 We are going to see a big crowd here and some great information for you to share and some very distinguished guest speakers from the Department of Veterans Affairs. So welcome, those of you who are coming in, come on right up front so we can see your smile on your faces. I'd like to begin by recognizing our Dean of the Amy's Interim Veterans Committee, the Chair of that Committee on the School of the Hill. We have Ginny Hansen from Rhode Island, Amy Shepard-Ball from Iowa, and Todd Lovett from North Carolina. Could you see him? Oh, there he is back, there he is back, helping out and handing out. So, we appreciate all the work that they've done over this past year. We're engaged, we've had a couple of conference calls and they've been bringing through to work, and we really appreciate all that they do. There they are, I should click there. Everybody should have a quick tip or copy of Women Veterans, the journey ahead, that was our second report that we did. It was released right after the Amy's National Convention last year in September. We did a great roll out on Capitol Hill. We had a hundred plus members of Congress, their staff, and lots of interested parties and women veterans. Our new report really focuses on women who have made that transition to veteran status and we want to make sure that all of our women veterans have access to equitable, comprehensive health care services from the Department of Veterans Affairs. We want to make sure that programs are generally tailored to meet their unique needs. And we also want to make sure that the environment here issues that we know some exist at some facilities related to safety or privacy or culture that they've been addressed as well. And most importantly, we want to make sure that our women veterans are recognized as veterans and that we recognize them for their contributions in military service. I'm going to show a brief video here that Davey has done out of what Davey remembers. I am a combat veteran and a Navy veteran, legally blind. I am also a master in the field as a trainer. And my civilian job, I work behind team, an active volunteer, a mom, and a Navy member. And a life-time Navy member. And a lot of times, Navy members. My job that I worked as a combat medic, I took care of the sick and the wounded that he had. In female, when people do find out that I'm a veteran, that I'm a combat veteran, they are totally shot and they can kill them. DAV is leading the way for one of the veterans. They're getting a recognition out there that when they are veterans, they are actually helping push women's issues at the VA hospital. We still have a long ways to go with that aspect, but it's getting there. And I'm proud of Navy is doing that. It's awesome. I have been part of Colter Press for three years, and it's been a good part of my life. I needed to come to Colter Press because my life was in a very dark place. I struggled for the last five years with the locks and the helicopters that I was carrying. Colter Press is a safe place. No one here does you. Everyone here will make sure they will make you feel comfortable. They will help you transform your life. This is a wonderful way to introduce Colter Press. What I get out of being a DAV member is feeling the support of others and being able to support others. So DAV has had many events that have participated in the National Pre-Tournament in Iowa, where you gulp and literally sports play the game. There's a lot of women veterans at these events. To have more of my big conflict with the DAV, to put on an event like this is liberating. It's interesting when I tell people that I've been shot at, you can tell that there's a disconnect. One thing I did with the DAV was go to an additional myself for practice, which was awesome. It gave me a very enjoyable time watching another team work well together and just to know what their history was. I think these events really help all because it brings multiple female veterans together and with that camaraderie gets to be more recognition. There's issues. And I'm pleased to report as well that Congress has really been interested in women veterans' issues. We started the 2016 Congress in January. We've already had four major hearings in the House and talking about a variety of issues, female veterans' access to VA services, some discussion on cultural barriers affecting women veterans' access to healthcare, ensuring access to disability benefits for veterans survivors of military sexual trauma. In the most recent hearing, DAVs have been testing money for economic well-being of women veterans that dealt with employment opportunities and transition challenges for women. There's also been a number of bills that have been introduced and set up a legislative hearing that talked about two very comprehensive women veterans bills. Also, I'm happy to report Chairman DeConno is the House Senate Spirits Committee Chair and when he came in he assigned Dr. Julia Brownlee, Representative Brownlee in California, to co-chair a task force on women veterans. And this is a great task force. They hit the ground running. The first roundtable in May inviting women veterans from the various service organizations as well as different representatives of groups that often have a chance to talk about women veterans' issues that might be working with homeless women veterans in the community, LGBTQ women veterans, other folks that have been sort of marginalized. The DA is really working with them as well and I'm happy to report that the task force meetings are going well. We also have a number of bills that can be introduced. There's about 17 at last count on the House site that have been introduced on a variety of healthcare issues, homeless issues, childcare, newborn issues. And many of these have been from DAB's report, our latest report, some of the 52 recommendations that were made. So we're pleased that Congress has really paid attention to wanting to approve the services and help preserve that benefits for women veterans. We have three very distinguished speakers with you here today that you've not met before and I think we've had the pleasure of having you at our women veterans seminar before. And so I'm going to do introductions of our first guest speaker. That is Dr. Linda Davis. She is a former RV signal officer at the mother of a veteran who serves as the Chief Veterans Experience Officer for the Department of Veterans Affairs. Dr. Davis is nationally recognized for her leadership in the development and implementation of sustainable programs that successfully support military personnel and veterans, their families, caregivers, and survivors. Her previous government ten years include serving in the Department of Defense, as the Deputy Secretary of Defense for Military Community and Family Policy, and at the Department of the Navy as the Deputy Assistant Secretary for Military Personnel Policy. She also served as the designated lead with joint D&D and VA response to the recommendations of the Commissioner on Care for America's returning wounded warriors. A former VA clinician, Dr. Davis served on the faculty of the Department of Psychiatry and Public Administration at the University of Southern California, where she earned a Ph.D. and a Master's of Public Administration. She holds a Master's of Arts degree in Community and Clinical Psychology. It's my pleasure to introduce Dr. Linda Davis. I just raised my hands because as you can see I'm vertically challenged, and it is worth seeing me over there. Sometimes these podiums are very, very big. Thank you very much for your work. I really appreciate it. First, I want you all to know how determined, how good your staff is in Washington, D.C. at the VA. She's calling out how responsive Congress is to you all because of the representation you have in Washington and an example of how responsive we are at the Department of Veterans Affairs. You're going to hear about that, but it's also because of the leadership that you have in Washington and that includes you too. Thank you. Some of the brightest, most technical people. And I know they're giving that from you all, okay? So continue to voice that. It's essential to us. I'm going to run through some slides to share with you, overarching the Secretary's commitment to what we're trying to do a little bit differently in the VA under his tenure. And I will be around afterwards with my team, and part of what you will hear in the theme is we are truly trying to listen through every channel we can to understand the moments that matter to you and to make a change to get those so that you can have a better experience. We'll stay around and listen to what recommendations that you have. So I do get to run something called our Veteran Experience Office. Well, we all have experiences with veterans, but they're not always good whether we're using the VA or not. What I want to tell you what we're doing under this group on the VA Secretary is we're trying to take the best industry that they have to deal with in improving customer service. And we're trying to make that available to the way we run things in the VA, whether it's benefits, whether it's healthcare, memorial services. Memorial services doesn't mean a lot. They're doing a bang-up job. But we can always do better. So we're leveraging all these tools. The kind of support that you get when you call the USAA or another organization where you feel like you may have gotten really good customer service. That is our goal. It's a stretch goal. I understand. I started in the VA in the 70s. I know what is and isn't working. A lot more is working out than it used to. So we're trying to be this shared engine and help all the administrations. We have some principle and it starts with this commitment by the Secretary to improve the culture and get to the point where we're truly giving you all a world-class customer service. So the Secretary talks about customer service and he applies it to our veterans, their families, caregivers, and survivors. Most recently, you will hear us talk about not just the veteran, but it's the families, caregivers, and survivors. When I was at DOD, we know that you may assess an individual service member, but you retain the entire family and the entire family is impacted, even if there is not a marriage there is a mother and a father and siblings. We are all impacted. So our job is to look at the whole veteran and make everybody that supports him or her. We're also looking at our employees. It doesn't do any good for us to try to give you customer service that is positive if we're not training our employees and empowering them and making sure there's enough of them to be able to deliver that service. So this is what we are working on. In my job, my office, we have the job to implement this for the Secretary. And the way we evaluate it, the way we hold ourselves accountable, is through these metrics. So our greatest goal is to earn your trust, but you will choose the VA. How do we know if we're achieving that? I'm going to tell you a little bit about the way we basically rate ourselves and let you rate us, but it's along three metrics. Three, let's say, one, two, three. Okay, I'm dyslexic, but I should be able to still count. So these three metrics are the ones that are used by industry to rate customer service. Ease, can you get in to get an appointment? Effectiveness, once you get the appointment, is it helpful? Did it do what you needed to get done? And then three, the emotional resonance, were you treated with respect to that person who was helping you accord you the dignity that you deserved? So these are the things we're looking at, and we're looking at how we then take all the information and tell you that we're collecting. We're using it for specific purposes. One of those purposes is we're using it for customer service, and I'll give you an example of that soon, a specific woman veteran that gave us feedback that we did something about it right away. But we're also trying to improve overall performance, change if 12 veterans at one location are telling us something, it's probably something we need to learn to, learn from that we can then help change that program. And we're also using it in policy. So you're going to begin to see changes in the way we make determinations and decisions about our own budget based on how we're performing. Okay, and including Joy in your booklet, the wonderful booklet that you shared. On page three, there's a recommendation that DAB has about performance improvements. And in fact, we are now building into the performance of SPS, so you cannot be a leader in the BA unless you are doing the things I've talked to you about in terms of customer service. We've got some core capabilities. I told you about business and industry and using their tools. I just want to run through some of these and I will hand show some of our tools, the DAB, et cetera. And then you can, I'll tell you how to get a copy and other things like that. First of all, the DAB, this is key. We want to make sure we're listening to the voice of the veteran. We have a tool called eSignals or veteran signals. And that leads us to survey veterans in real time as soon as they've had a service and to give that feedback to the providers and the leaderships. So let's just take outpatient services. Some of you may have received the last time you had a visit to an outpatient, whether it's the pharmacy, whether it's dialysis, primary care. You might have gotten a survey. And on there you have some simple questions that you can fill out, you know, in a quantitative main method and then you can also give your comments. We actually collect those twice a week and that information goes immediately into the facility where you've got the service. And our directors and our vision directors are looking at that and determining what they can do to improve not only the programs that are serving you but also any one particular service that may have not been the best it could be for you. Now I did hear from my good friend Pat who's in the audience that he asked for a call back on his survey and he hasn't gotten it yet. But he can tell me and I can tell the director of that hospital that Mr. Mayne is still waiting for his call back please, sir. So we have this, our eSignals that we're working on we also have other tools. We have things that you're going to hear like our quick start guides. How do we make something simple and easy to understand, to get access? Remember our 70s? This happens to be for survivors. This is coming out. It tells somebody who is surviving the loss of a military or veteran loved one how to get the benefits. It's an overwhelming, difficult thing at a time that is very hard for most of us to bear and to have something very simple and then have our wonderful offices to buy their assistance is a great benefit. We've got different things that we have there. Also our VA welcome care and if I don't show you the VA welcome kit I'm going to give and a bunch of trouble. These are in the back. Tim's handing them out. There are Tim's over there and Annie. We've got these welcome kits. We want Jim, we want to make sure that you get copies of these. Keep your hands up and we'll give them to you. When you left the military you went through the TAP, Right Transition Assistance Program. They gave you something that looked like the Code of Federal Regulations. You couldn't read it. You probably didn't try. You did try the invention through your way and nobody else has handed it back to them. It's totally confusing. This is not that. This is awesome. So this is based on something other cool thing we do. I'm all about toys. So we use human-centered design, fancy words for listening, to map the experience of our veterans from the point at which you assessed to the point at which you're using memorial services and beyond because even after you're gone your family will still be in the family of the VA. So these, when we do this across the continuum we listen and hear the moments that matter to you. Those moments that matter are all in this welcome kit that you're going to get and under each one healthcare it gives you the phone numbers it gives you the website. It will tell you how to get the office of suicide prevention and it will also tell you how to get the women veterans office. So here's the map I'm talking about now. You see, CX means it's a fancy word for customer service. So it is the journey map that I'm talking about now too and this is all available online so we can make sure that the VA has lots of confidence. But we capture those moments and then what do we do with those? After we understand a moment matters to a veteran we're doing training. We have a training call in the moment and it teaches people literally when you see some of the 10 being away you look at them. When they're four feet you acknowledge them. You engage with those veterans and connect with them because that is the single thing about emotional resonance and respect. We've already trained 75,000 at our VA medical centers across the country. We are going to get to every single employee at the VA with that training. We can now look at not just all veterans but we can dig deeper and we can look to women veterans. So with organizations like Focus Groups like DAB and Joy and I were talking about making sure we're using the DAB membership who happens to be women when we're doing Focus Groups with the Office of Women Veterans then make sure we reach out to you but we can do this. Your experience across that journey and we've done these journey maps for how we use application, information, telemedicine, etc. My experience as a woman veteran will be different than my colleagues whether I'm using benefits or I'm using healthcare. It is what it is and we need to understand those moments that matter to the women veterans so we can make adjustments in the way we deliver services if they're needed but in all cases they have to be the highest consistent quality. So I'm just telling you how to get out of these signals when we do the surveys. I want to give you an example we just pulled out of there today from my staff in Washington. We can look at all of these and we have tens of thousands of these and here's some veteran feedback on one of them because they can leave a comment. This is the fourth time I've been rescheduled due to the doctor's availability instead of the original three months between now and six months. I also do not receive a call about needing to be rescheduled until I'm waiting for the equipment. It's affecting my own schedule and work. Who's ever had that experience? Any trouble with scheduling? It's actually one of the number one challenges that we have. Veterans tell us of the moments that matter most to them when receiving outpatient care and scheduling an appointment meeting the care provider and follow-up visits and specialty care in or outside of where all the hardest ones to do. So this particular person this veteran who happened to be a woman we can tell from the surveys if it's a male or a female they self-identify. They responded and our service recovery remember I said we're doing something about this but for individual veterans was to go to the veteran about the cancer appointment call that veteran back willing to reschedule to in this case Pittsburgh tell a psychiatry so that veteran did not have to come in and the veteran ended up having that distance tell a psychiatry male health that was satisfied with the treatment option. That's what we're trying to get to is satisfaction. I don't want too long that I'll go into just really quickly we couldn't do any of this stuff I can have tools technology so what it doesn't matter unless it's engaged with you all and it's put to your service and what I mean you I'm really talking to about the day and in your communities so when we wait I'm talking about the different areas we're working in data tools technology regularly quickly engagement what does that mean we know we can't do it alone I'm in your community because I want to listen to what you're saying but I also want to partner with you and work with you and your local whether it's a chapter or a post or a nonprofit or a faith based organization so we have these what we call our community veteran engagement boards all over the country and if you're not engaged with one I would ask you to please please please do so Jim where are you okay with any more welcome kids Jim is going to be in the back of the room he and Andy can help you identify to sign that first seat up I want those seat ups to be flooded with you all from the DAB and also especially with women veterans okay we really need to do that with your family members too we're doing this we're doing clergy training around mental health suicide prevention legal weapons and I know you'll be hearing a lot about more of those from Lisa we're working on the mayor's challenge with your community the governor's challenges we're doing I said the clergy training we're also going to be doing surveys in communities these signals news signals which will help us understand what's different about this community and do they have enough resources generally for addressing mental health needs so we're glad that we could get more engaged in those as I mentioned we're doing this with partnerships we have a very conservative effort to work closely so if you have an organization in your community that you think is helpful and he's going to be very very interested over there in hearing about it here's the partnerships we're doing and look at I love this I've been to one of myself the Boulder Crest retreats up there you heard that in the wonderful video that Joy had put together we have retreats with a lot of different organizations the cool thing about here is so the Bollywood Foundation has a lot of collaboration with them that was also mentioned in things like in the Tories report the intro fertilization if you look up there into LinkedIn you you can get every premium membership for LinkedIn related to getting better connections for employment and education we also have my last we have a great new resource that Tim has put together and we send out almost 10 million emails every week that has it's easy to use maybe it's got four or five things in there it starts off with telling you what you can have for free how do you get your park memberships for free travels for free LinkedIn for free and that takes that takes us one of the examples that we have of their free concert tickets students are like that but it also will give key information about some very important things that the VA has for you or how to welcome you or how to access the national resource directory resources not only from VA but from DOB and from your community you can put in something that's working for you into that national resource area it's the yellow books that we all need to be using so I'm a little bit excited about what we're doing I'm excited about the potential after coming on board in the 70's with my fellow peers from the Vietnam and seeing what we did and didn't do then I am very honored to have a second opportunity to be of service and to work with these wonderful people both in the VA and outside the VA and we've got to get we're not going to fix it all I'm going to be out of my ear or collapse in a couple of years but I'm catching myself now I just had another birthday but but we're going to do a few things so these moments that matter to you what is the most important thing on your list what are the three things we have to solve that would help you increase your trust of the VA and your voice and your choice of the VA and I know you've got an idea we'll talk about it in a minute but I want to work with you to get those things and so you will see this slide I know Jordan will have it available later this is all the resources that we have to tell you about including please, please, please don't hesitate to call our White House VA hotline 24-7 365 run by vets and their families for veterans that's available, warm hand off to the women's line and soon for the crisis line thank you very much I appreciate you for that wonderful presentation I think it's really important to point out because these are things that we're seeing to be done for the first time and those of us that have been around and I've been using the VA for a long time as well we've seen tremendous changes we made the copy from the Veterans Experience Office for all of you to pick up about women veterans listening and collaborating I think this when I said this I definitely wanted you to be here to tell our women veterans about this because it's really having these giving the feedback for women themselves, VA will always ask what's the one thing that we can do I said talk to women veterans they will tell you with other questions they will tell you what's working and I think I really enjoyed looking at your publishing building to most of the women veterans which goes through much of what you were talking about today and has the information for the women veterans call center on here so that's a great resource for everyone and I just for sure wanted to be make sure that you have the opportunity to be here right from VA so let's give her a great hand to talk about one of the best speakers today is Ms. Jacqueline Paisford she was appointed Executive Director of the Department of Veterans Fair Center for Women Veterans on February 17, 2019 in this capacity she serves as the VA Secretary-Women's primary advisor at the department policies, programs and legislation affecting women veterans she oversees the center's activities through monitoring and coordinating VA's administrative administration and healthcare benefits and programs for women veterans her duties also include serving as the chief advocate for cultural transformation focused on embracing women veterans service and accomplishments recognizing their military service and contributions and raising awareness of the responsibility to treat all women veterans with dignity and respect Ms. Paisford is a veteran in the U.S. Air Force where she attained a rank of major and served as an education training officer she has held a variety of leadership positions in the executive branch federal and state government as well as the private sector it's my pleasure to introduce Ms. Jacqueline Paisford before I get started there was a young woman sister a sister veteran in the math and you know who you are please don't leave without us finishing our conversation okay thank you alright first before I get started on behalf of Secretary Wilkie I met with him and he asked me to specifically pass on to you all thank you for your service the center for women veterans appreciates the invaluable opportunities like this to be able to participate and talk with you because it really emphasizes the being committed to providing quality service to our nation's women veterans and it's truly my honor to be able to speak about you today before I go any further please make sure to take out your phones and take pictures of our video too because I want you when late at night absolutely nothing to do you can pull these out and do your homework and I'm serious when I ask you to please use our resources that's why we're here alright so I want to tell you guys so I take notes and I specifically read because I love to talk and if you knew my husband I cut that down so I've got 20 minutes worth of speaking right here so I'm going to stick to it but I also have written it down because I want you to make sure that you all understand and hear my words and use them so the center for women veterans was established by Congress in 1994 and the reason it was established was because I wanted to make sure that the VA monitors the administration of benefits and services for our women veterans as executive director of the women's center my job is to advise the secretary on issues that impact women veterans my team and I are dedicated to empowering you and we do this to ensure that you're aware of and have access to the benefits that you earn and you deserve you deserve them because you earn them our vision is to create policies to the women veterans across the CIA our office works hand in hand with BPA for benefits administration health administration NCA which is the cemetery administration and this is to ensure that your needs are recognized and met the CWP or our office is the portal for all things women veterans did I dare? did I just put that? ok thank you so we're the portal for all things women veterans and we are proud of the veterans experience for you why does the center help women veterans and my short answer is this we integrate we advocate we connect and we conduct out routes to recruit women veterans not connected to the B.A. and further inform those that are meeting you the center serves as an integrator through our management of the B.A. cross administration women's veterans programs the collaboration promotes an open exchange of information about what the B.A. is going to address the needs of women veterans and more importantly helps to identify gaps so that we can enhance how the B.A. meets those needs so if I started dancing it's because that music gap was scary as an integrator we refer women veterans to assist to the appropriate B.A. offices and we do this to ensure timely action to your concerns the center advocates and serves as a resource for you and those who serve you as a connector the center connects you to the local state federal resources to address your individual concerns and we conduct outreach activities to educate you on benefits and services you have earned and you deserve I don't know if everybody knew this but there are 22 million veterans currently living today women veterans represent about 2 million or approximately 9.5% of the total veterans population although the overall veterans population is expected to decline for 2040 it's anticipated that women veterans population will continue to increase reaching 12.4% by 2020 the center's long term desired outcome is to achieve full equity in access wait times outcomes use, trust and satisfaction for our women veterans it's the center's goal to shape the strategic approach and operating plan to accommodate those evolving needs and ensure that VA's program that our VA programs and services continue to anticipate those evolving needs through research and development to accomplish this extraordinary endeavor the center divides a strategy that aligns of mandate with the PhD goals across five critical areas of outreach which is internal and external advocacy we also include research performance management and compliance working collaboratively with offices across the VA the modernization and alignment of the center will ensure we assist with enterprise-wide performance management and compliance in order to ensure women veterans receive equitable services and benefits I think I'm ahead of myself but let me just say this through our internal and external partnerships and initiatives we're diligently working hard to increase public awareness of women veterans experiences and contributions to our nations collaboration with local and state federal government as I mentioned before are some of those areas that we're looking at veterans service organizations such as the DAP and other non-governmental organizations lets the center have a strong impact in addressing the evolving needs of women veterans because if we're to meet women veterans you're due to consideration and recognition to your contributions we have to work together now we're over in 2019 the center launched its women veterans trail blazer initiatives we recognized 15 women veterans selected from across the nation these phenomenal women blazed the trails for others to follow and continues to give back to their communities we honored them with the ceremony of the women's memorial in carlinton and act the backup for our organization or the headquarters of Washington where we showed a documentary featuring these amazing women we educate our internal and external stakeholders on their responsibilities to acknowledge the contributions and cultural transformations of women veterans through awareness campaigns and initiatives we've been replicated being wide and by other organizations nationally and internationally here's something that we've talked to though as women since many women veterans don't identify as veterans the center wants to find those women and educate them on the services that the PA offers for their specific needs one way of doing that again we have these contributions that you saw for our translators but we also have other programs such as the I am not a visible campaign many of us don't see ourselves as women veterans we want to change that and one way of doing that is to let the whole country know that a lot of our programs that these women in your communities were on the front lines they were supported for the military they put their heads down we put our heads down and our chin up and we conducted business as a student when we came back home we didn't necessarily tell people what we did we just did it because that's what we do I told you I have to say our crap next year we'll have a women veterans summit and we're looking forward to seeing many of you there so I want to make sure that you get our website so that you can follow us in the time next year we've got the national baby showers that we make sure that women veterans who choose to raise families start out with a good foot and have baby blankets and diapers and all that they need to start their families out right every month we have a national partner's breakfast every single month who over here put that on representatives and for those that can't come to Washington it's a 34 if you know it's 1-3 but Marks is 1-4 Marks is 1-4-2-1-6 so it's not bad yep alright yes I am not a visible campaign or the I am initiative was initially developed by the Board of the Board of Department of Veterans Affairs to celebrate the contributions of 2 million living women veterans and to increase awareness and dialogue among women veterans in 2018 we began to sponsor similar exhibits by dispatching videographers Jean Russell if you haven't met him you will meet him we are going to have presentations on our website but he's been phenomenal in reaching out to these women veterans at various sites throughout the country to photograph women veterans serving our nature these photos have been shared through the center's digital channels as of August 2019 1,135 women veterans in 19 states and 31 cities have been photographed and by October we're projected to have photographed in 31 states the center will assure that it's messaging and congressional mandated activities aligned with the secretary's priorities our aim is to increase the awareness of women veterans and their supporters to aid and encourage them and apply for and obtain their VA benefits and services we want to eliminate disparities in benefit usage service and care and improve the overall women veterans experience within the VA and we want to increase the understanding of root causes that impact women veterans through research with a focus on vulnerable populations to improve VA modernization initiatives and we want to emphasize accountability in our centers cultured by setting ambitious goals while transparently and honestly assessing program and progress towards those goals and influencing pure organizations to do the same in addition to what the center is doing to serve women veterans and to enhance their access to veterans or VA benefits and services the VA's Women's Health Service has a call center and it's up on the board up there and that is to provide information about gender specific healthcare and other healthcare emergency services each medical facility has a women's veteran program manager available to help you and coordinator here and the regional offices have women veterans coordinators on hand to assist with claims finally I want you to make sure please to visit our center's website I have the honor of working with some of the smartest folks in VA and those that are very smart in technology you're going to see some major changes there and you'll hear my comments of what I found based on talking with you the other reason I want you to follow up and look at our website too is because I want to make sure that I include your voice as well and quotes as well so please make sure you take picture of our website because I haven't asked that's the other thing that my husband says well you asked a lot don't you well you haven't come to do because I need your help I want it before I do that I want to reiterate that the VA is committed to ensuring that you receive quality care to meet your evolving needs we are the portal for all things women veterans at the VA and our job is to work with all of our stakeholders to ensure that women veterans are taken care of needs are met with world class support so here's my answer I know that there are many women who are doing well I know that there are many million women veterans who can be doing better I want to make sure that women veterans across the board but especially those women veterans who see themselves as women veterans who see themselves as invisible receive the support that they need and deserve so my answer to everybody in this room is if you know of women veterans when you go across women veterans who are not receiving the support who are not receiving VA, ABA NCA that's a cemetery you're not receiving those grafted by the hand and help them find us help us find them because that's why we're here so I want to just tell you too I haven't mentioned this but till I come from a family of veterans that's all I know my dad was a 33 year marine master gun my uncle was a modern point marine you do your homework you know what that means my sister was Army and I was Air Force so you could imagine what that was like when I went home and we lived right outside of campus so when I go home I have to sneak in but I'm saying this to say I know veterans I was born in the campus campus you know what I mean you're a terrorist so what I am looking for is I need your support because I can't do it by myself thank you very much okay so don't make me cry there is Michelle is in the backpack there and I was very happy to see you all take the paraphernalia that's back there but let me just tell you the men veterans can you raise your hands for me these are our partners we need to go through the slides again to make sure we do that but I want to make sure you guys get the animation and I want the year for you and you've got our website on our business cards back there we've got a website that you can go to and please please please use it because once you respond on there I'm going to use you I'm going to ask for your help we bet your boots on that one okay and we'll use your quotes on how good, bad and different on how you feel about the VA because we can use that to make things better one more thing when I was a kid everybody we would be on a low dependent basis when I was a kid and everybody knew it if you had a loved one you would not send them to the VA because you knew they wouldn't comment back but I'm here to tell you right here right now that the people that are in these positions and making these changes they are the right people to make those changes at the VA the best support veterans women veterans needs and anybody who knows me knows that I don't say a thing that I don't know so thank you for allowing us to be here and very honored thank you very much I'm going to break a little bit on Jackie she has hit the ground and you know it's just been great working with her she immediately informed this group brought in everybody to have meetings with her to get all the updates and keep us posted and that inspired us to again send out and Peter Scott sent sign-in sheets if you're interested in signing up for getting information on the veterans for DAV or maybe we'll do it quarterly and we'll pass on information from the VA that we're getting that's specific to women veterans he's going to make sure that each aisle has one number you signed up in the back and we'll also have that available for the rest of the conference so please sign up, we want a good collection of people who are interested in women veterans I'm sorry about the music that started next door right when you were starting they promised me they were going to start so I sent a message that you promised we would wrap up early but then sorry I also wanted to say one of my questions was when is the next summit people are always women veterans are always wanting to know when we can have the next women veterans summit so make sure that you get signed up there website that they have your information and as that starts to happen you'll get that information with it and finally I'd like to say just regarding your presentation I really like that VA has more specific materials to choose VA and I keep telling women veterans with the research that VA does with all of its efforts to even though it's still a small minority population women VA help their system in general the best place for women veterans is at VA I've gotten my help here there for years many of the women at VA here use VA health care services as well it's not perfect like you said but there's been so many changes it's been incredible and I know that it's because of people like the three of you that you just have a passion about the inches and want to see the changes for women veterans as women veterans yourself they passed me a message let me just make sure www.va.gov slash welcome dot hit so it was www.va.gov slash welcome dot hit we'll also this could be there's the electronic link and the hotline number for the white house that she mentioned one eight five five nine four eight two three one one repeat that again that was one eight five five nine four eight two three one one and I would like to say regarding that although they can use the white house hotline your office has been incredible Jackie your office any time you have an issue one veteran either Dr. Pace's office or your office you guys jump right on it I've been associated with a woman that just recalls us and they're upset they had a really bad experience you guys are on it we have relational people throughout and everyone who has called is really thankful to say oh my gosh I have a call right now and they took care of the issue and that's what I want to hear if someone's listening if something's better problem we just want to resolve so thank you your team for being so responsible for taking that priority I'm going to now talk about our next guest speaker Dr. Lisa Curney is the acting deputy director in the department of affairs of mental health and suicide prevention her work focuses on the development of the comprehensive public health approach to suicide prevention and overseeing offices day to day operations Dr. Curney working nationally as part of the executive team and the VA office of mental health operations through consulting and technical assistance overseeing mental health policy implementation through quality improvement site visits across the VA system Dr. Curney is a graduate of the University of Texas at Austin with a PhD in counseling psychology and has a board certified critical health psychology she served as the chief of psychology assistant chief director of training and director of primary care health integration at the VA sub-Texas health care system it's my pleasure to introduce Dr. Lisa Curney I'm very honored to be here as one of the three of you but also to be in a room full of veterans I can't imagine a better place to be right now I have the honor of speaking specifically about something that's very near and dear to my heart which is suicide prevention efforts and speaking particularly about this and the women's veteran population and to call each of one of you to come and join us in an effort to save the suicide I'm going to just take a moment here these are all the folks that have been involved in efforts around women veterans and any suicide women veterans and who helped prepare the presentation today but I couldn't help but put in a picture of the very first woman veteran who was near and dear to my heart and taught me about women in the military this is my great mother Mary Gillian and she and my grandfather served together and like Jackie I was raised with many veterans in my life one also near and dear to me is my dad because I'm a Vietnam American later after this picture was taken she raised four wonderful children but we lost one to suicide and to watch her strengthen as well as her vulnerability and sharing the challenges that she lived on was something that spoke to my heart and eventually led me to be a psychologist as well so I think this is something our family has lived and I say that because suicide touches each of our lives personally and it's something I think we all feel very passionate about how do we achieve this it's a problem not only for veterans but it's a rising issue a public health issue in the United States so just to give you a little bit about our experience of this and the veteran population among women veterans 13.9 women veterans that's the age adjusted for 100,000 of the population what does that mean in what real direct numbers that's 257 deaths in 2016 we lost that many women veterans here and this rate is about 1.8 times higher than the rate for civilian civilian women I point that out in particular one of the reasons why we hypothesize this is higher is because women veterans have a greater likelihood of using firearms compared to non veterans in fact 41.2% of women veterans who died by suicide died by firearm compared to the national population of women generally 32.4% so I also want to point out the rate is highest for middle aged women veterans so we must do something about this men are more likely than women to die by suicide but I would like to point out the second item here is more women to have suicide in them but they're less likely to die because they're less likely usually to leave women are more likely to afford suicidal ideation attempts and more likely to hospitalize for attempts but I'd like to share with you a little gap in what we need more knowledge in this area and what the VA is doing in partnership with researchers across the country is to study things beyond just mental health concerns lots of people die by suicide not because of a mental health issue but because of other life struggles that they're dealing with so we need to study more factors related to social issues that one's facing economic challenges financial concerns that we face cultural factors educational factors the experience of childhood abuse or interpersonal violence these are all things that bring increased likelihood of suicide so one of our calls is to begin to shift more knowledge of what we're thinking to also look at these other factors that are salient for us so we really need veterans I'd like to point out a few risk factors things that you all may begin to wish to look for yourselves and begin to identify how do I personally reach out to women veterans who may have some of these risk factors one in particular is substance use disorders substance use disorders robustly predictable like we've had a suicide attempt in one slide and to complete suicide this is actually higher for women than men this is often something we use to help cope problems we use more drugs that's the case for men and women and one of the things I loved in the report that you all just gave me was able to read that this morning was talking about how we need to expand our substance use disorder treatment to also have women's only types of groups available some of our ways have not some of those don't and how do we work with our community partners psychiatric disorders I don't want to not underscore this certainly individuals who have mental health disorders are more likely to attempt to complete suicide that's the case for men and women but this link is stronger for women veterans one thing that I'd like to note is also a concern about eating disorders eating disorders are more common in women and those with eating disorders are more likely to have suicidal ideation in attempts another issue that's particularly salient that puts someone at risk is a life technique of traumatic experiences that might be experiencing abuse as a child that could also include both physical abuse sexual abuse neglect but also there can be both whether that's a sexual assault or intimate partner violence and I'll talk a little bit more about that in the next slide and then finally military sexual trauma those who experience that are more likely to die by suicide are in their population so a few points here about the suicide risk and factors associated with partner violence this is as I said earlier increased likelihood of dying by suicide attempts of suicide and ideation but I do want to point out women veterans have a higher risk of civilian women for experiencing interpersonal partner violence and that's associated with factors such as greater health concerns greater mental health concerns hopelessness, social isolation so as we see women veterans who are struggling with intimate partner violence really thinking practically how can we reach out to help those individuals so that's important there's some unique factors for women that I wanted to highlight related to women's reproductive cycles so treatments focus for a disorder individuals with this also have a greater likelihood of having suicidal ideation I do want to point out things have changed related to our research about women who are pregnant that is not a protective factor sometimes people think that and it's not in fact we know that discontinuing antidepressant medications is common in women's pregnant of course we're thinking about the baby but that can also increase suicide risk and among pregnant women who die of self-harm we have had discontinued antidepressant medication it's something we're working on folks who prescribe medication to continue education about this and up to 20% of those who die of post-harm are death related to suicide and you all know that we have increased risk of depression during that time period and then lastly is women begin to intermittent pause it's another time that they increase risk for experiencing loss of suicide so those are some of the risk factors I just want you to think through individuals in your life or folks in your life that you know have any of these risk factors and how we began reaching out to them but I also like to focus on what are the positives that we can look for to what are the protective factors against suicide motherhood has been shown particularly with young children are less likely to have attempted suicide lower risk of suicide and one of the things that we think about that is women with younger children are often more connected community with family members with friends and connectedness is critically important I love what Dr. Davis said a little while ago when people are 10 feet away from you making eye contact 4 feet away doing a greeting how do we continue to engage connectedness and I can't help but think about that with DAV because I think this is what you do so beautifully and hearing the women in the video at the beginning it's about connection and you build a home for veterans and you build a home for women veterans and that's a beautiful way to have protection against suicide meaning in life what makes a person continue on what is that for them the time that in daily our discussions about this another thing that's different for women it's a family that women are more likely to ask for help which is a good thing we want people to feel comfortable reaching out asking for help they're more likely to use help life they're more likely to talk with their family position they're more likely to discuss problems with others I don't know about you although I think it's still hard is it not when we're struggling to ask for help I know I have that I have to tell someone hey I really could use some help here this is a really rough time that's tougher than to do too in their life they're talking this is a tough time for me know how hard it is for them to to express that and really take that as a cue this is the time I need to kick it out the box with my outreach to them with my friendship to them which my support to them and interestingly religious activity and spirituality have been found to have some protective factor for suiciding women those who have frequent attendance or reduction in suicide risk and for some populations the spirituality that we protect from so these are all things just to consider what our help so here's my call suicide prevention is everybody's business it's something we can all do we can all help save lives and in particular there's five different items that I want to touch on for you one is now our work will continue in the office of mental health in this area one thing your report also indicated was the importance of having standardized screening related to suicide risk I can tell you a great happiness that this year we have rolled out the largest standardized suicide risk assessment process in the country is the gold standard and today already we have 1.5 million veterans who have been springed and have been able to get help because of that big process so we're very much in the moment the other thing that our office has ruled out and is recently in the last couple of years is saving access to the health care so that when a veteran comes in you can get access that day developing innovative prevention strategies and that's where I'll talk a little bit about our public health model reaching out to you all and asking your assistance for this but also using analytic strategies where we can actually identify your medical records system individuals who are higher at risk and we notify their providers and their providers proactively reach out to them it's called ReachVet and we're having some great outcomes related to that use of the data that's there in our system going on the far right reaching veterans and their families some of the things that we've been working with the community on is our first community-based program to increase safe firearms storage we work with seven in states of the National Shooting Sports Foundation and the American Foundation for Suicide Prevention that we also have in part of my network over there is a gun lock there are free gun locks available up at the VA booth there if you'd like to get that to anyone or have that on hand if you're storing your own weapons at any time it gives a little bit more time and it's just a thanks group when we actually store our arms in a safe manner and that's something we'll talk about with colleagues Dr. Limland that's very much in his heart as well and so we appreciate the partnership around safe storage we also launched the governor's challenge and the oral challenge related to suicide prevention as some of my colleagues mentioned in February of 2019 seven states 24 cities all committed to have proactive suicide prevention and then lastly working across the United States in a hundred largest markets of the campaign along with the USA advertising starting in Times Square advertising would be their initiative for veterans finally changing the conversation y'all talking about suicide is hard and I don't want to dismiss that as a trained professional it is hard for me to talk about it but it's more important that you let that person know you care it's important to reach out and as we do we will feel that response from the others around here and give you support to also reach out to others so what we're doing in VA's public health approach is realizing not every veteran is enrolled in VA healthcare there's a lot of veterans every year who die by suicide have never been enrolled in VHA and this is my quality each of you in the ring we need your help reaching women veterans that we don't touch we need you to come alongside us help us to partner with you better so that we can reach those who aren't enrolled in our care as well as give us feedback so we can improve our own care to the veterans women veterans for VA care and they feel just a number of individuals and organizations that we're working to partner with right now important points along this line is don't be afraid to start the conversation don't be afraid to reach out to leaders and ask them to join in the efforts there's no special training to show genuine concern you all know this as veterans are how do you reach out do you have someone else's background how do you continue to do that daily small actions of support matter sending some texts writing a copy of somewhere those things matter and use the resources available to you I'll show you a few at the end of the slide that I think will be helpful I do want to highlight here I'm very grateful for the men and women who came before the interest rate prevention who really saw it's not just about reaching the the few at the end so what this classification says we have to reach everyone for suicide prevention all of us are at risk every single person is at risk you can get to a low point super quick you never know what life is like so we have to reach everyone then we have select individuals who are at higher risk that we need to do at a low proactive and then we have few these are people who are at imminent risk of harming themselves and there's different strategies for you to create so my call for you is to think through how can I help across these different sides and in particular DAE I hope that you will help with the universal strategies as well but that you become even more knowledgeable about other things that you can do to partner together for those at higher risk in the selected field so some women veteran resources so we have a few things here I wanted to highlight the veterans crisis line wonderful resource to have and moment I'll put the number up and I'm going to ask you to pull out your phones and put it in you never know when you may need that number that's now for that coaching into care that's a wonderful resource for supporting others and family to talk with someone who knows about VA resources and how do you get people into care in the system because it's not always easy getting into the VA system sometimes that's very difficult so coaching into care helps along those lines we also offer a full spectrum of mental health services from did you all know that there are mental health providers in primary care that's where I started so when someone's first talking with your primary care doctor they can walk across the hallway to the mental health professional right there in our same day access all the way out to more specialty services residential treatment inpatient services but a whole host of outpatient services as well and that includes evidence based psychotherapies it includes peer support I'm excited to work to expand peer support I think that's really critical to expand the number of women veterans serving those roles specialty treatment for PTSD we've talked a lot about that in the past for DAV beginning folks into evidence based care as well as providing additional services I do want to highlight there's a national network of women's mental health champions so each of your sites in VA each healthcare system has a point of contact that can help you navigate the services that are available and special services in screening related to military sexual trauma I do want to highlight particular suits of the profession for women's mental health services in particular we focus on gender sensitive mental health training for clinicians in the mental health lane as well as in primary care and other settings and we have a few things I wanted to highlight you may not know about DOD women's mental health many residency skills training this is a training program in particular for mental health providers who want to have even more specialized understanding and awareness of the needs of women veterans so this was launched just a couple of years ago the skills training for active and interpersonal regulation that's a mouthful I prefer just call it STARE and STARE is 80 to 10 sessions related to trauma treatment veterans only and it also includes for those who are parents a parenting component we also are very excited about this new 8-week application program that's been started over the last couple of years it's an interdisciplinary leading disorder treatment program and it's something I know you'll report highlights as well there's unique needs that are needed for that population and I already spoke a little bit about these other things and I'll highlight here just one of the things and I think sometimes people think of military sexual trauma as just for women and I know I'm highlighting and here that's not the case military sexual trauma happens to women and to men the military sexual trauma coordinator each site is available to help get individuals into service and it is free of charge for us I'm always here, I've talked a little bit about being partners for women veterans these individuals in each site are so helpful and a number of ways to help navigate some of the processes locally to get in here and our women's veterans call center if you didn't touch it before take a picture real quick, I know Jackie mentioned it but I wanted to highlight it again and you have been on the make the connection site okay, you really want to go here is maketheconnection.net and one of the things I love about it I learned more from hearing personal stories and experience of navigating difficult times I've always heard when I hear someone speaking in their own voice versus me in a suit I'm here telling you hear another veteran and what I love about this website is it's got hundreds and hundreds of interviews you can search by concern that they have or if they're a female veteran or not a whole variety of things and you can hear the voice of the veteran and how they address whatever challenge was in their way at the time and talk about resources available to them to me that makes much more of a difference in hearing personal stories so it's for veterans but it's also for family and friends when you think about what kind of resources can I share with other people make the connection is a great site we also have highlighted on here something that our program has dedicated in doing is translating the best research into practice this is something we use for providers you know as you're connected with community providers as well but it summarizes the best in your science in different areas I highlight this because we have two recent issues related to women veteran topics that I think would be of interest to all of you and this whole website here has a host of resources and things that you can use the other is the be there prevention initiative this is where I told you get your phone number your phone out here's the number for the hotline you never know when you need to use that or also when you may be with someone who's struggling in front of you so I encourage everyone I have a coded in my phone because I'm afraid I may forget the number but I'm in a crisis situation sometime so it's one 800 273 8255 I encourage you all to put it in you never know when you might want to share that contact by text with a friend and also have that thing I'll repeat, 1-800 273 8255 and as we move into suicide prevention month next month I encourage you to share that on your facebook pages share it on your instagram share it with other people so that they have that resource handy and the hotline prevention initiative also talks about be thereforveterans.com talks about what the simple things are that we do every day as part of the suicide prevention and then I encourage you just to stay connected there's all kinds of different resources for you but my call is this we need your hotline reaching those who we never touch at the end you all have such a great relationship and connectedness with women veterans help us to reach out to them and continue to give us feedback so that we can do an even better job at reaching out to those already nurses our best again for these three great presentations I know this last one is one that's near and dear to my heart is well based on a great job that came out done training at the DAB office in Washington because again you never know when you might be on the phone that may be the crisis line there for help please code those in your phones make sure that we're looking after each other all veterans but for women veterans we really want to walk by somebody to see their down and they just need to say hey are you okay it's not that difficult it's a simple thing to do when you see somebody that's really struggling and if you have problems if there's an issue with any care you need or something's happened at one of the medical centers or clinics speak up make sure that the clinic director knows about that the hospital director the women veterans coordinator people are there to help us get the care that we need and we serve and so Doug just said that didn't work out for me we want to be able to get everyone who needs it and it's the best place they've done the most research about women veterans specifically we know the most about that and we have some early protection dedicated to being providers so let's give a round of applause to all of our veterans they've been creating to be here to answer if you have any comments or questions they're going to stay a little bit since we we know that music is coming in but again thank you to all of you so much for coming and watching D.C. with us and it was a great presentation yes the welcome kit okay let me read it again the welcome that wants the information is over here so welcome that kit okay I need to give it to you the problem