Amy Brown, a licensed clinical social worker and military veteran, talks with Dr. Jones about addressing the mental health of veterans, the suicide risk among veterans, treatment modalities and working with personal barriers to therapy.
Amy Brown is a licensed clinical social worker providing counseling to combat veterans and survivors of military sexual trauma at the vet center in Lexington Kentucky. She is also a doctoral student at the University of Kentucky, emphasizing in Military and Veteran Mental Health. Amy hopes to integrate her experience working in Hospital systems and small clinics into research and program development for veterans programs and services.
If you, or someone you know, are at risk for suicide, there are people who can help. We suggest one of the following:
- National Suicide Prevention Lifeline (24/7) 1-800-273-8255
- Crisis Text Line – Text 741741 (24/7) a live, trained volunteer can talk you through your crisis
- Call 911 for immediate help
Transcripts are created using a combination of speech recognition software and human transcription and may contain errors. Please check the full audio podcast in context before quoting in print.
Dr. Jones: [00:00:02] Hello and welcome to the social work conversations podcast produced by the University of Kentucky College of Social Work. My name is Blake Jones. Here we explore the intersection of social work research, practice and education. Our goal is to showcase the amazing people associated with our college and to give our listeners practical tools that they can use to change the world.
Dr. Jones: [00:00:25] I’m joined today by Amy Brown. Amy is a doctoral student here in our college I’m so glad that you decided to join us today – thank you.
Amy Brown: [00:00:32] Thank you. My pleasure.
Dr. Jones: [00:00:33] So I wanted to talk with you a little bit about your research interests. I know you’re a doctoral student you’ve been in the program a couple of years but you have a really interesting I think thing that you’re studying and that is the military and trauma you know as we’re recording this we just came through. We celebrated Memorial Day yesterday and I’m very aware of of the trauma that’s associated with the veterans who have served and I wonder if you could talk a little bit about what brought you to that particular topic why is that important to you.
Amy Brown: [00:01:07] I am interested in military veterans because I myself am a veteran of the United States Army. And I deployed in 2003 and I saw myself in a lot of other people you know we went through together a series of readjustments as we entered new climates and different types of risk environments and experienced separation from our families and experienced a new kind of growing up that most of us had had not yet had not yet come to. And so I always had kind of in my soul I guess an interest in giving back to my fellow veterans. And I took the long way around in terms of coming to social work. But when I decided to pursue social work I was certain that I wanted to do something with military and veterans.
Dr. Jones: [00:02:03] Yes, you had kind of a business career before or so. Tell us a little bit about that.
Amy Brown: [00:02:10] After my bachelor’s degree which was actually in sociology so related I worked at RMZ research in Tampa, Florida. So a little ways from here. And we did program evaluation for educational programs at all different levels all the way from pre-kindergarten through different college programs depending on what the different projects involved. And so I was working there in some basic program evaluation. And you know kind of technical writing things like that. And so that’s what I did before I got my master’s in social work. And then on learning that my contract there that I was hired for was going to and I started looking for other types of career opportunities that might be interesting. And I fell upon social work and just thought you know of pursuing the military and veteran social work was really going to be my thing.
Dr. Jones: [00:03:07] Yeah. You know it strikes me as I think about the the military and war and veterans that the military now is very different in terms of the number of deployments that we’re seeing the type of fighting that’s being done. The trauma that’s being done with things like you know drone technology and things like that. Can you talk a little bit about how the the contemporary soldier is different than in wars past in terms of their coming home and the trauma they experience.
Amy Brown: [00:03:46] Sure. I think we we tend to isolate two different eras in the common conversation about veterans and that is Vietnam and now and I think it’s important to remember that we have had conflicts all in between there and all kinds of stuff as well. More and more of the progression I think I’ve seen is we’re having more frequent deployments. So people are deploying three and four times in a very short career. You know a six year career in the military or something like that and this increases their exposure to trauma, losses, injuries and you know engagement with enemy – this increases that, you know the likelihood of that the frequency of that in particular for combat troops were having an increased number of women that are serving in the military and an increased number of women that are forward deployed in the military and that have the potential to be engaged in some of those things as well. We also have an increased awareness of military veterans suicide and military sexual trauma which is something that I think we just did not address with previous eras in terms of mental health you know in terms of social work and mental health and within the structure of the military also they’re trying to address things that within military culture were just not dealt with just kind of suck it up and drive on. It’s turning into more of a you know here’s how you can get help here are these resources things like that. So I think there’s there’s a lot more going on with a lot younger people. But that doesn’t necessarily mean that previous eras didn’t experience those things. It’s just that I don’t think we were aware of what that did to people and we were aware of you know what we needed to do for something like that. Also people are coming back with Polly traumatic injuries you know mental health or physical health kind of co-morbidities and they’re serving things that used to not be survivable because of medical technology.
Dr. Jones: [00:05:48] And the are very young. We have very you know 20, 21 year old people surviving with traumatic injuries. You know so their lifetime is ahead of them and they have to adapt to that somehow.
Amy Brown: [00:06:02] Correct. And some of them will need a lifetime caregiver and things like that. And it’s that lifetime is not they’re going to need a caregiver from you know 40 or something they’re going to need a caregiver from 19 all the way through. So. So it’s very I have a great deal of respect for everyone from every era but we do have some definite differences with the combat situations that we see now.
Dr. Jones: [00:06:28] You mentioned suicide and I believe you when we were talking off air that the quote is that is the rate about twice the normal population what is the suicide rate for veterans versus others.
Amy Brown: [00:06:42] The suicide rate as I can say at this point is about 20 to 22 per day in the in the military population. And the veteran population is only about one percent of our national population but represents about 20 percent of the overall suicides that occur. So so pretty substantial. I mean in terms of the the chunk they represent suicide.
Dr. Jones: [00:07:09] What sets a veteran up for suicide what are the risks things that that maybe a social worker should be looking for if we’re working with veterans.
Amy Brown: [00:07:19] What I find right now is Joyner. Thomas Joiner – He’s a researcher that’s done a lot of work on this and has proposed a model that involves perceived burdensomeness – feeling like you’re a burden to society or feeling like your new role within your family is somehow creating a burden. Thwarted belongingness feeling like you don’t belong even if you have a lot of people expressing social support and love just feeling like you’re not connected to the world that you’re in and then acquired capability for suicide so veterans are particularly at risk. Military veterans are particularly at risk because they may have access to firearms or they may. Certainly they are trained to use many different kinds of weapons and their fear of death is diminished just by the experiences you have in training. You know that that is intentional so that you’re able to participate in the military actions without without hesitation and things like that so that component is enhanced. You know in those populations. And so that kind of mix of things. So where we’re seeing people who may have had one deployment and they didn’t have six deployments like the next person but if they are isolating if they’re experiencing significant issues with post-traumatic stress symptoms if they are having a lot of depression you know not sleeping things like that that will impact their overall day to day functioning then that’s going to impact their relational functioning as well. Right. And so their sense of belongingness and their sense of social participation is going to be affected by that. So those are important things. And also people who express sort of a dismissive nature about death. We have some veterans that in my clinical practice in the Vet Center we have some veterans that will express Well I don’t want to do anything to myself but I don’t care if something happens. Right. And that’s a higher level of risk than Oh well I absolutely want to preserve myself because I have family or because of something else you know. So just listening for that sort of dismissive nature and that that’s part of the psychology of the acquired capability right.
Dr. Jones: [00:09:38] Right. It strikes me in my clinical practice I work with a lot of police officers and some of the things that you talk about are very similar. That idea of you know I don’t really want to die but I don’t want to be a burden to my family or to my department. And I have lots of guns I know how to use them and sometimes there’s no drinking and drugging involved too. And you know I think we do have to really give them a sense of purpose a sense of meaning right because it seems like for veterans so much of their meaning was is derived out of that out of being a soldier.
Amy Brown: [00:10:21] Absolutely.
Dr. Jones: [00:10:21] So if they’re not able to do that anymore what do they do now.
Amy Brown: [00:10:25] Absolutely. And that sense of when you come out of the military it’s not just what do I do now it’s who am I now. It’s definitely a change in identity. And so belongingness is very very difficult and not to forget you know we talked a little bit about weapons but not to forget that we have a lot of people who are prescribed a lot of medications. We have a lot of people who you know they they maybe they get out and they get their finances together and they buy themselves a really fast car. And those are also lethal means if they’re used that way. And so we have to think about you know are people talking about reckless driving. Are people talking about well I took a couple extra. Are people talking like that to us when they’re when they’re discussing you know how their day to day activities look and do we think that they’re getting to a point where they’re just you know be being kind of like I don’t care if I wake up kind of thing you know in that respect. So there’s there’s other things that we consider that may be come out in that didactic conversation or come out in some relational thing with their families that that we should be concerned about as well.
Dr. Jones: [00:11:36] Yeah I think that’s really good. Now I want to ask you a question. About. Someone who is not a veteran. Working with veterans. And. Again this is. Something that I. Face sometimes I’ve never been a police officer. Have no intention to be a terrible cop because. I feel too much and too much emotion in me. If a soldier. Goes to see someone who is not a veteran or who may even have some very. Strong kind of pacifism or. Anti-war political sentiments or whatever. Will that work?
Amy Brown: [00:12:15] As a clinician. Our responsibility is to acknowledge where we have barriers as well. And if the clinician is recognizing that and trying to develop this relationship there are such strong barriers that a relationship cannot happen in terms of therapeutic progress then I think it’s their responsibility to maybe move that person onto someone else but it’s totally possible for someone to have a great rapport with someone who’s a former soldier or a Marine airman and seaman and whoever whatever branch they served in they come into it and they’re like I don’t know either. So their anticipation of what a civilian practitioner might be like is you know maybe similar. And so breaking down that hesitation getting to the root of I’m human you’re human. We’ve both had some things happen in our worlds. You know the things that you have experienced I may not completely understand but let’s just talk about you know say in terms of CBT let’s just talk about how your thoughts are shaped around that. Let’s talk about how your feelings are shaped around that. Let’s talk about how your behaviors were adaptive to a certain environment and now you’re in a different environment and you have to really focus on and consciously change those behaviors.
Dr. Jones: [00:13:40] So you mentioned CBT are there other treatment modalities that work really well with veterans.
Amy Brown: [00:13:46] Absolutely motivational interviewing and some types of brief therapy are helpful in terms of just letting people know that you’re available. Sometimes they don’t want to be engaged in a very emotional and deep process but they just need to know that they’ve got a team somewhere especially if they’ve had to leave their team by themselves. You know if they didn’t come home with their team for some reason and when I came out of the military I came back by myself because I had a heat injury and I couldn’t stay in theater. And so I had feelings about the rest of my team still being overseas. And so I think it’s just important for us to instill that they still have a team somewhere. And sometimes it’s situational stressors a kind of a brief treatment situation sometimes it’s finding for them what has worked well for you in other situations. I know this is a struggle but let’s talk about you know how you have difficulty in the classroom but you’re OK in a group therapy situation. Right. So you’re OK. And so what is the success point of that group situation that is different from the classroom. How can you organize yourself different now. How can you reorient yourself in the other environment to kind of borrow from that success. And so so that’s helpful. Sometimes cognitive processing therapy is helpful and sometimes it’s absolutely not. It just depends on you know it depends on the case. But but you know we’re absolutely engaged in many different kinds of evidence based practices just to make sure that we’re we’re getting people where they need to go.
Dr. Jones: [00:15:26] The last question I want to ask you is kind of a question a future question I guess and I kind of want to get at your passion and kind of what you see as your as your vision for your own work and really for this work more broadly in society so let’s say that Bill and Melinda Gates gave you a call one day and said You know Amy I’m going to give you unlimited amount of funding for five years and to help the world in some way. What would you do with their money.
Amy Brown: [00:15:59] Oh my gosh I’m not really sure off the top of my head. I think I would be interested in supporting the military veteran community in terms of reintegration and in terms of reintegration at all levels people adjust to disability as they get older just as much as they just a disability from injury. And so I think it’s really important for us to consider the whole life cycle of service members and veterans as they as they go through they you know they have families. Things change. Are we able to provide a therapeutic treatment environment that has some place for the children to go. So he or she can participate in treatment without having to make child care arrangements and oh if that falls through I can’t come today you know as we have a younger population they’re returning to work they’re returning to schools. Is there something that we need to do in these various environments to help that adjustment be more – be easier and more graceful for them. And certainly dealing with critical issues and I think there’s room for a lot more research into what makes a great accessible environment for military veterans. There’s a lot of not seeking treatment right. There’s a lot of stigma in opinion about mental health. And part of that stems from the military culture and the understanding of what is capable and what is tough and wanting to represent that I guess by not needing to seek help or something but really looking at what is it about the military culture that makes it work. What makes it work really well what makes the team function really well and how can we incorporate concepts from that into what can make a therapeutic situation work really well and people desire to access them. I mean if I had unlimited funds of course a lot of ideas come to mind as far as what could be developed for our military and my fellow veterans.
Dr. Jones: [00:18:02] Yeah it sounds very holistic and “lifespan-ish” if that’s a word. Yeah. Very social worky. Yeah. Well Amy thank you so much for joining us. I really appreciate it. I’ve learned so much about your work and just this important work you do so. Thank you. Thank you so much doing the work.
Amy Brown: [00:18:21] I appreciate it.
Dr. Jones: [00:18:21] This has been the University of Kentucky College of Social Work podcast. Thank you for joining us. You’ve been listening to the social work conversations podcast. Thanks for joining us. And now let’s move this conversation into action.
Announcer: [00:18:36] This production is made possible by the support of the University of Kentucky College of Social Work, interim Dean and Vail and all the faculty and staff who support researching contemporary social problems and prepare students for the social work profession. Hosted by Dr. Blake Jones, produced by Jason Johnston. With thanks to our webmaster Jordan Johnson. Music by Billy McLaughlin. To find out more about the UK College of Social Work and this podcast visit socialwork.uky.edu/podcast