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Q&A with Dr. Barbara Van Dahlen to discuss how together, we will prevent suicide for Service members and Veterans. Submit questions below!
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Join a live Q&A with Barbara Van Dahlen, PhD and Travis Bartholomew to discuss how together, we will prevent suicide for Service members and Veterans. Submit your questions below!
Dr. Barbara Van Dahlen-
Dr. Van Dahlen, a licensed clinical psychologist, was appointed to lead the PREVENTS Task Force in July 2019. She is the Founder of Give an Hour, a national nonprofit that provides free mental health care to those in need including service members, Veterans and their families. In 2012, she was named to TIME magazine's list of the 100 most influential people in the world.
Dr. Van Dahlen is an expert on the psychological impact of war and a thought leader in mobilizing constituencies to create large system change. She is widely recognized for her work in changing the culture associated with mental health. A licensed clinical psychologist who practiced in the Washington, D.C. area for over 20 years, she received her Ph.D. in clinical psychology from the University of Maryland in 1991.
PREVENTS Background-
Executive Order 13861: Signed on March 5, 2019, the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) is a call to action to amplify and accelerate the progress in addressing the Veteran suicide epidemic in our Nation. While there have been other efforts to address suicide prevention, this is a cabinet-level, inter-agency effort charged with developing the first federally coordinated national public health strategy to address suicide.
The goal of PREVENTS is to prevent suicide — among not just Veterans but all Americans. By adopting a holistic public health approach, PREVENTS is acting on the knowledge that suicide prevention is everyone’s business, and that by working together, locally and nationally, we can prevent suicide.
PREVENTS is building on the critical successes of suicide prevention pioneers and agencies working with Service members and Veterans. The PREVENTS Task Force is partnering with stakeholders from multiple sectors, including nonprofits, state and local organizations, Fortune 500 companies, and government leaders, to implement best practices to improve health and prevent suicide.
PREVENTS recently launched REACH, the Nation’s largest public health campaign with the central message that suicide is preventable. The REACH campaign recognizes that to prevent suicide, we must reach beyond what we have done before– including the way we think about, talk about, and address emotional pain and suffering. The REACH campaign is for everyone because we all have risk and protective factors that we need to recognize and understand.
Dr. Barbara Van Dahlen-
Dr. Van Dahlen, a licensed clinical psychologist, was appointed to lead the PREVENTS Task Force in July 2019. She is the Founder of Give an Hour, a national nonprofit that provides free mental health care to those in need including service members, Veterans and their families. In 2012, she was named to TIME magazine's list of the 100 most influential people in the world.
Dr. Van Dahlen is an expert on the psychological impact of war and a thought leader in mobilizing constituencies to create large system change. She is widely recognized for her work in changing the culture associated with mental health. A licensed clinical psychologist who practiced in the Washington, D.C. area for over 20 years, she received her Ph.D. in clinical psychology from the University of Maryland in 1991.
PREVENTS Background-
Executive Order 13861: Signed on March 5, 2019, the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) is a call to action to amplify and accelerate the progress in addressing the Veteran suicide epidemic in our Nation. While there have been other efforts to address suicide prevention, this is a cabinet-level, inter-agency effort charged with developing the first federally coordinated national public health strategy to address suicide.
The goal of PREVENTS is to prevent suicide — among not just Veterans but all Americans. By adopting a holistic public health approach, PREVENTS is acting on the knowledge that suicide prevention is everyone’s business, and that by working together, locally and nationally, we can prevent suicide.
PREVENTS is building on the critical successes of suicide prevention pioneers and agencies working with Service members and Veterans. The PREVENTS Task Force is partnering with stakeholders from multiple sectors, including nonprofits, state and local organizations, Fortune 500 companies, and government leaders, to implement best practices to improve health and prevent suicide.
PREVENTS recently launched REACH, the Nation’s largest public health campaign with the central message that suicide is preventable. The REACH campaign recognizes that to prevent suicide, we must reach beyond what we have done before– including the way we think about, talk about, and address emotional pain and suffering. The REACH campaign is for everyone because we all have risk and protective factors that we need to recognize and understand.
Suicide
Mental Health
PTSD
Department of Veterans Affairs (VA)
Health
Responses: 70
Barbara Van Dahlen, PhD
Thank you, SPC Lowder. We greatly appreciate your kind response, and we hope you find this discussion helpful. If any questions or remarks should come up that you would like to offer, feel free to reply to the thread or add your comment in the box.
A major contributing factor is substance abuse. There are a lot of tools out there to help people.
Barbara Van Dahlen, PhD
Thank you for your comment, LTC Hartman. Yes, substance use challenges are a known risk factor for suicide. In addition, substance use disorders and other mental health conditions (like depression and anxiety) often co-occur. In fact, substance misuse and suicide share quite a few of the same risk factors (ex: history of mental illness, exposure to trauma, family history, isolation, and poor quality of life).
As you note, however, there ARE tools to help. Substance misuse treatment is available that helps address the physical and emotional well-being of individuals in the process. We are working closely with our colleagues at VA and around the country to ensure that we are addressing all of the contributors to emotional pain and suffering. Sometimes a substance misuse problem develops in response to an individual’s wish to numb his or her emotional pain. Sometimes there is a family history that places someone at higher risk for substance misuse. And sometimes, as we know, someone may become addicted to pain medications – and be unable or afraid or ashamed to seek help.
As we all continue to talk openly about what causes emotional pain and suffering – as well as talking openly about substance use and accessible treatment – we will continue to break down barriers. This will, in turn, open the door to more conversations that lead to help and healing.
You may already have these resources – but perhaps others can benefit from accessing care and the VA. I hope these are helpful:
https://www.va.gov/health-care/health-needs-conditions/substance-use-problems/
https://www.mentalhealth.va.gov/substance-abuse/programs.asp
SAMSHA’s National Helpline: 1-800-662-HELP (4357)
SAMSHA Treatment Locator: https://findtreatment.samhsa.gov/
Thank you again for raising this important point.
As you note, however, there ARE tools to help. Substance misuse treatment is available that helps address the physical and emotional well-being of individuals in the process. We are working closely with our colleagues at VA and around the country to ensure that we are addressing all of the contributors to emotional pain and suffering. Sometimes a substance misuse problem develops in response to an individual’s wish to numb his or her emotional pain. Sometimes there is a family history that places someone at higher risk for substance misuse. And sometimes, as we know, someone may become addicted to pain medications – and be unable or afraid or ashamed to seek help.
As we all continue to talk openly about what causes emotional pain and suffering – as well as talking openly about substance use and accessible treatment – we will continue to break down barriers. This will, in turn, open the door to more conversations that lead to help and healing.
You may already have these resources – but perhaps others can benefit from accessing care and the VA. I hope these are helpful:
https://www.va.gov/health-care/health-needs-conditions/substance-use-problems/
https://www.mentalhealth.va.gov/substance-abuse/programs.asp
SAMSHA’s National Helpline: 1-800-662-HELP (4357)
SAMSHA Treatment Locator: https://findtreatment.samhsa.gov/
Thank you again for raising this important point.
Substance use treatment for Veterans | Veterans Affairs
If you're a Veteran struggling with substance abuse or other substance use problems, find out how to get help. VA substance abuse programs offer drug and alcohol abuse treatment, residential (live-in) rehabilitation, peer support, and other programs at medical centers around the country.
In truth, I get why so many soldiers and veterans give up. It is hard in uniform and even harder in the civilian World, especially in this day and age and the World we are living through.
One of my last duties before retiring was to conduct a command wide, mandator Suicide Prevention training for our battalion. USAREC had created this excellent video that everyone would view and there was a discussion after viewing the video, in reality pretty good stuff. What knocked me on my heels was, one of the people in the video was a friend from my time in USAREC and another was one of our ow soldiers! Our soldier had not mentioned he was even in the video to anyone in our Battalion? I'm standing there on the stage staring at one of my sergeant, giving him a look of "You could not even give me a heads up you were in the video?"
I think we are peeling back the onion on this but I fear we are still a long way from the core and the onion is still growing, so every layer we peel away, another grows back. If we do not start looking at that core, we will never get on top of this scourge.
One of my last duties before retiring was to conduct a command wide, mandator Suicide Prevention training for our battalion. USAREC had created this excellent video that everyone would view and there was a discussion after viewing the video, in reality pretty good stuff. What knocked me on my heels was, one of the people in the video was a friend from my time in USAREC and another was one of our ow soldiers! Our soldier had not mentioned he was even in the video to anyone in our Battalion? I'm standing there on the stage staring at one of my sergeant, giving him a look of "You could not even give me a heads up you were in the video?"
I think we are peeling back the onion on this but I fear we are still a long way from the core and the onion is still growing, so every layer we peel away, another grows back. If we do not start looking at that core, we will never get on top of this scourge.
Travis Bartholomew
Thanks for joining the discussion, MSG Sand. Your comment gets to the heart of what my office and the Department of Defense (DoD) are trying to do to minimize stigma and encourage help-seeking across the Force.
There is a widespread stigma associated with suicide, which may lead people to be afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions, and share their story with others. Most people who attempt or die by suicide have communicated their distress or plans to at least one person. Talking about suicide with a person gives them an opportunity to express thoughts and feelings about something they may have been keeping secret, as well as obtain help and support as needed.
We must be supportive of Service members who need help. We must allow ample time for the Service member to gain access to help. We should speak as leaders about the importance of mental health. An effort to reduce stigma in the DoD is the Real Warriors Campaign, which is aimed at reducing the stigma of seeking mental health care by sharing the stories of Service members who successfully sought care and improved their mental health as a result. The campaign educates Service members, Veterans, and their family members about signs and symptoms of stress and strategies for building resilience. It reaches up to 4.5 million individuals each day through its social media channels. Almost 50 individuals per week reach out for help through the campaign's live chat, phone calls, and "seek help" webpages. At the policy level, the DoD completed reviews of mental health policies and procedures in order to identify stigmatizing language that could be influencing views on mental health issues and help-seeking behaviors. These reviews provided guidance on developing policies and procedures with language that is more supportive of mental health care and less stigmatizing toward mental health difficulties experienced by Service members.
Additionally, DoD has launched several pilot initiatives striving to reduce stigma and strengthen access and delivery of care. For example, DoD is piloting a barrier reduction training designed to address the most prevalent help-seeking concerns of Service members (e.g., career and security clearance loss concerns, loss of privacy and confidentiality), and encourage Service members to seek help early on, before life challenges become overwhelming.
There is a widespread stigma associated with suicide, which may lead people to be afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions, and share their story with others. Most people who attempt or die by suicide have communicated their distress or plans to at least one person. Talking about suicide with a person gives them an opportunity to express thoughts and feelings about something they may have been keeping secret, as well as obtain help and support as needed.
We must be supportive of Service members who need help. We must allow ample time for the Service member to gain access to help. We should speak as leaders about the importance of mental health. An effort to reduce stigma in the DoD is the Real Warriors Campaign, which is aimed at reducing the stigma of seeking mental health care by sharing the stories of Service members who successfully sought care and improved their mental health as a result. The campaign educates Service members, Veterans, and their family members about signs and symptoms of stress and strategies for building resilience. It reaches up to 4.5 million individuals each day through its social media channels. Almost 50 individuals per week reach out for help through the campaign's live chat, phone calls, and "seek help" webpages. At the policy level, the DoD completed reviews of mental health policies and procedures in order to identify stigmatizing language that could be influencing views on mental health issues and help-seeking behaviors. These reviews provided guidance on developing policies and procedures with language that is more supportive of mental health care and less stigmatizing toward mental health difficulties experienced by Service members.
Additionally, DoD has launched several pilot initiatives striving to reduce stigma and strengthen access and delivery of care. For example, DoD is piloting a barrier reduction training designed to address the most prevalent help-seeking concerns of Service members (e.g., career and security clearance loss concerns, loss of privacy and confidentiality), and encourage Service members to seek help early on, before life challenges become overwhelming.
Thank you for the invite. Maybe I'm not reading right but I don't find where do we sign-up and join this program?
SrA (Join to see)
Hi WO1 Eva - There is no sign-up needed for this Q&A. You can type your questions to Dr. Barbara Van Dahlen in advance on this page, and they will be answered in writing starting at 3PM EST on Tues, Aug 18th.
Barbara Van Dahlen, PhD
You’ll be able to join the program and view responses by logging in to RallyPoint at the time of the event: Tuesday, 8/18 at 3pm. Additionally, if you’re looking to get involved further in the work of PREVENTS, an important first step is taking the PREVENTS Pledge to REACH, which can be found here: https://www.wearewithinreach.net/pledge/. Thank you for your interest in our work!
1. How does the VA participate in the DoD transition for service-member's? Should there be training on the differences and expectations of the military cultural experience into the civilian sector? We give service-members training on how to transition into a civilian sector jobs market, but I did not see any training on the stressors of dealing with masses of unruly civilians who appeared only out for themselves, a contradiction to the teamwork culture you serve in the Military.
2. Why hasn't DoD and the VA done research on many of the medicines given to service-members are considered harmful and controlled in other industrialized countries? For example, modafinil given to older service-members for issues related to attention deficit and sleep disorders (possibly combined with other prescribed medicines) has the side-effect of suicide ideation.
2. Why hasn't DoD and the VA done research on many of the medicines given to service-members are considered harmful and controlled in other industrialized countries? For example, modafinil given to older service-members for issues related to attention deficit and sleep disorders (possibly combined with other prescribed medicines) has the side-effect of suicide ideation.
Travis Bartholomew
Thanks for your questions, LTC Wright. I consulted with my counterparts in the Military-Civilian Transition Office on the transition piece, and they certainly see the loss of identity and camaraderie as a concern for many Service members as they leave the military. Transitioning from the military to civilian life is challenging, and, thankfully, there are a number of tools and resources available to help make the process a little easier. The military-to-civilian transition process entails a transformation in perspective. It also involves a number of decisions about where to live, whether to seek employment or education opportunities and how to do so, how to meet family needs, and many other considerations such as difference in culture and loss of tribe.
During the Transition Assistance Program (TAP), Service members receive information and training to help them make educated choices regarding their transition. It also gives them a safe space to ask questions, receive additional assistance from a TAP counselor, and more.
During the Initial Counseling session, which starts the TAP process, TAP counselors meet one-on-one with transitioning Service members and work with them to map out their individual transition plan and to help them switch their mindset from a “we” to “me” as they begin thinking about their transition. TAP counselors also bring a variety of experience and perspective that can help transitioning Service members shape their thought process from thinking about the civilian world as being one that is “unruly and filled with civilians who are only out for themselves” as one that is instead filled with opportunity, challenges that will help them grow, and one they can be a productive member of society in.
Additionally, there are also many touchpoints in the mandatory TAP curriculum that cover the stressors of loss of tribe, culture differences from the military and civilian life, and how to translate skills obtained in the military into a civilian equivalent. They are talked about in the DoD Managing Your Transition Curriculum, the DoD Managing Your Education curriculum, and the Department of Labor Employment Fundamentals of Career Transition curriculum. These are publicly available on https://tapevents.org/courses.
During the Transition Assistance Program (TAP), Service members receive information and training to help them make educated choices regarding their transition. It also gives them a safe space to ask questions, receive additional assistance from a TAP counselor, and more.
During the Initial Counseling session, which starts the TAP process, TAP counselors meet one-on-one with transitioning Service members and work with them to map out their individual transition plan and to help them switch their mindset from a “we” to “me” as they begin thinking about their transition. TAP counselors also bring a variety of experience and perspective that can help transitioning Service members shape their thought process from thinking about the civilian world as being one that is “unruly and filled with civilians who are only out for themselves” as one that is instead filled with opportunity, challenges that will help them grow, and one they can be a productive member of society in.
Additionally, there are also many touchpoints in the mandatory TAP curriculum that cover the stressors of loss of tribe, culture differences from the military and civilian life, and how to translate skills obtained in the military into a civilian equivalent. They are talked about in the DoD Managing Your Transition Curriculum, the DoD Managing Your Education curriculum, and the Department of Labor Employment Fundamentals of Career Transition curriculum. These are publicly available on https://tapevents.org/courses.
Travis Bartholomew
Regarding your second question, I reached out to my Health Affairs counterparts. They asked me to share the Military Health System's formulary includes only those medications approved as safe for use by the Federal Drug Administration. The medication decisions made by the prescribing providers of the Military Health System are undertaken with careful consideration of the patient's symptoms, needs, and medication regimen. Prescribers also consider the risk-benefit ratio to the patient when developing or changing pharmacological treatments. Once a treatment plan has been developed, the Military Health System's prescribing providers educate their patients about possible negative side effects and instruct their patients to contact the provider as well as to seek emergency care if a life-threatening side effect occurs. The Department of Defense (DoD) recognizes the risk factors associated with Service member suicides are numerous and interact in complex ways. For an accounting of the risk factors that the DoD is currently tracking via its suicide surveillance system, please consult the DoD Suicide Event Report Annual Reports (https://www.pdhealth.mil/research-analytics/department-defense-suicide-event-report-dodser).
LTC Brian W. Wright
Travis, you have a critical job for DoD. Thanks for taking the time to look into my questions.
WO1 Ricardo Eva
Travis Bartholomew - My own experience in transitioning my military career, Spanish/English Judiciary Interpreter was a harrowing one! Extremely happy with my Defense Language School "Diploma" and over 10 years of experience as a Defense Language (Spanish Interpreter -LATAM) I approached the U.S. Federal Court Language Department, then at the U.S. Federal Court Building at 101 Rusk St, Houston, sure that they would immediately hire me, I come to find that not only were my DoD diploma nor my 10 years of experience neither "valid" nor "useful" I had to "retrain" and spend close to 1,500.00 in testing to become federally certified...Not only was I NOT advised of this by my military transition or education advisors (whom actually stated that I would have NO PROBLEMS getting a job a a federal interpreter since the DoD is also FEDERAL) but I got NO SUPPORT from the VA when I approached them...I found that pretty much all of the separating servicemembers have gone, and are still going thru similar horrors
Barbara Van Dahlen, PhD
Hi A1C Ready, thank you for taking time to talk today. Our current environment is certainly unexpected, unprecedented, and disruptive. I can understand that you feel like you are missing something through phone contacts with your provider, but I am so glad you are maintaining contact with your health care team. We all need to prioritize our mental health and emotional well-being – and find what works. Have you been able to try seeing your provider using telehealth? If you prefer seeing your doctor, many patients report that telehealth video conferencing is closer to seeing their provider in person. VA offers extensive telehealth services across the country– you can learn more about how Telehealth works at VA here: https://telehealth.va.gov/how-telehealth-works-va.
While in-person doctor availability may vary depending on your location, provider, and appointment type, I want to assure you that no matter what you are going through– there are people and resources ready to help. As our environment continues to evolve and change, some doctors are beginning to see patients again in person. However, some doctors may still have limited appointment availability as their offices try to provide the safest environment possible. If you feel that in-person services are the most helpful to you, I would urge you to ask your doctor if they know of any providers in your area who are currently offering in-person services. You can contact your local VA to see if they are offering in-person services at https://www.va.gov/find-locations.
More than ever before, we must continue to prioritize our mental health and well-being. This is not an option, it’s a necessity. I hope you are able to find the option that works best for you. Thank you again for joining this conversation. If you are in crisis, please do not hesitate to call the Suicide Prevention Lifeline at [login to see] , press 1 for Veteran or Service member, or chat online at suicidepreventionlifeline.org/chat.
While in-person doctor availability may vary depending on your location, provider, and appointment type, I want to assure you that no matter what you are going through– there are people and resources ready to help. As our environment continues to evolve and change, some doctors are beginning to see patients again in person. However, some doctors may still have limited appointment availability as their offices try to provide the safest environment possible. If you feel that in-person services are the most helpful to you, I would urge you to ask your doctor if they know of any providers in your area who are currently offering in-person services. You can contact your local VA to see if they are offering in-person services at https://www.va.gov/find-locations.
More than ever before, we must continue to prioritize our mental health and well-being. This is not an option, it’s a necessity. I hope you are able to find the option that works best for you. Thank you again for joining this conversation. If you are in crisis, please do not hesitate to call the Suicide Prevention Lifeline at [login to see] , press 1 for Veteran or Service member, or chat online at suicidepreventionlifeline.org/chat.
VA Telehealth Services is changing the way Veterans access VA quality care.
I don’t have a question I have a comment. I have been going thru a very rough time and about six weeks ago I was really at my lowest and thought suicide was my only option. Now unfortunately my phone had been cut off and so the only way I had to reach out was my Alexa. So I tried calling the suicide hotline but you cannot connect with anyone unless you actually have a phone that allows you to press 1. So after calling 6 times and reaching a real person 5 of those times and explaining my problem and still not getting help I gave up. And it is by the grace of a Tarot card reader that I am still here. I know you thought I was going to say God but nope. The point is there has to be a way that you can talk to someone at the suicide line when you can’t dial one. I came real close to just literally hanging myself because I had no one to talk to and that’s not supposed to happen.
SSG Carlos Madden
Hi Kathleen,
Since a phone isn’t an option at the moment, are you able to reach out with Zoom, or another app?
Since a phone isn’t an option at the moment, are you able to reach out with Zoom, or another app?
SSgt Kathleen Clinton
SSG Carlos Madden I have my phone back now so I can talk to them normally but at the time no zoom wasn’t an option either—all I had was Alexa. I had hit rock bottom. I’m still climbing back up and hanging on to my phone for dear life.
Mary Carlson
So sorry that happened and I'm glad not all of you wanted to die, just a part. That is important to know.Check out HelpforTrauma.com ~Mary
When can I see my primary Doctor. I have been waiting since March. Trieied to contact him three times. I am having problems with pain in my back all the way thru to my chest. right belowthe left shoulder blade. Help!
I hold great regard for Suicide Prevention theories and the resultant applications that weave their way into allopathic medicine. As an advocate and practitioner of recreational therapy, past life deep trance hypnosis, there seem to be signs and intuitions I remain alert to ...”I’ve tried everything; you’re my last hope,” causes an inner pause of private concern before proceeding with the hypnosis session.
Strangely, deep trance somnambulistic hypnosis pretends to skirt directly focusing on the concern expressed by the client. Skirting the topic allows room for the client’s subconscious to focus on root issues. Most Clients seem to have little idea why they feel the way they do. They think they know the source of their depression but they do not. There are exceptions of course, trauma being one exception.
”I’ve tried everything; you’re my last hope,” is the desperate conscious self responding. The Subconscious on the other hand, has it’s own remedies. https://1fpkq.edit.ihouseelite.com/quantum-healing-for-any-veteran
I am the last person that can explain why hypnosis helps. I’ve read a number of very sophisticated medical doctors explain mind placisity and realignment. It’s all above me. I just observe that somnambulistic trance work seems to help with you healing yourself in deep trance and me only serving as a guide to get you there.
Strangely, deep trance somnambulistic hypnosis pretends to skirt directly focusing on the concern expressed by the client. Skirting the topic allows room for the client’s subconscious to focus on root issues. Most Clients seem to have little idea why they feel the way they do. They think they know the source of their depression but they do not. There are exceptions of course, trauma being one exception.
”I’ve tried everything; you’re my last hope,” is the desperate conscious self responding. The Subconscious on the other hand, has it’s own remedies. https://1fpkq.edit.ihouseelite.com/quantum-healing-for-any-veteran
I am the last person that can explain why hypnosis helps. I’ve read a number of very sophisticated medical doctors explain mind placisity and realignment. It’s all above me. I just observe that somnambulistic trance work seems to help with you healing yourself in deep trance and me only serving as a guide to get you there.
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