Short Takes on Suicide Prevention

Searching for the meaning of life is only natural. A meaningful life leads to a sense of purpose, self-esteem and psychological well-being. How do life experiences that are unique to Veterans alter these feelings? In this episode, Dr. Edgar Villarreal speaks with VA researcher Dr. Adam Kinney and Army Veteran, Jeff Moe to find out. They discuss how Kinney’s research, on meaning in life among Student Veterans with combat exposure, relates to Moe’s life experiences. His journey from military to student life led to supporting others as a Student Veteran Outreach Coordinator with the VA VITAL program. Transcript Episode 135 Short Takes VITAL: VA Veterans Integration to Academic Leadership Article Discussed: Protective factors that mitigate the indirect risk of combat exposure upon meaning in life: A longitudinal study of student veterans Host: Edgar Villarreal, PhD, is a Psychologist and the Director of Education and Training at the VA Rocky Mountain MIRECC for Suicide Prevention. Guest: Jeff Moe, LCSW, is an OEF/OIF Veteran, Social Worker, and Advocate. He currently works as the supervisor of a Department of Veterans Affairs (VA) Suicide Prevention Telehealth Program that specializes in providing mental health services to at-risk Veterans across most of Texas and parts of New Mexico. Previously, Jeff built on his experience as a Student Veteran and worked for eight years as a VA Student Veteran Outreach Coordinator at colleges and universities in the Austin, Texas area. While in this position, he worked collaboratively with Student Veterans, faculty, and staff to develop peer mentorship and other preventive programming while also providing counseling, health care enrollment, and other support services tailored specifically to Student Veterans. Guest: Adam Kinney, PhD, OTR/L, is an occupational therapist who completed his PhD in the Department of Occupational Therapy at Colorado State University in 2019. While pursuing his PhD he collaborated with New Start for Student Veterans, a supported education program for student Veterans, to investigate factors influencing a range of clinical outcomes, including resilience, community reintegration, and academic performance. His current research focuses on improving care quality and associated outcomes for Veterans with mild traumatic brain injury (mTBI) and sleep conditions.

It is well known that exercise can improve both physical and mental health. But what about preventing and treating PTSD in Veterans? In this episode, Dr. Edgar Villarreal speaks with researcher Dr. Daniel Reis and Army Veteran Adam Holt. Through the lens of both research and lived experience they explore exercise as an alternative treatment option for Veterans living with PTSD. Reis shares the findings of his article that reviewed research on the effect of exercise on PTSD symptoms in Veterans. And Holt shares his own journey from struggling with trauma, substance use and suicide attempts to literally running from relapse. Holt recently opened a free gym to create an active, sober community and support Veterans in recovery.   Transcript Episode 134 Short Takes Article Discussed: Exercise to Reduce Posttraumatic Stress Disorder Symptoms in Veterans Host: Edgar Villarreal, PhD, is a Psychologist and the Director of Education and Training at the VA Rocky Mountain MIRECC for Suicide Prevention. Guest: Adam Holt is a U.S. Army Veteran and the Executive Director of Outsiders Anonymous - a 100% free gym for individuals in recovery, Veterans with PTSD, and the community that supports them.  Guest: Daniel Reis, PhD, is an Advanced Fellow in Mental Illness Research and Treatment at the VA Rocky Mountain MIRECC for Suicide Prevention. His research interests include the relationship between lifestyle variables and mental health outcomes as well as the impact of seasonal sunlight on depression treatment outcomes. The appearance of external hyperlinks does not constitute endorsement by the Department of Veterans Affairs of the linked web sites, or the information, products or services contained therein.

Veterans experiencing homelessness face unique challenges that increase their risk for suicide. In this episode, Dr. Edgar Villarreal talks to our guest Dr. Ryan Holliday about the need for research focused on this population. They discuss an article that explores research priorities identified by experts and Veterans with lived experience in suicide prevention and homelessness who came together in a recent VA meeting. Today's conversation covers reaching Veterans with the services they have access to, upstream interventions and the need for tailored approaches for subgroups such as women and men or rural and urban. Targeted research will help broaden suicide prevention efforts beyond mental health interventions to support those experiencing or at risk for homelessness. Transcript Episode 133 Short Takes Article Discussed: Establishing a Research Agenda for Suicide Prevention Among Veterans Experiencing Homelessness Host: Edgar Villarreal, PhD, is a Psychologist and the Director of Education and Training at the VA Rocky Mountain Mental Illness Research Education and Clinical Center for Veteran Suicide Prevention. Guest: Ryan Holliday, PhD, is a Clinical Research Psychologist at the Rocky Mountain Mental Illness Research Education and Clinical Center for Veteran Suicide Prevention and Assistant Professor at the University of Colorado Anschutz Medical Campus.

Acquired neurologic conditions can lead to functional challenges and changes that might increase risk for suicide. In this episode, Dr. Jordan Wyrwa and Dr. Lisa Brenner discuss three recent research papers on suicide rates among Veterans with Traumatic Brain Injury (TBI), Amyotrophic Lateral Sclerosis (ALS) and Stroke. They talk about the similarities and differences of how these conditions impact mental health and offer guidance to providers on suicide risk screening and lethal means safety. Learn more from the resources below. Transcript: Short Takes Episode 132 Transcript Articles Discussed: Suicide and Traumatic Brain Injury Among Individuals Seeking Veterans Health Administration Services Between Fiscal Years 2006 and 2015 Suicide Among Veterans with Amyotrophic Lateral Sclerosis  Suicide After Stroke in the US Veteran Health Administrative Population Lethal Means Safety for Providers: Information on lethal means safety  Free training on lethal means safety   Guest Bios:   Lisa A. Brenner, Ph.D., is a Board-Certified Rehabilitation Psychologist, a Professor of Physical Medicine and Rehabilitation (PM&R), Psychiatry, and Neurology at the University of Colorado, Anschutz Medical Campus, and the Director of the Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center. She is also Vice Chair of Research for the Department of PM&R. Jordan Wyrwa, DO, is a Board-Eligible Fellow Physician in Pediatric Rehabilitation Medicine at Children’s Hospital Colorado. He is a recent graduate of the University of Colorado, PM&R Residency Program.

Several states in the US have legalized medical cannabis as a treatment for Post-Traumatic Stress Disorder (PTSD), a condition that many Veterans experience. While many people with PTSD use cannabis products, questions remain about the effectiveness. In today’s conversation, forensic neuropsychiatrist Dr. Hal Wortzel talks with our guest host, Dr. Suzanne McGarity, about his recent observational study on cannabis use among people with PTSD. They discuss the nature of observational studies, the current state of the research and the results of this recent study. Transcript: Short Takes Episode 131 Transcript Article: The long-term, prospective, therapeutic impact of cannabis on post-traumatic stress disorder. About Hal Wortzel: Hal Wortzel, MD, is a forensic neuropsychiatrist at the Denver VA’s Rocky Mountain MIRECC, where he serves as Director VA Advanced Fellowship Program in Mental Illness in Psychiatry, Director of Neuropsychiatric Consultation Services, and Co-Director of the VA Suicide Risk Management Consultation Program. He is also an associate professor of Psychiatry, Neurology, and Physical Medicine & Rehabilitation at the University of Colorado. He serves as the Michael K. Cooper Professor of Neurocognitive Disease, Director of the Neuropsychiatry Service, and as faculty for the Division of Forensic Psychiatry. Current areas of clinical and academic focus include aggression and suicide in the context of PTSD and TBI, incarcerated veterans, and the application of emerging neuroscientific tools to the legal arena.

Short Takes Episode 130 Transcript The VA is known as a leader in suicide prevention, offering innovative approaches to preventing Veteran suicide. And yet, many Veterans are not enrolled in VA care. It is therefore imperative that community organizations that serve Veterans have the resources and knowledge to help with veteran suicide prevention. The Patient Safety Center of Inquiry - Suicide Prevention Collaborative is an innovative partnership with community agencies that serve Veterans, such as homeless programs, veteran service organizations, private mental health clinics, and legal services. In this episode, Dr. Bryann DeBeer, Clinical Research Psychologist at the Rocky Mountain MIRECC for Veteran Suicide Prevention, tells Adam Hoffberg about the Suicide Prevention Collaborative, which recently won the 2021 National VHA Community Partnership Challenge, and why building community partnership is essential for Veteran suicide prevention. About Bryann DeBeer: Dr. Bryann DeBeer is the Director of the VA Patient Safety Center of Inquiry – Suicide Prevention Collaborative, a Clinical Research Psychologist at the VA Rocky Mountain MIRECC for Suicide Prevention, and a Visiting Associate Professor at University of Colorado Anschutz Medical Campus. Dr. DeBeer received her B.A. in psychology and fine arts from New York University in 2003. She completed her doctoral training in clinical psychology at the University of Maryland, College Park in 2012, and obtained her clinical license in 2014. She joined the Rocky Mountain MIRECC in 2020. Dr. DeBeer has extensive experience in longitudinal assessment, treatment development, and clinical trials, particularly related to PTSD, suicide risk, and complex comorbidities in Veterans. Dr. DeBeer serves as a panel member of the VA Clinical Science Research and Development Data Monitoring Committee. Resources: Article about the Suicide Prevention Collaborative Press Article about the 2021 National VHA Community Partnership Challenge Award

Suicide prevention is a worthy goal itself, but it’s about more than stopping just one suicidal event – it’s also important to address the emotional pain underlying suicide and build a meaningful life that’s truly worth living. Acceptance and Commitment Therapy, known as ACT, is a therapy approach that helps people experience their emotions in a new way, take perspective on their thoughts and build a more meaningful life.  Is ACT a useful approach for addressing suicide? In this episode, Dr. Sean Barnes, clinical research psychologist at the VA Rocky Mountain MIRECC for Suicide Prevention, talks with guest host Dr. Debbie Sorensen about his research on ACT for Life, a new treatment designed to help Veterans respond effectively to suicidal thoughts and actions using Acceptance and Commitment Therapy.  In this episode, Barnes and Sorensen discuss:  What ACT is, and why its approach to suicide is unique Sean’s intervention, ACT for Life, and how he and his colleagues are targeting suicidal behavior from a contextual behavioral approach Current research on ACT  Responding to suicide-related thoughts using ACT The importance of values in building a life worth living Article:  Acceptance and Commitment Therapy to Promote Recovery from suicidal crises: A Randomized Controlled Acceptability and Feasibility Trial of ACT for life Resources:  National Suicide Prevention Lifeline/ Veterans Crisis Line: 1-800-273-8255 Veterans and Military Press 1 Suicide Risk Management Lecture Series About Sean Barnes: Sean M. Barnes, Ph.D. is a clinical research psychologist at the VA Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for Veteran Suicide Prevention and an assistant professor in the Department of Psychiatry at the University of Colorado Denver School of Medicine. Sean is a consultant for the Department of Veterans Affairs Suicide Risk Management Consultation Program and an Acceptance and Commitment Therapy (ACT) for Depression provider and training consultant. He is also the principal investigator of the ACT for Life study, testing a brief ACT protocol for maximizing recovery after suicidal crises. Other aspects of Sean’s research focus on the use of contextual behavioral interventions for moral injury, and the study of suicide risk assessment, but all his projects share a common goal of alleviating suffering and helping others build vital meaningful lives.  

The transition from military to civilian life can be an important time for service members. For many, it is an exciting life transition. For some, however, it can be a time of high stress, and even crisis. Whether it’s changes in social support, financial stress, a change in identity, or a cultural adjustment, some service members struggle during this period and are at heightened risk for suicide.  What are the factors that increase suicide risk during that transition? Which service members are at the highest risk? Do length of service and military branch matter? What outreach and prevention efforts are being made? And what can everyone – friends, families, and clinicians – do to support our service members and veterans during the transition period?  In this episode, Dr. Bridget Matarazzo, Clinical Research Psychologist and Director of Clinical Services at the Rocky Mountain MIRECC for Suicide Prevention, talks to Dr. Mark Reger and Brady Stephens about their research on this important topic!  About Mark Reger and Brady Stephens:  Mark Reger, Ph.D. is the Chief of Psychology at the VA Puget Sound and a professor at University of Washington School of Medicine in Psychiatry and Behavioral Sciences. His research focuses on veteran and military prevention, risk and protective factors unique to the military community. Brady Stephens, MS SAS.C.P. is a statistician and the Director of Data Analytics and Informatics for VA VISN 2 Center of Excellence for Suicide Prevention. Resources:  Article: “Association of Suicide Risk with Transition to Civilian Life Among US Military Service Members” https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770538 Make the Connection website (stories of other service members): https://www.maketheconnection.net/ In Transition Program (DoD) https://www.pdhealth.mil/resources/intransition

The relationship between PTSD and suicide is important to understand if we want to prevent suicide among veterans and military service members. So what is the relationship between PTSD and suicide? Well, according to suicide and PTSD researcher Dr. Ryan Holliday…. It’s complicated! In this conversation, Dr. Holliday talks to fellow MIRECC Psychologist, Dr. Nazanin Bahraini, about his review of the recent research on suicide risk and PTSD. They discuss who is most vulnerable for suicide, and what drives suicide risk. Dr. Holliday talks about how clinicians can navigate these complex factors to help their clients in therapy, and offers some words of wisdom and support for veterans and service members who are struggling.

Social connection is a key aspect of suicide prevention in older adulthood. Dr. Kimberly Van Orden, who researches isolation and connection in older adulthood, talks to Dr. Lisa Brenner about her background in suicide prevention and older adulthood, benefits and vulnerabilities associated with aging, and why social connectedness is especially important in later life. She tells listeners about social connection planning and describes the Cognitive Behavioral Therapy model for helping older adults cope with isolation.

In our last show for season 4 we close with a look at post-traumatic growth and suicide with Dr. Daniel DeBrule. Daniel was mentored by Drs. Lawrence G. Calhoun and Richard G. Tedeschi and brings that wisdom and ideas to this podcast. 

We recorded this podcast in early April just as we were still trying to understand what life would mean during the pandemic. I didn't start working on the podcast until the end of July and was worried if it would still hold up. I think it does for the most part though we are all a little wiser. One part that I really like was when Ted talks about how he got interested in working with Veterans. It was through his practicum at the Jesse Brown VA Medical Center in Chicago. I bring this up to encourage students to explore placements in the VA as a way to gain valuable experience in the field.

I read a column in the gardening section of the Denver Post in spring of 2019 and stumbled on the writer Chryss Cada. In the last two paragraphs she announced that this was her last column that she'd be dedicating the next portion of her journey on telling the story of losing her brother, Mark, to suicide when he was 15 and she was 12. We touched base but it was too early in her journey. Chryss got back in touch when she had finished her writing and we accomplished this podcast. Take some time to listen please.

Some time ago Adam attended an immersive theater presentation at Rose Medical Center across the street from our old VA medical center. The performances, First Do No Harm and The Clinic, were performed in the hospital and bring the audience into the experience in a wholly different way. Tara recently recorded COVID Stories. With Adam she discusses art as a way to heal.

This week we talk with gero-psychologist Evan Plys, PhD about suicide prevention in long-term care settings; from independent-living to assisted-living to nursing home. Evan has volunteered and worked in long-term care since he was young and has a special affinity for our elders. He offers advice on how to discuss suicide within these settings and with this population. He also discusses the idea of creating an environment which promotes wellness and a life worth living.

For this episode we turn the mic over to Ryan Holliday a clinical and research psychologist at RMIRECC. Ryan asked for the mic so he could interview two Sean's. The first is Shawn Liu with the VA Programs for the Homeless and the second Sean Clark, VA Veterans Justice Outreach. The three team up to get in depth on the intersection Homelessness, Justice Involvement and Suicide Prevention. They also make the case why every clinician working with Veterans should get to know their local VA staff working in homelessness and justice involvement.

Adam Hoffberg got a chance to talk with Dr. Pearl McGee-Vincent, of the National Center for PTSD Dissemination and Training Division about the updated release of the app PTSD Coach. The wildly respected and used app now includes a digital safety plan for suicide prevention. Pearl takes us on a guided tour of the app and how it can make a difference in the lives of Veterans.

My partner came across an article from The Colorado Trust on Trauma Informed Design. The article was titled, "Using Trauma-Informed Design, Buildings Become Tools for Recovery". The article lead me to Jennifer Wilson, a social worker and research associate with the Center for Housing and Homelessness Research at the University of Denver. Jennifer agreed to the podcast and invited Laura Rossbert, Chief Operating Officer at Shopworks Architecture to join. We have talked about trauma informed care and I just had to find out about trauma informed design. Laura and Jennifer will help you gain an appreciation of the 3 C's and just what it means to truly listen to those we serve.

This week Adam is in conversation with Shane Kraus to talk about addiction and suicide prevention. Dr. Kraus discusses the behavioral addictions: gambling and sex. The great thing to hear is that both are responsive to treatment and there are many treatment resources within the VA. It starts by talking and by listening.

As the producer for the Short Takes podcast I usually just sit back while Adam interviews our guest. This week both Adam and I sat out while we turned the mic over to Tara Galovski, the co-director WoVeN - the Women Veterans Network. Tara interviewed 3 WoVeN leaders and they had such a great time telling their story. You just know this group works and loves one another and what they are doing.