- [Jeff] Welcome to "Healthy Minds."

I'm Dr. Jeff Borenstein.

Everyone is touched by psychiatric conditions, either themselves or a loved one.

Do not suffer in silence.

With help, there is hope.

(gentle music) Today on "Healthy Minds."

(gentle music) - You're not alone despite the fact that you think in this moment you may feel alone and isolated, you're not.

There are people like me who feel very strongly, and the team that's part of this organization, that we exist to help you get that person connected to care.

You'd be surprised.

Oftentimes, that first conversation is from a family member or a friend or a colleague who just has enough intuition going on in themselves to say, "This isn't right.

I'm in a position to do something about it.

I'm gonna say something.

I'm gonna do my best to get my pal, my buddy, my colleague, my wing mate, connected to care."

- [Jeff] That's today on "Healthy Minds."

This program is brought to you in part by the American Psychiatric Association Foundation, and the John & Polly Sparks Foundation.

(gentle music) Welcome to "Healthy Minds."

I'm Dr. Jeff Borenstein.

Today I speak with Jim McDonough, the director of the Headstrong Project.

He shares information about what this project is doing to help our service members, veterans, and their families.

(gentle music) Jim, thank you for joining us today.

And in addition to that, I wanna thank you for your service to our country and all the work you're doing on behalf of those who serve and their families, thank you.

- Well, thank you Dr. Borenstein.

It's a pleasure to be with you today.

- Let me jump right in and ask you, tell me about Headstrong.

Tell me what is Headstrong doing?

- Yeah, well, first and foremost, it's an organization that I love, but beyond that, let me tell you a little bit something about the organization.

Headstrong is an 11-year-old nonprofit organization that was put together to treat the invisible wounds of war.

It was founded by a returning Marine, really at the height of these past wars who came back from Iraq and understood that many more of his Marines were, in fact, dying by their own hand than he had lost in combat.

That origin story today is really an organization that is a national facing mental health treatment practice of choice for our military connected members and their families.

- And how does it work?

How does somebody get help from Headstrong?

- Well, it's really a beautiful story.

I mean, in this day and age, we're digitally based, and it's very simple to kind of connect to care through the organization's website.

There actually is a Connect To Care button.

And one of the things that we pride ourselves on is keeping the barriers to access to high quality care, very low.

I think that's important in terms of a differentiating stance for the organization.

We simply ask for very basic information, name and email address, how to reach out to you to get more of a personalized and highly individualized intake session scheduled with our intake and our clinical team.

So it's really a simple pathway into care, and I wish all systems of care were designed similarly.

- So basically you're able to make use of technology to really streamline the process to help people similar to how we're not in the same room, but we almost are in the same room as we have our conversation right now.

- Very much so.

By early design, the organization was postured to be responsive to individuals and their needs, and to kind of take advantage of technology that really was at the origin story of the organization, using a digital platform, our website, to connect people to care.

We've maintained that these past 11 years out of the opportunity understanding that keeping barriers low is what gets people connected to care quickest, and the most expeditiously, and the easiest way possible.

And I think that's important for everyone to understand.

We do recognize that barriers to care can be significant, and anything that we can do to lower those barriers is not only in the interest of the organization, but in the interest of those we're trying to serve as well.

- I'd like you to tell us a little bit about the types of problems and challenges that people are coming to you with, and what you're able to do to help them.

- Yeah, well, Headstrong, I guess the niche that we occupy and that which we specialize in is in the treatment of trauma.

And as you know, Dr. Borenstein, trauma comes in many shapes and forms, and at different intervals of life.

For us, that trauma could be as far back as individuals who experience an adverse childhood experience, enter into the armed forces, serve in our nation's, you know, military.

And sometimes, perhaps through that service, you know, that condition is exacerbated or it's compounded or altogether, it can be a set of traumas experienced while serving in the military, or in fact after serving in the military.

So we like to think of ourselves as that arc of trauma treatment that joins an individual wherever they are in their journey into care.

But importantly for us, it is trauma that is connected to military service before, during, after.

It makes no difference to us.

But what we really pride ourselves in is in the ability to treat trauma in many forms.

The organization treats post-traumatic stress, it treats depression, treats anxiety, it treats adverse childhood experiences.

It also treats military sexual trauma.

There really is a plethora of traumas, as you know, that one can experience.

And Headstrong was built with that seminal understanding that we're gonna specialize in the treatment of trauma in many forms.

I would also point out that, oftentimes, comorbid conditions kind of exist, a lot of co-occurrence with other forms of issues presenting our population.

And over the years, Headstrong has become very good at kind of simultaneously treating things like substance use adjacent to trauma.

These things are not distinct, and as simple as we'd all like to think they are, they often overlap.

And Headstrong has been that organization that can deal with complex forms of trauma.

- Yeah, you make an important point that we need to help the whole person, not just one aspect of them, but if there's chemical dependency along with post-traumatic stress, we need to treat both together, not just separately.

- Well, and I think that's what makes us different, is that the organization has developed the capacity to do exactly that over the years.

And, you know, I, for one, a veteran of the armed forces myself, I've seen far too many organizations that own a piece of the solution but are not interested in building or partnering with other entities that can wrap around those things, which treat the individual as an individual rather than a set of complex conditions that need to be treated in somewhat analog fashion.

This before that, this after that, but never combined.

We recognize that's not life.

Life is often messy.

And we try to do our best either through our own resources or through relationships with others.

Just treat people like people.

- One of the real problems and challenges is the issue of suicide and suicide prevention for our service members.

I'd like you to speak about that.

- Yeah, this is still a huge problem for our community, whether you're actively serving, you're a member of the National Guard, the Reserves, you're part of the veteran community as I am today, or that you're the connected family member.

This is the issue of the day for us, this is the epidemic within a pandemic that we deal with every day.

The numbers are out there.

You know, this is really something that we struggle with as a society writ large.

And our military connected communities are no different.

Their traumas and their experiences are formed by different life experience or lived experience.

But for us, it's all about taking the steps necessary to get people connected to care so that we, in fact, prevent the individual from thinking about ending their life.

That's what we exist to do.

So I do think we work fairly upstream of the problem set.

We try to make sure people are connected to care.

We try to do a good job of delivering care that matches up with their needs.

And by extension, we think we're doing a fairly decent job of keeping people alive and keeping them connected to care.

And the one-on-one, highly individualized, no barrier, no boundaries to care approach, I think makes a difference every day.

- Making the care easily accessible is extremely important for all people and, in particular, our service members.

Often people don't seek care.

They may suffer in silence.

What do you say to them and how do you engage them to actually get the help that they need and so very much deserve?

- Yeah, well, Dr. Borenstein, I'm glad you're asking that 'cause the stigma associated with asking for help is the number one barrier to care itself.

And, as you know, and as I think as your viewers will know, you know, the military connected community is a population of resilient men and women.

By their very nature, we have to be.

It's tough duty, at times.

It demands a lot of us and our families, and resilience and strength and all the things that allow us to lead from the front while taking care of others is what we're known for.

Unfortunately, that gets in the way of asking for help.

And I've found, over time, that the best means by which to ask for help is through others who have asked for help themselves.

And I'd like to think that there are many people who have served in our nation's armed forces who every day serve as exemplars for other individuals to look at life through the lens of, "Geez, if Dr. Borenstein can ask for help, so can I."

You know, and I think what we find in our practice is we find that the number one referral source for individuals getting connected to care is, in fact, another individual that we connected to care, who tells a friend, tells a family member about their experience with the Headstrong Project.

And I think this thing, stigma, unfortunately, it's alive and well.

And it permeates the military connected community so deeply, overcoming it to the point of being vulnerable enough to ask for help is really difficult stuff.

I mean, I've had to do it myself.

I know how tough it is.

My friends, the colleagues I've served with.

I know intrinsically the degree of difficulty with asking for help amongst the people that I served with.

It's tough stuff.

But importantly, it's the first step on the road to the rest of your life.

- One of the challenges for our service members who are returning back to civilian life is, after being used to being with their co service members who they care so deeply about and vice versa, they're sort of thrown back here, and it's hard to make that transition.

I'd like to speak a little bit towards that.

- Yeah, what you're raising right now is the issue of our identity, you know, and whether you served four years or whether you're like me and did 26 years, it's easy to fall into this pattern of I'm defined by my military service.

And I think that that's in fact one of the transition challenges is to reimagine your next identity.

And while fundamentally helpful in establishing what was an identity, I've found in my experience has been is that unless you open up to be creative around creating your next identity, it's really tough to kinda step away from that identity that was forged through hard fought military service, and the reputation you gain from it.

I think the most important thing is to kind of take stock of that, recognize the contribution that it made to your life, but opening yourself up to the next chapter of your life, following your transition from military service.

You know, people tend to think that transition is this collective responsibility, this collective task of the armed forces.

I think that's a mistake.

It's highly individualized.

It's really you as a person.

The research indicates that we do one of three things.

When we decide to step away from the armed forces, we'll likely stay where we served, or we married into a family that is in that geography, or we'll go home and kind of be surrounded by family and friends, or we'll find work completely away from all that and pursue employment somewhere else.

Any of those scenarios is challenging unless you ground yourself in the understanding like, okay, that was then, this is now.

It's time to, once again, reimagine who I wanna be.

Take one step forward, put one foot in front of the other and create the next chapter of your life.

And for anyone considering the transition challenge, that would be my advice.

You know, and I think the second thing I'd offer is that there are people who came before us in this transition journey, and I've often found speaking with them about their transition experience has been very helpful in forming my own transition experience.

It's a reference point, it's a north star, it's one of those things like, if Chris can do it, so can I, if Donna can do do it, so can I.

And I think I would encourage people to seek out individuals who come before them in the transition journey.

But it is a challenge, that point of transition.

When you drive off the installation you served in, you put your flag in the car and you head out to parts unknown, there's a lot of uncertainty with that.

And we were in a fairly certain environment in terms of its rhythm, its pace, its cadence despite the fact of the uncertain nature of what military service is all about, there was a comfort, there was an identity to it all.

And when you take that away and have to recreate it, it can be a challenge, Dr. Borenstein, for many.

- All very good points.

And I think the perspective of speaking to people who have been there and done that, - Yeah.

- Somebody that you can respect and say, "Okay, if that person did it, well, so can I."

That's, I think, an important aspect to the transition.

And then, the other piece is if the person really is having difficulty to seek help, not to suffer in silence.

- Yeah, that's exactly right.

I mean, you know, time in the military is spent looking for mentors and being a mentor yourself.

And I think, so when you draw upon the strength of that equation, being mentored by others and mentoring others yourself, you begin to understand that you're not alone.

That there have been many more people who came before you.

And usually through that example, breaking down the barriers to becoming vulnerable to confiding in someone how you're feeling, the challenges, those are all the things that friends and colleagues exist for.

And, you know, it's tough asking for help.

I've been through it myself.

Somehow, we take it upon ourselves as it's a mark of weakness.

And many, myself included would say, when you reach that point, it's actually a point of strength that you're willing to step forward into that unknown, that abyss of asking for help by skilled professionals who exist to help you.

And certainly here in Headstrong, we understand that challenge.

And I'd like to think that the hundreds of clinicians who have a great deal of experience, who work for the Headstrong Project, are really skilled at getting people to feel comfortable with understanding that this is okay, I'm here to help, I'm gonna help you get through this, and we're gonna get you back on your feet and get you headed toward the life that you deserve.

- I wanna shift gears a little bit and speak about the families, because we often overlook the sacrifice that families make when their loved one is serving.

Tell us about the support for families.

- Yeah.

Well, in my own life, it's a story of taking things for granted.

And I think it's the invisible side of our military service that we should never take for granted because, you know, and I'm guilty of it, I would be the first to admit that there were moments in the pursuit of my career where, right or wrong, family came second to some of the career choices and decisions that were being made.

I will say that when you're all in to serve in our nation's armed forces, that's kind of what's expected of you, and you do your best to keep everything in tow and on track.

But there's certainly in my DNA an understanding that, at times, I did take all this for granted, but I caught myself.

And as I reflect on it, and I look through this as if it's a lens into another side of our military service of equality, and I think we need to think of it that way.

You know, there's an old saying in the army, you recruit a soldier, you retain a family.

It's also true out here in the real world when you're connecting people to care, that, oftentimes, the baggage and the issues confronting a service member, a veteran, you know, those by extension also impact the family.

And so, that's why we go to great lengths to talk about our willingness to connect care to those connected family members.

Because it really is, at times, more than just treating the individual military connected member.

It's also about recognizing a responsibility to treat their family as well whether that's a child struggling with the absence of a parent over prolonged deployments, whether it's a spouse, a significant other, a partner, it really doesn't matter because it's a unit, it's a unit.

And when we think about what's necessary to create goodness amongst those who serve their country and their families, we need to think of it as a unit, a family unit.

And no parts of it are immune from the challenges of military service.

And it's as if, at times, we need to commit even more resources to the family members because, by their very nature, they're trying to keep us serving, they're trying to keep us in the game.

They're doing everything they can do to take care of themselves, but they're also doing the things to keep us in the game.

- What types of symptoms do you see among family members?

What are the issues that they come to you with surrounding their loved ones?

- Yeah, I mean, they talk in simple terms about avoiding responsibility for actions, about shutting down, of engaging in behaviors that exclude the family from what it once was included within.

So they speak in simple terms of being shut out of not being of help, of reading the tea leaves of their partner's life and not being able to do what they really know they'd like to do about it.

So I think there's a frustration.

They see what's manifested in the individual service member, and they love them so dearly, all they wanna do is help, but the individual service member themselves or the veteran is a barrier.

And so, they come to us with this understanding, like, my partner, my spouse is struggling, I don't know what to do.

And, oftentimes, the nexus of connecting to care is in that initial conversation between an individual family member, and a clinician who is trying to connect their loved one to the clinician themselves.

And so, we'll take steps to kind of take what we're getting from the family member, and then connect ourselves to the individual, military connected, the individual, the veteran, the person serving and begin that process of turning on care.

But you'd be surprised.

Oftentimes, that first conversation is from a family member or a friend or a colleague who just has enough intuition going on in themselves to say, "This isn't right.

I'm in a position to do something about it.

I'm gonna say something, I'm gonna do my best to get my pal, my buddy, my colleague, my wing mate connected to care."

- I wanna ask you, Jim, if somebody's watching now, a person who served or is serving, their family member who's worried about them, what do you say?

What do you tell them right here and now?

- Well, thank you Dr. Borenstein for that question.

For anyone out there struggling to connect a loved one to care, I wanna make sure you understand the essence of this organization.

This organization was founded by returning veterans for people like us.

Just out of the understanding that in this moment when you're struggling to understand how to connect, who you love to care, that's exactly what Headstrong was put together to do.

We are here 24 hours a day, seven days a week, two clicks through our website, the headstrongproject.org, and then Connect To Care, and you'll be seamlessly guided into an intake session that usually occurs within 24 hours.

And I will point out that usually we connect to a therapist for the individual that you're worried about.

They'll be seated either by Zoom or physically with one of our therapists in a really short amount of time.

Today and in the future, our standard is under 30 days, which is unprecedented to get connected to care.

But our organization really understands that in this time of need, we are here for you.

I'm here for you.

The team of professionals in Headstrong really believes very strongly about connecting people to care in the easiest amount of effort possible.

You're not alone.

Number one, there are people out there like us who ensure that in this journey of singular solidarity that you're confronting, that you have allies to come to your aid and help you get the person connected to care.

Our ability to treat trauma in this community is at the forefront of non-traditional and really innovative approaches to opening up access to high quality care.

We believe in it.

So the first thing I would say is, despite the fact that you think in this moment you may feel alone and isolated, you're not, there are people like me who feel very strongly, and the team that's part of this organization, that we exist to help you get that person connected to care.

Don't go about this alone.

Singularly, you are not as strong as we can be collectively.

And you have friends and allies in our military connected communities who believe in the same things you do and wanna do everything they can to help people really get on with their lives.

And I will point out too that, at times, you know, when we safely exit people from care, life changes, I know this firsthand.

Things change in people's lives.

And what I like to talk about is how people are always welcome back into care.

It is not a one and done for the Headstrong project.

You're always welcome back into care as your life changes, as the lives of your loved ones change, we are here, we're not going anywhere.

We're here to stay, and we're here to help you get connected to care.

- Jim, I wanna thank you so much for sharing what you're doing and for the work that you're doing.

More importantly, thank you for being with us today.

- Well, Dr. Borenstein, it's my pleasure.

And I consider you both a friend and a professional colleague, and I believe very strongly in what you're trying to do to introduce organizations like ours to your audience.

So my thanks to you and your team for doing the great work that you're doing as well.

(gentle music) - [Jeff] Do not suffer in silence.

With help, there is hope.

(gentle music) This program is brought to you in part by the American Psychiatric Association Foundation, and the John & Polly Sparks Foundation.

(gentle music)