction.

VA has some very good programs, whether it's inpatient outpatient, we've got a like a 28 day stay program.

We have intensive outpatient programs and we've actually been able to, as a result of the pandemic, expand that to offer a virtual intensive outpatient program.

So it doesn't matter what part of the state you're in, you can live as long as you have a device that connects to the Internet.

You can connect through to to their intensive outpatient program, and you know there there are a lot of really helpful interventions, including medications.

Can help with controlling substance substance disorders.

Let's get final thoughts.

'cause we're at the end of the road here.

What do you want to leave our viewers with?

What is it?

We've given them a lot of information, but in addition to all of that.

What are your final thoughts?

I would have to say that if you are truly feeling hopeless to know that there is some hope out there, and if you can't hope for yourself, I can hope for you or somebody else can hope for you and do it until you get there yourself.

But if you take that final step.

You're going to miss any chance ever, and so just reach out.

It might take more than one time of reaching out, but reach out.

Yeah, I definitely agree with what you're saying there and the family needs to be aware.

I always preach the family because the family knows the their family member better than anybody else.

So family, please pick up on these resources and have him.

You may not need him now.

He may need him five years from now.

You may need him tomorrow, but the family members need to, you know, make sure their their family members OK and ask the questions and don't be afraid and know what to do.

If you're one of those people that sitting at home feeling useless and and uninvolved, and what have you look to your community to where you can develop a purpose driven life?

There are so many things you can be involved with the veteran service organizations as opposed to asking for help offer the help that you have.

Our hospitals are our county sheriff's.

All of them use volunteer labor all the time for specific purposes.

Are Baxter Regional Medical Center.

I don't think.

Drive rate without the cadre of volunteers that are every day they're there and that's how I stay involved.

I told somebody one time.

If you hear Dan Hall committed suicide, call the FBI.

Something is wrong there because I live a perfect driven life.

I have reason to go get up every day and go do something.

So help somebody else and that's a huge value.

So don't sit out there feeling like you're worthless all the talents you got.

You can bring to bear in your community.

I'm going to one more thought.

I'm going to have to wrap this up.

From the Veterans Coalition, veterans are not a special needs community.

Were special skills communities so enroll us in those efforts in the Community and make sure don't be afraid to ask the question.

How are you?

You're not alone.

What's that?

808 hundred numbers veterans crisis line one 802 seven three talk or 1-800-273-8255.

This is the same number as the National Suicide Prevention Lifeline.

Anybody can call it.

It will say, if you're a veteran press 1.

We know that they don't always press one, and that's fine.

They're still getting help.

They're about to implement 988 that will get you to the same distribute call centers 988 and program that in your phone.

And I also see a text number there on the screen, so we got it covered.

All right?

Thank you so much.

Thank you.

Been such an important conversation.

You guys were great.

Thank you, thank you, and unfortunately we're out of time.

Yet this is a crucial conversation and it should continue.

Encourage.

I encourage you.

To take a look at the resources that we talked about this evening.

Because your well-being is worth fighting for.

Again, thank you for joining us.

I'm down at RL goodnight.

Worth fighting for is made possible by AARP.