we have to think that the consumer gets what they are paying for. if the winter wants to use service from an appraisal management company to broker these valuations services they are operating an agent for the lender. let the lender pay for that service. don't make the appraiser pay for it and don't make the consumer pay for it. the lender is getting the benefit. makes the lender paid for the

benefit. >> i admit i am getting old. i am building interest from 40 years. i have tremendous respect for appraisers. is specially when i make applications to a bank that usually in-house. they were taking a risk lending me the money. i consider it a fair market appraisal. they praised the house the block away and appraise the house down the road and understood the area. what we did was overturn the apple cart. nobody has figured out even though we directed them how to put it back the way it was. government doesn't change rapidly. coming back the other way, it has not done a good job and it has done a disservice to the appraisers in this country who

do excellent work. it hurt them and create a situation where the lender is no longer have appraisals to compare with theirs and they can't deal with issues like you could in the past. and the appraisal can't -- one person -- it is proprietary. we create a situation where they are putting out and bidding these things on a bulk basis to whoever gives the crisis in respect of of the lender you read to me about geography. i took notes on what you said earlier. you talk about geography and fully capable and guidance. every one of them was followed by at -- if. will be capable if. the problem is defining. it opens up a huge problem that we started and we got to

correct. the realtors are out trying to provide service to buyers and sellers. mortgage brokers are providing a service to the realtor and the appraisers are granting service to everybody and we put them in such a difficult situation that is not working and we put them in a situation where in some fashion it is stifling the ability of the economy to recover because we have decimated value in homes with this downturn in the economy and not doing what is necessary to hit bottom and build back up the. of we are stopping it right there because we have mandated things that don't work. i hope somebody has started to listen. we are not happy with what we did. we messed up but we're also not happy with you not listening to us. wanting to correct what we did wrong. that is the problem today. it has got to be done and somebody needs to listen. you have been more than generous. i would yield back my time

twice. [laughter] >> madam chair. >> mr. kelly. >> i appreciate your summary and description and i agree with much of what you said. however, i don't believe that we should consider legislating on the basis of anomalies or hearsay. i have heard the stories and i didn't mean to do that. i appreciate that. there are 350 imcs in the country. are they all the best and good? no. are they good and great ones? yes and they are associated with my association but they do

indeed provide real value to the process and aid to help protect the appraiser but they also allow for the types of transactions you are talking about to be facilitated. we mentioned in the testimony earlier that the p.o.s and other methodologies and utilize to either check appraisals or give a sense of what the trends are in any given neighborhood or property and those tools are very much available land in use in today's world. i was deleted to see my friend karen mann using and ipad to give her testimony today. as you know from your real estate experience the big technology is back in our day was the memory code in the electric typewriter. so things have changed. things are indeed available that

can help. go to the issues -- >> what is your opinion? >> there are a couple things that are incumbent on all of us that we need to make short change and one of those is lenders are held accountable for these appraisals and the opinions and for their actions but we also need to make sure that people who are regulating this industry who are the regulators are well versed and we have a sufficient staff to take care of the problems that are coming and to make sure that what is happening in the appraisal business is well maintained and understood and they try to do their job. >> i am not disagreeing with what you said. we all make mistakes. we did. congress did. we tried to correct that but what we did was exclude

everybody from being able to be involved in this process using matching appraisals dealing with areas that were done wrong or errors that might have been made. it happens in every business but we have taken and excluded that ability to be competitive, comparative and dealing with mistakes that occur and we messed up and it is not in tuning any of fraser anywhere. it is saying let's get back to a system of accountability and affordability and reliability. that is all i was saying. anyone who took any statement in tuning anybody was never intended to be that way. i am saying we goofed up and other people make mistakes too. and other. up with something that is good.

>> in that line of thinking, you offer an alternative regulatory structure for real-estate appraisers, miss stephens. how would this structure differ from the one we have today? >> let me start by emphasizing what the appraisal institute is speaking about and what we are proposing is not a self-regulatory organization like some have mentioned. self-regulatory organizations involved industry whereas national mortgage losses system is owned and operated by bank regulators. in this case state supervisors. fundamentals of the state appraiser certification and adherence to uniform standards of professional appraisal practice would remain unchanged. as i alluded to before the

regulatory structure assumes states are not capable of administering a system of certification or specific agencies intervening with the process. it assumes that a state can assume the responsibility and administer state certification maintaining a federal presence. for many years congress and others found a way to advance regulator coordination and this mortgage licensing system has developed a solution. we understand they are offering the system to regulators outside the mortgage loan origination business and as they are a common problem all state regulators -- it would not be appraiser regulators to participate in this system. thank you. >> one last question, miss mann. on page 2 of your testimony,

stunning and completely inappropriate federal reserve rule on customary and reasonable fees as required by dodd-frank and also mentioned that this creates a loophole. could you expand on these points? >> let me catch up with you. creates a loophole whereas the amcs were able to go out and check customary fees. within the scope of their investigation they reused as part of the of re. customary fees should be outside the amc realm from the general marketplace. for instance fha. appraisals done for other purposes, whether for

dissolution or state work. just to get an idea what the customary fee is 4 in independent appraiser in the field trying to make a living in their small business. >> the you have a response to that? >> yes i do. we believe appraiser is should be paid appropriately. these for appraiser is, compensation for appraiser has always been set by the market. supply and demand equation. appraiser is deserved reasonable customary fee to be paid for the services that they provide. the notion that amcs are driving down fees for appraiser is, really mistaken. we don't set fees for

appraisers. we work for lenders or agents of the lender. we are doing reassessment pieces of what lenders have traditionally done. we provide as i indicated in testimony services for lenders and appraisers. one of the things i have been told in all the years i was with the appraisal institute that one of the largest costs for appraisers was marketing. that in addition to the risk, warranties, real costs for appraisers, retail assignments. that has been offloaded to the amcs so there is a share in compensation. the risk and those duties are no longer done, no longer done by a traditional appraiser. the consequent the that they get is one that they agreed to and

has been negotiated with. you go to this assignment on 12 number 3 maple, what is your feet? $300 or whatever it might be and strike an agreement. there may be anomalies on that like we talked about on travelling but those are truly anomalous as far as i can tell. >> would anyone else like to comment on that? >> it is important to distinguish the importance of what has happened over the past eight years at the height of the market. 60% of mortgages were or originated by mortgage brokers the majority of whom were professional lenders. we all know we saw many problematic for some prime loans and issues where appraiser is working exclusively with companies like ameriquest. the point was to make sure

arm's-length transaction -- we agree it should be changed. the reality jumping forward to today is the unintended consequences of efforts to improve performance in the marketplace. appraisers tell us where we ask about valuations given to consumers with regard to accuracy issues in the past they would have a day to produce or more to produce appraisal or lender. today a xps expect them to do two or three in the same time period. they're leaving in droves because they cannot make ends meet. that is not a product of quality. these appraiser is are committed to providing quality products but it is a product of a changing marketplace and i hope we do see back to the purpose of this hearing that we do see the subcommittee working with the

prudential regulators to ensure safety and soundness and the return of robust when thing. thank you. >> thank you. i would like to thank all the witnesses today and before i dismiss you i have to add to the record i ask unanimous consent to insert the following material into the record. june 28, 2012, statements for the association of home builders, and from the american enterprise institute. june 28, 2012, statements from the american guild of enterprise appraisers, new statement from mortgage bankers association. in 28, 2012 statement from the dallas-fort worth association of mortgage brokers. june 28, 2012, statement from the builders of america. with that, the chair notes that some members have additional questions for this panel which they may wish to submit in writing. without objection the hearing record will remain open for 30

days for members to submit written questions to the witnesses and place their responses and the record. i would like to thank you for your expertise that you have brought to this panel and to help us as we move forward so i thank you all for being here. this hearing is adjourned. [inaudible conversations] [inaudible conversations]

[inaudible conversations] >> author david right about the president. >> kerri truman goes to the white house and says to eleanor roosevelt can i pray for you? she says no. we need to pray for you. there are a lot of promises made. they have to rent a large home larger than this one to get all the people jack kennedy promised the vice president see. >> and their ideals. >> calvin coolidge may have been a last jeffersonian, resisted the temptation to extend our. >> your questions and comments for david pietruuza. and released expert on the obama administration's response to the

arabs spring, afghanistan, iraq and the israeli-palestinian peace conference on booktv this weekend. >> the supreme court in a 5-4 decision upheld the individual mandate in the affordable care act health-care law. the heritage foundation hosts a discussion. live coverage at 10:00 a.m. eastern on c-span3. >> with suicide on the rise among veterans the defense and veterans affairs departments are stepping up their efforts to address the problem. next, enlisted military leaders take part in a suicide prevention conference co-hosted by both departments. this is an hour and 45 minutes.

[inaudible conversations] >> good morning. please welcome janet kelly. >> i figured you knew me by now. good morning and thank you for coming back. this was my time this morning to give you a few minutes on of the a update--va update. as i lay in bed last night and thought about everything i heard and have seen and thought about over the last few days i decided you all probably know by this point all the great and wonderful things that the va is doing and it seemed a little

silly to stand up here and talk about them yet again after that extremely powerful survivor panel yesterday afternoon. so i am not going to do that. but for those of you who care about those things the va is doing great and wonderful things. but what struck me is as great and wonderful as all of the service branches are and how strong their programs are andy va's program we don't have a long way to go. i think that this is the time to take on that challenge. i make some quick phone calls this morning and yesterday

during that period when powerful speakers were telling us their stories. 42 people called the crisis line. 28 of those identified themselves as veterans. two identified themselves as active duty service members. ten friends and family members called. the others chose to remain anonymous and that is always there option when they call the crisis line. referrals to suicide prevention coordinators and chaplains on bases during that timeframe and we made two rescues and one of the people that called started taking pills and they got there in time. that left, if you figured that out, a significant number of

people who called the crisis line, who didn't get a referral. they did not get rescued because they were not in immediate crisis or we didn't know who they were. i suspect for every one of those there are several of those out in our communities and on our military bases every moment of every day that we don't know who they are and are not touching their lives. there are several people yesterday in that time period who may be did sir -- tell someone they were in trouble. and in a half-hearted sort of way, the level of ambiguity, probably some of those people were not responded to.

the hard part of our jobs is yet to come. we have done the easy things and we need to continue to do those. don't get me wrong. we are making an incredible difference every day in people's lives. i want to challenge you to take the extra step and reach into those corners where we don't know what is in there when we reach in. and it is all about being there and be invisible and contacting people and touching people's lives and not being afraid to say are you ok? can i get you some help? maybe it is scary to talk to amend the health professional and maybe people won't do that because of the stigma but they ought to be able to talk to us and their friends and neighbors and the people they work with

every day. without any fear of reprisals. some challenging us to be those people. this year, suicide prevention awareness month which is coming up in september we chose the same--the theme stand by them. it is a call to action for friends and families and co-workers and all of us to be there for each other, to be their for service members and veterans, to help them get help but more importantly to stand with them in their struggles and their joys and triumphs. i am putting out a call to all of you this morning to take that on as a personal challenge. not something someone else has to do but something i have to do and you have to do and we have to do for each other. so let's stand up now if you are

willing to take the challenge, stand by them for our veterans and u.s. military service members and give ourselves a round of applause for the wonderful things we have done but more importantly the great and wonderful things we are going to accomplish this next year. [applause] >> i witnessed all of you standing up to do that. i suspect we will hear more challenges during the rest of the morning. i am excited about the two secretaries coming to talk with us. i think it winds another level of importance to what we do, so we are in for an exciting morning. we also had a great evening last

night. for those of you who went to the poster session i think it was a wonderful experience to see what everybody is doing. approximately 250 participants at the poster session and a total of 150 of you actually voted on the best posters so that was exciting. the winners are going to receive a package of fun stuff including the book carrying through the moon by dr. ritchie about suicide by dr. joiner and the american journal of public health focus on military families and suicide prevention. they also receive a certificate which we will be happy to put on wall. so the first-place winner in the practical application track if they're in the moon please -- in a room please stand up, strategies to reach

underregistered veterans experiencing post deployment. [applause] the second place winner is from the clinical track. bling santiaglynne santiago, fr recovery. sir stephanie miller, the difference between suicide and suicide attempts and a veteran population. stephanie. so thank you will for participating. on that note i think we will move along to our first panel this morning. to introduce that panel of would like to introduce to you u.s. army retired sergeant major

walter moralists,morales. he is a good friend. [applause] >> good morning. let me tell you, you are in for a deep treat this morning. this morning you get to see, you get to listen to the most senior advisers we have to offer across dod. this group will share with you their views, those policies and services for the particular services. what i will do now is call each one of them to the stage and please welcome them with a big round of applause. i would like to introduce the chief mental sergeant of the air

force, james roy. [applause] did mike leavitt make it? chief petty officer of a coast guard, mike leavitt. [applause] senior enlisted adviser to the army surgeon general and my classmates, donna barack --borok --brock. . sergeant major for the marine headquarters in the marine corps, john gilstaddle. the senior enlisted leader for the national guard bureau chief

master sgt denise hall. chief hrrrtrrerrry prince. the command senior enlisted leader of the walter reed national medical center. this is how this is going to work today. i will turn it over to the senior enlisted advisers starting with james roy. then bill will provide three four minutes of briefing on those things that are working on the themes that they helped craft. we will go through the panel and turn it over to q&a after words. with that in mind -- >> good morning. thank you for joining us today. i don't know if you noticed the there are different levels of acceptance. little over here but the one

that caught my eye was master chief prince. his wife is over here. welcome. as we always say everybody has to have a wing man or a shipmate. go ahead -- thank you for putting this on and to dod and veterans affairs you make this seem less. ..

as a group, as dod, we still a long ways to go. we still have long way to go but we are there. we are ready for the challenge and we are up for that. i may be -- you may be asking yourself, in your capacity and what you do each and every day, this should not be any surprise, quite frankly when i go out and talk with their man in my case, what i usually begin with is why is this important. it's very personal. it's important because life matters. that's why this is important. i tried to explain to the young airman, their families are

actually concerned about them. their families can trust the military with their health and welfare. and we are up to that challenge. but we are also concerned about the health and well being. so i have to tell you that life does matter, and it matters every single day. scheuer i could go through a litany of things that the united states air force does, and kind of the program piece of this. i don't think that's what you want to hear, quite frankly. i think what you want it is what's going on in the field. that's kind of the perspective i think we offer most. what's going on in the field? yes, certainly our suicide program that we have, our comprehensive airman fitness, that culture of take care of yourself and take care of others is relevant out there today, but what's happening in the field is, are things like this.

things like what i framed as the art of communication. communicating with people, not so much digitally, because people do that. that's kind of our culture today, but more so this analog communication. i think that is a piece, if we focused on how we do that, and how people tee mccabe with each other, it certainly will resonate with our airman and resonate with the topic we're talking about today. another area of focus, i believe that comes up quite often is this idea of, there's a lot of hope out there. and we know that. you know our airmen know that. their families know that. but quite frankly a lot of times they just don't take, they don't take that, they take it for granted. they don't necessarily go down

that path. for some they are concerned in effect their career, and and that's pretty prevalent out in the field. and you try to talk with the young person about that, and it's difficult. it is difficult because you've got to explain to them that there is, there are times when we do have, you know, look at what we call prp, maybe take the person off the rolls for a little bit while they are in recovery. but the fact is we still have been in our roles. and that's difficult to explain to some people, that that's the reason we have to do that. but bottom line is, life matters. each and every one of them matters, and we are concerned about how the situation is rolled out today, and then also about their families. i look forward to the questions that you have. i think that's probably the most important part of this, because

it helps us take back what we do in each one of our services. >> thank you, chief. [applause] >> next, michael leavitt. >> thank you, sir. good morning, everyone. i think, this is awesome have a 100 talk about this very complex elements that lead to these types of things that actually lead to suicide. in 2010, the commandant and i, admiral papp, we assume the duties in the coast guard and we had a rise in suicides, and you say, we talk about a personal that committed suicide. doesn't sound like a lot but it's about the same as dod, the number of we have. that is eight too many. so we took a look at that, and recognized that at the core of this week really believed that leadership, leadership at all levels of the corpus. we came out with a message.

and with all hands. in the message to talk about how devastating these types of things are to our family members and to our units. it is no different, suicide is no different than an operational mishap. it has devastating consequences. in our message we talked about this but we also talked about having an engaged and involved leadership at all levels on and off duty. talked about some of the programs we have in place and all the services have certain programs in place. some programs are probably better than others. some our online stuff and all the meat and social me things like that, i think some things get lost in the translation. those are things we've got to get a look at. but one of the things that we shamelessly scrolled from the needy and them in court as our operational -- navy and marine corps is our operational stress control. what this is is a guy. we piloted program out on the west coast. what is the unit commanders taking a look at their

operational stress they have been color-coded, taking a look at how their units are responding to so that his leadership and opportunity and element to look from a leadership perspective but also focuses down to the members to give them a self look at what these stresses are, how the stresses impact them both on and off duty. what i really like about the program is our coast guard men and women teach the program. so when they get this it is train the trainer and they're getting it from the shipmates who have been through same type of experiences. we had eight and 2010, and we slowly have been declining ever you. this year we have to. that is to too many as i said. but maybe, and 2010 when the things we started keeping track of is how often our folks hospitalized for suicidal ideation. we thought we should keep track of that to find out are people going to seek help, are they doing this kind of things but i noticed in 2010, looking at the

data it may not mean a lot but there's a trend that looks like we're to folks going to for suicide ideations. 2012 we have had 17. who have an uptick in the. people seeking help, trying to get those things. i think that's what our job is. so i the end of a we can take a look at all of our programs, we can do all these different things, we can throw a lot of money. is a very complex the issues and it's all about the people, about caring for our people, about engaging at all levels. all different age groups. so thank you for your time. i look forward to any questions you may have. [applause] >> thank you, master chief. next, chief master sergeant haul. >> good morning. there we go. over the past couple of days i have been deeply moved by the collaboration and the synergy in this room. many people and organizations coming together, working

together, united in purpose. i have been deeply moved by your good work here. yes, we, too, and the national guard have challenge was suicide. we continue to employ leadership practices at every level from the top down and bottom up. as you know, the national guard is in every state, territory and the district of columbia, and every zip code across america. the national guard comprises our citizen soldiers and airmen. we are a community-based organization. we were, live and play in our local communities across the united states, and our part-time warriors are the businessmen in the business women in the cities and towns across america. and they fully understand the importance of developing strong community partnerships. the rear admiral yesterday spoke about building bridges of trust. i was really moved by his

presentation and it really struck me. i gave a lot of thought. this is something that the national guard has been doing for, well, quite frankly for 375 years. as health care experts, our directors of psychological help at the headquarters have built trust within our organization. we have bridges of trust between self and peers, or soldier to soldier and airmen to airmen. this comes some working side-by-side for years, and in many cases for decades. in addition to exercising all the leadership principles and tools within copperheads soldier and airmen fitness, an area of high importance is building bridges of trust with institutions, our partners throughout the country. we have made significant strides in reaching out to local communities to for partnerships to assist our soldiers, airmen,

families and veterans. for example, maryland, they have partners in care. arizona's national guard total force team mvp resilient program. new jersey's debt to debt helpline, the very first of its kind. and the oregon national guard resiliency risk reduction in suicide prevention program, or are three s. p. more recently, the national guard bureau has been engage with joining community forces. the primary goal is to leverage and promote existing state best practices and build community capacity. it focuses on the efforts of local partners to strengthen veterans, family members, and families through wellness, employment and education opportunities. joining community forces is primarily a communications and collaborative initiative,

providing a platform for exchanging good ideas, resources, reference, and guidance. it's sort of a conduit at the national level service providers to volunteer their services to the faith community forces at the state level. government, nongovernment and nonprofit and corporate partners. i commend you on your good work that you have done so far, and chief roy said, with much to do, and that is too. and i challenge you to be aggressive in your pursuit of crossing community lines to effectively collaborate and communicate. together, we will succeed in our effort to develop a culture of a warrior mindset of a zero-tolerance suicide. i thank you for this opportunity and look forward to your questions. thank you. [applause] >> thank you chief. our next speaker, command

sergeant major donna brac. >> how is everyone doing? my goodness okay. at least i see of you army folks in your sign know you guys can lease get right. let me hear you? all right, thank you very much. first of all, i do apologize that i've not been here throughout the so congress. i wasn't able to attend this year. i want to make sure that i didn't next year, it is another conference. i've been hearing there's been a lot of good information sharing going on, and i really do hope that you all receive something from this. i'm sure that you have. i want to thank each and everyone of you for being here. on behalf of the sergeant major of the army, i'm representing him today. so he's a little bit taller than me but we had a sergeant major graduation going on today and, of course, we have 500 plus

brand-new the nine sergeant major's going out the army world and he wanted to make sure that he gave up his message. some going to speak for him today. after 10 years of war, the army has experience the second highest year of suicide in 2011, slighted him from the wreckage are we had in 2010. the indicators of high-risk behavior such as drug use, suicide attempts and an accidental overdose continue to be a challenge. however, the dramatic increases in suicide the army has experienced between 2006-2009 have been slowed unfortunately we have seen a spike in the last six months. so in other words, as chief roy said, we definitely still have a lot of work to do. as a sidebar, it saddens my heart, just yesterday had a note of a young enlisted soldier, e-mail, that committed suicide. and i tell you, and it happened

to be in the army medical department and it really, really touched my heart because there was no reason that we know of why she did it. so the work that you do here is very important. we've got to continue to work very hard at this problem that we have. the army continues to institute a multidisciplinary holistic approach to health promotion, risk reduction in suicide prevention. that it comes with many challenges our soldiers, families and army civilian space. we have a composition of various working groups on the army staff down to the installation staff that reflected this approach. and it includes a monthly suicide senior review group, which actually happens in the pentagon. they take each and every suicide that happened in our ranks, and they just feel -- they just peel back the onion and tried to figure out what we could have done, or what happened.

also, we have the headquarters at dh help promotion and risk reduction council and the many installation community health promotion council. the key elements of the army approach are ensuring that soldiers have prompt access to the best quality, behavioral health care, increased screening and documentation of mild traumatic brain injuries and approved a leader a witness of high-risk behavior. collaboration and cooperation among the leaders, the medical community and the chaplain cannot be over emphasized. now, in behavioral health the army has increased its capacity by 18% per year for the past four years. during this same timeframe, the army increase its behavioral health workforce in the army medical command by 101%. the army substance abuse program increase its counselors by 57% in one year by adding 183

counselors in 2011. we also have a program strong bond, relationship improvement retreats, and it included almost 98,000 soldiers and family members in 2011. and that includes all our disciplines from active army, reserve and national guard. in response to the increase in suicide and stress on the force, the army has improved its health and promotion program to include availability to behavioral health care, implementing a campaign to improve appropriate use of narcotic pain medication and reduced medication adverse effects, expanded family support programs, and implemented and in theater mild traumatic brain injury screening. it's also worked on decreasing risk a behavior by initiating army suicide prevention and substance abuse training at the battalion and brigade courses to

expand a leader understanding. and improved communication between law enforcement and the units during the investigation, and we also launched my prime, which is an online alcohol and substance abuse risk assessment tool that provides a substance abuse risk assessment and targeted education. the improved suicide prevention efforts that the army has invested in our and aggressive campaign launched to expand the acronym base, which stands for ask care and escort. suicide prevention training settlement of effective training program known as applied suicide intervention skills training, which is a cyst. we have released a new shoulder to shoulder suicide prevention training video. with collaborate with the military crisis line with a view to develop the army campaign theme and promote the use of free confidential service. we ventured soldiers subject to

investigative or legal actions are monitored for indicators of high-risk behavior or self harm, and although not specifically part of the suicide prevention program, in 2008 the army established company to soldier fitness program which is geared to bolster the strength of soldiers and their families by improving their resilience in certain important areas such as emotional, social physical. and which all have proven effective for our soldiers. through all these efforts and many more, to include research effort, we seek to discover why some of our soldiers are more greatly impacted by this source of ptsd and tbi while others are not. and why some exhibit suicidal thoughts or behaviors, and others do not. within the army, leaders, medical providers, scientific and we're all working together to understand suicide so we can better prevent its devastating

effects on soldiers families and units. now, together we're working and we're trying to remain army stronger connectivity, we are army strong. i look at this audience and i could tell, the ideas, i can tell you we are dod strong. thank you, and i look forward to your questions. [applause] >> thank you sergeant major. our next speaker, sergeant major john gilstrap. >> good morning, ladies and jim. it's my honor to represent sergeant major marine corps. deeply regret he cannot attend this event, but this week while out prepared for this pair he asked me if i could relate some of his thoughts and sentiments and i will do that first. he said the continued physical moral and mental health of all our marines it on the top of my list. our young men and women have performed magnificently. on and off the battlefields, around the globe, for over a decade without cause.

there's nothing more important to the commandant and me and continue to care for and the marines to carry the burden of defending our livers. it is the price of always been faithful, a price we will gladly pay. we have expended considerable efforts and building capacity to care for our marines and their families can and will continue to do more. we will continue to extend every effort to heal our wounded, support our families and help our young marines and sailors increase resilience. conflicted marines will always know that they're part of the core that understands the issues, and stands behind them. some major michael barrett, marine corps. when a marine died by suicide, the loss of life is felt across the core. we are dedicated to preventing this tragic loss of life. it hurts our families and hurt us. visual polish the first consolidated suicide prevention or, marine corps order 172020. disorder drugs unit commanders

to develop and sustain the units in suicide prevention program to a point in writing, a marine to assist the command and carrying out suicide prevention policy. unit programs must be comprehensive to be successful. programs that strengthen all marines and set a command climate to encourage marines to seek help, and proper referral for at risk marines. arena total fitness, a concept recently approved by the commandant, acknowledges the complexity of problems like suicide, traumatic brain injury, post-traumatic stress and sexual assault. our biggest opportunities in areas for improvement is getting marines to acknowledge problems, get help early before suicide is even an idea. earlier this year, the d. stress line counseling service originally filed in the western u.s. became available worldwide. while not a suicide hotline, these are capable of respond to

suicide crises. it's been focus is on solving problems early. when they are most manageable. when a marine calls or chats online, the veteran marine or numbering corpsmen will answer the call. the operational stress control and readiness program builds the unit which helps commanders build your strength, resilience and readiness. team members range from junior marines to senior marine leadership, into what we call extenders. those are our embedded navy, medical and religious ministries personnel. this is one our greatest assets. a sense of belonging, helps us whether the stress and creates a bond for shared experience. this year the commandant has ordered all the units were remain in tact 490 days after returning from deployment. few prevention efforts are successful 100% of the times we need a safety net. our safety net is the

award-winning never leave a marine behind suicide prevention training program. this train prepares the needs to recognize suicide warning signs to ask difficult questions like, are you thinking of killing yourself? to care for fellow marines in distress and to escort marines to help. ladies and gentlemen, never leave a marine behind is not just a slogan or a title. it is the bedrock that stretches back over 200 years. we will never leave a marine behind on the battlefield and we won't do it at home either. take you. semper fidelis. [applause] >> thank you sergeant major. and our next speaker, master chief terry prince. >> i hope this thing is on a. i get the pleasure of going last so your starbucks has certainly worn off by this point. plus have the added pleasure of my wife who is a behavioral health specialist and is look out for the health and well being of marines and sailors and their families at camp lejeune, and she's a licensed family

therapist to my left so you can imagine what nights are like in our household. [laughter] there you go. i gave your plug. thank you. good morning, everybody. on behalf of the navy, request, i'm proud to represent the united states navy this morning at the suicide prevention conference. no sailor stands alone. once a loss to suicide is one too many. you must know the training navy is focusing its efforts on providing both leaders and sailors the tools they need to live life fully while reinforcing that life is worth living. as you know we are a very busy navy. with over 47,000 sailors deployed currently. we know that the reason for suicide in the navy are complex, and as leaders and shipmates when you to be aware that non-relationship issues, career

stressors, legal and discipline concerns, financial and health problems are the leading factors. our efforts all lead to building lives worth living. we work to give navy personnel that support network, health care and skills to get through trying times to go on and thrive in the critters and our lives. we're also building a culture where leaders recognize that getting timely support for sailors and their families are keys to ensuring readiness. the navy recognize suicide prevention as an all hands effort. yet not only utilizing our program but your signs and expertise. we have discussed the aftercare treat model. our brothers and sisters of the united states marine corps as you are, united states navy corpsman survive alongside marines, answering the call. so our sailors have the benefit of two different services and their programs. the operational stress control

also used by the coast guard, covered that earlier. [laughter] our continuum of training, our life is worth living but not every major website that says click here for a lifeline, fleet and family support centers, our military one source program, our outstanding chaplain corps and all the programs with family readiness programs that they run. certainly the medical professionals that make me the medicine, the chain of command, the young group of sailors called the coalition of sailors against destructive decisions has done some phenomenal things to get to the root of this problem. here helping. certainly the national helpline and most important, a shipmate. we know these efforts may never fully tell us how many lives are saved, but we do know that we have had an impact. and what the impact means is a tragic loss of life avoided. sailors are getting the message.

they recognize the commitment that has been demonstrated by the navy and its leaders to develop and use multiple programs that will help them better navigate life's obstacles. and we always remember, no sailor stands alone. thank you. [applause] >> thank you master chief. again, let's give another applause to the entire panel. [applause] all right. we have a few minutes for q&a, and i see four microphones in front of me right here. so please, make your way to one of the microphones and let's get the show started. let's give them some tough questions. go ahead please. >> hi. my question is for all of you. and it is, how do we have this conversation? how do we talk about mental

health, ptsd, suicide prevention in a way that is authentic but solution oriented at the same time? so we talked about policies and the programs and research and the proper implementation of all those that have improved and will continue to improve with the people in this room. but as we've heard this week this is a leadership issue, and it is a human problem. so, having this conversation internally and events like this, and within families, within units, and externally in the larger community, so the national narrative and dialogue is responsible, is going to be really important. and, of course, i had just a couple things i want to add before i give it up do you guys. i think first of all we have to recognize that they suck it up and drive on attitude is necessary in a lot of ways. it's what's got me through 11 years of being an army wife and lots of deployments. so how do we have that part of

our culture, and also foster the health seeking behavior and the anti-stigma campaigns that we have? in order to build those, the bridges of trust that you guys talked about, we have to recognize that there's been, for this generation of military families. we have to do that before we jump into resiliency and skill building. there has to be a recognition that okay, you guys have had a tough, we recognize that, we will give you some skills on how to deal with the trauma. and then we're going to jump into teaching you have to be more resilient because honestly if we don't articulate that right, it doesn't really come off so hot. it just kind of makes us feel like well, yeah, we're just going making us all stronger, and that needs to be recognized. the new normal that we talk about probably we should call it our new reality. because there's nothing normal about 11 years of war. we have to be careful we call

things, so if i'm calling that normal and i can't attain it, that means i him week. i think we have to be careful of that. and, finally, if there's a silver lining to 10 years of war, it's that we're having this conversation out loud in a military for the first time. and we have the opportunity to lead the way in the larger community, how we have was country and with prosthetics -- how we have that with prosthetics. that was a lot of comment, sorry about that. >> thank you. thank you both for the questions and comments. i if we with most of what you said, and i will start off by saying that that's the reason we have conferences like this and talk about this in open, taking both what i'll call the art of coming you know, the art of leadership, the art of this piece, and then merging that with the science these as well.

to say that this is a science project or this is a leadership project, i don't think that's true. i think it's got to be a combination of both. you know, certainly leadership were to throw down into this, you know, it's like any other thing we drill down to. balance base we get from our experts. the experts are sitting in this room. so, although i agree with the fact that the science peace, it is being a leadership problem, i think it's all of our problem. it's not one individual entity. it's all of our problem. you had mentioned the resiliency and the stigma and some of the things. led me, this is the way that i would frame it. i believe that in order for somebody to deal with a situation, they've got to have the tools to do that. what i see, as i talk with amn,

here's what i find. some of them just do not have the tools. they haven't grown up the same way i did maybe in my generation, not to say i had all the tools. but when we think in terms of being able to just surely communicate with each other, that simple fact, all these things that were listed up there today, when you talk in terms of simple communication, and the fact that we, and i mentioned this earlier, the fact that we are digital natives today, not everything can be digital. you still have got to go back to the analog leadership and you got to go back to the analog communication. you've got to go ask somebody, are you doing okay, and mean it. you've got to get in their face. there's one young airmen told me a few years ago, you've got to get in their chili, cheese. [laughter] i thought about that for a minute, but the point was --

[laughter] the point is, you've got to get in front of them. you've got to get in front of them. you got to a one on one with him. so i take your point about that but i would also say that resiliency is one of the things that it's crucial to attacking this problem. and i'll call it is a dash the i'll call it a problem that it is a problem. if the people do not have the skills to work to these situations, then they simply won't. one of the things we started, i'll study, that essay does a lot, is this idea of initial resiliency training. we do this, not in basic training although we give them the label of it, but we do this after they get to the first duty station. in other words, sitting down and walking them through, how do you communicate with each other, how do you have a relationship with each other. if you don't, how do you break up with somebody?

not all of us have that skill. we've got to work with folks like that. i take your points, and i think it's a combination of both the art and the science have to work together. >> great question. real long question. there was a couple that come to my mind. whether my shipmates dana mentioned about our programs. we call respecting our shipmates. underneath that respect we have to take a look at all our programs, the hazing to what's going on with regards to that, sexual so, what's going on with regards to that, discrimination. and we have to take a look at programs we have to get to our folks when you first come out of recruit training. recalled individual development plans. i know there are mixed feelings. we been doing this.

i'm not sure of all the other services do it, but one thing, that's an opportunity for us to get down at the lower leadership levels of mid-leadership levels to the top and talk all a bit about those finances, talk about some of these elements that could lead to these types of things. because at the end of the day, you want people to have successful careers. i told you about the operational stress control. one of the key things about this, we did theater it to the coast guard because we are a little different, 11 of them, is that we have people that have gone through these types of things at all different grade levels but we have master chiefs of their teaching us and say do know what, it is okay, these are things i had to do and you can see i was a successful in the things i had to do, but i need help at a certain point in my career. i didn't understand what was happening to me. when these young people see that and hit on people that are very successful, they start earning the trust. we will seek that out.

so it's going to take time because trust is earned. it will take a lot of time. so i will pass it on down. >> okay. great questions there. thank you. not to be repetitive, you asked a question and going to kind of focus my comments on the first question of how do we have those conversations? and it believe that we are having those conversations, and we have been having them for some time. certainly much work to be done yet. they are happening at all levels but now obviously as a component of nine states army, united states air force, we do think different than the national guard with some things. and the things i wanted to talk about was in the army national guard we have what we call recruit sustained program. program. as soon as they enter the army national guard we have been in this program before they go to basic training. where we are having this conversations, these are young men and women right off the street, right out of high school. and they may not have gotten

some of those resiliency skills through parenting at home. so we're having those conversations one on one with them. and the same for our airmen, same concept. as soon as they enter the air national guard we have them and students flight in which asian and various things, that one of them is how to be a resilient airmen. both army and air, we're doing, we are having a very serious and harsh conversations because quite frankly, they have probably not have those at home in many cases. so we need to do that as their leaders, as their leadership at all level. so they may have been instructed that teaches them until they go to basic training in the two programs but then we also have various levels of leadership that rolls through the program, and have conversations with them as well. and that's important it's important to start right there. for us it's free, you know, basic training and they when they go to basic training they did it again. and all the way through until you reach a level like this.

so those conversations are happening. we have many tools, many resources out there. quite frankly i think that they're probably enough resources we need to fund and keep those a very good programs that are working for us. when you to focus our energies on those programs and make sure that we have those available for our people. 10 years, you bet. you bet. 10 years. almost 11. optimal, primeau. start all over again. that's the rhythm. that's been the battle rhythm for every service across. so now as we come out iraq, coming out of afghanistan, that operation tempo were reduced somewhat. we will keep going, so that focused in gears and leadership, striking to the heart and having those conversations one on one, eyeball to eyeball, at the lowest level, to the highest level, is important to and where

going to continue to to have our leaders focusing in those areas and engaged all through its members. and our families, because quite frankly, they are our first line of defense women come home from the battlefield. they are our first line of defense. and to take a step further for national guard soldiers and airmen that are part-time, they are employed in each energies. we need to get to our employers as well because they need to be our battle buddy and our wing man in the civilian sector as well. they need to understand what to look for, the signs, symptoms and how to ask those tough questions. so we have initiatives working with our employers as well. i think that's a very important part as well. thank you. >> since i see folks lining up at the microphone i'm going to keep it real short. real quick, just add to the conversation, he said something about having the conversation, how do we do that, second up and drive on. so suck it up and drive on, there's a limit to everything.

i'm going to tell you, the sergeant major of the army, he is talking to us as army and telling us we need to go back to basics. when he talks about that he talks about getting back into knowing your troops. knowing your people, caring about them, letting them know that they are important. it's very simple, and we have kind of gotten away from that a little bit because of the 10 years f war and the height of temple. so getting back to basics, knowing of people, not they know their limitations. so the suck up and drive, you're right, some people can do that. then others can't. so you have to know your folks. having the conversation, got to be able to get in the face, got to be will have the conversation but it's just like today, the message i got yesterday about a soldier committing suicide. you know, those examples is will what we go back to work organization and talk about. it's not the best kept secret.

it's not a secret. we have to talk about those things and let folks really kind of think about what happened there. so that's just my comments on that, just to add. >> i'll keep this short, really quick. i think i'll answer is yours a little more leadership and the stigma side. we are getting this from the leadership, from the top of the the, that from the marine corps himself when he tells marines it's okay to not be okay, to break that particular stigma. the way we're breaking the stigma is through education, and continued teach marines about stress, how to deal with stress but i think more importantly having that leadership. it's one thing to just walk up and ask a person how are you doing today, but it is what difficult and i'm sure most of you will agree the difficulties of that is to look another person in the eye and literally ask them, are you thinking of killing yourself. for getting that message out and

communicating, i'm going to leave it at that. that's what we are without. >> back to me. so i will have to say something. most of it has already been covered. an excellent question at a lot of things that i could go in different directions but i think the key is, it's been said again and again, it's more leadership and fellow sailors to understand and know the people. as a chief petty officer of the united states navy who grew up in a world where we are taught to in every signature in my charge book, take care of your troops can take care of your troops, take care of your troops. that means knowing them. in my world having experienced suicide as a leader in the united states navy, and i was every case, the post part where the interview, people did see signs but they knew the person was having financial trouble. they were showing up late for work. intrusive leadership. they ride on peoples if i you wishing to be used to be a term that was taken the wrongway. it means they need those leaders

to get in there like mom and dad. our young men and women in the united states navy represent the best that this country has to offer. the best 1% that are able to join the service. but many of them don't calm from your typical mom and dad home. therefore, their first experiences with their recruiter followed by the recruit division commanders who serve as the moms and dads. so boot camp often the problems are not identified as easily because they are in an environment that is controlled. and it's typically occurring at the schools when the freedom part comes. that's what he sees that program i mention comes in and the 10 other phenomenal programs because we know that we put a web of programs together. that along with that intrusive leadership, with those chiefs and those leaders are getting in there and getting in the face and saying let me see your budget, let me see, did you talk him out of debt today. when is the last time you took vacation? the things we don't often think about because we are at war for 11 years.

but all those are key factors of getting to that problem. and every case is different. >> thank you panel. i'm going to apologize to those folks who were waiting to ask more questions. let's hold off right now just for a second on the q&a because i still have another portion of that needs to be added to the panels up here. i'm bringing another senior enlisted advisor to the panel. and it is my great privilege and pleasure to bring up your the senior enlisted advisor to the chairman of the joint chiefs of staff, and the senior noncommissioned officer in the u.s. armed forces, united states marine corps sergeant major bryan battaglia. please. [applause]

>> well, good morning, everyone. again, i apologize for the lack of time, the time ran out as question. we will make these panels available after the fact if you wish to come up and address your questions at a time as well. so before we wrap this up i think it's a great place to yet again throughout a much deserved thanks to the va, dod, eco-team and all supporting elements and sponsor and making this conference really a reality. so thank you again, ladies and gentlemen for all of their efforts. okay, you can see this is a slight twist to a normal panel format, but hey, there's not a whole lot of normalcy of you anyway so it fits in nicely with our scheme of maneuver ugly. what i'm hoping to do here, i speaking on the heels of both the service's comments and the q&a is one, now that you have heard on both monday and this morning the services programs and their prevention, intervention and postconvention efforts, i'm going to wrap up

some things with an overarching perspective if you will, from the armed forces standpoint, and then share some thoughts and clarify a few things that i have picked up along the way, especially during the course of this conference as well. so, my thoughts and occupations are not meant to be critical, and we are all big boys and girls and must have some thick skin, but i want to be sure that we help shape and prevent any administrator or strategic fratricide in her efforts, and a continued efforts to reduce suicide in our military. and i'm going to start by poking myself in the chest so jennifer, if you be so kind to play that video. >> over the years and specifically fisher, suicide within our ranks and across the

total force are savvy onerous. as an ongoing effort in the reduction of suicide across our force one of my priorities is persistent and continued implementation of our resiliency programs that are targeted to the service member, family, unit and organization. working in concert with a senior enlisted advisor of the army, marines, navy, air force, coast guard and national guard we are confident that our first resiliency programs effectively guide us in methods to overcome adversity and sustained optimal performance. from private to general, we shoulder an obligation to look and listen for signs. we stand ready to intervene and assist our fellow service member or battle buddy in time of me. let's turn this around and reduce suicide in our armed forces. i'd like to project three key points and want you to remember the acronym now. no problem is too big that would drive one to use suicide as a prevention. we will find a better way and we can do it together.

outreach for help is literally a fingertip away. what is pushing a button on the telephone, knocking on the chaplain store or texting your team leader, help is readily available. and lastly, we care. we clearly recognize that this news of this professional organization, you have committed to our country and we are committed to you. now is the time. stay fit, stay strong, stay resilient. >> so ladies and gentlemen, maybe some of you have seen this before, and if you have my apologies are yet begin putting you through more agony. but i show you this because of that message and acronym now. its resident very positive around the force, but a few have come back. and new, we are afraid that there's a portion of this acronym that is not being used to its fullest extent. while the o for outreach us to work in order for us to get on the left side of once decision cycle, when your comments like i

tried to get help but waited for six hours in the waiting room, or my first sergeant tommy to stop wasting his time, and if i'm going to do it, do it right, that means that the o is simply ineffective and not working. it causes the entire process to break down and raise the risk for potential for injury and sadly death. so as chief roy other two, we do have work to do. it's not only educating our force or where to go and what to do, if they feel bad, but rather continue to educate our leaders. more importantly like in the case of the first sergeant, holding those leaders accountable who take their leadership responsibility's and such a callous and unprofessional and irresponsible manner. he's probably the exception rather than the rule. nevertheless let me say that it is pretty easy to pick up on the heavy load of medical expertise within the course of this conference. but i hope you agree that it's going to take, both art and

science to reduce suicides to maintain readiness, resiliency and wellness across our forces. so i feel that our resiliency programs that are services have, which are designed to provide a lot of the art, line leader engagement, offer the necessary ingredients to a daily menu. in which our service members or units, or even families, build and sustain toughness and ability overcome adversity and maintain some degree of optimal performance. as you know, there's no magic one size fits all balance. we are all different. some need more than others, and is going to take participation from both the science and the art. in our military cradle-to-grave lifecycle, one just simply doesn't work without the other. jennifer, could i have that pinwheel, please? i cochampion some of you may know the total force fitness

program. this wheel is somewhat sore to what the programs are. as some of you may have seen this, it's what we use in the armed forces as a guide, and hopefully will become part of our normal culture, to maintain that very resiliency and readiness throughout the force. as you have heard earlier, our services manage similar resiliency programs using this as the overarching model or template. they use all or some of those domains, the eight domains that you see listed around this wheel effective. we don't have enough time to deep dive into the inner workings of the total force fitness, but let me say i'm confident that when our servicemembers and units and families, and veterans to fully emerge into a culture and the behavior of a total force fitness lifestyle, we will certainly and definitely see reductions in suicide, divorce, crime, quicker recovery from injury, more use of compliment and alternative methods of wellness, and more.

i belong to total force fitness because they use but after my times overseas i did not unfit i was, or how fit i could be until i digested this holistic design of resiliency. i and others who joined on the stage here are no different than the average garden-variety servicemember. so if it works with him like a i know it can work for the force. let me bring up another topic and talk to you in reference to a few things that i've heard during the course of this conference. and things that may not just pass the sniff test. it's important, ladies and gym again our efforts here are so wide that within many involved entities that it takes to bring the solutions together, we remain and synced as we possibly can. since we are sitting below the national average, we as a military are not doing that bad in our quest to reduce suicide. that's been a quotation that i

heard, and we simply can't afford that kind of thinking. and i beg to differ with that analogy, in any leaders that would have involved in this process who had used such a metric and it positive measuring stick is really off keel. i really enjoyed the opportunity to talk to anyone who thinks that this way to try to convince you otherwise, because we shouldn't use the national average is that any sort of measuring stick that our program is in anyway a success. a failed suicide attempt is a success story. yes and no. yes, of course because the attempt was, in fact, unsuccessful. and we still have that individual with us alive and breathing, another chance to get him or her immediate help. but no, because in reality we were too late. the decision, the act had already been executed. and for me personally as a

leader, i failed. by the grace of god or some other factor, i have been given hypothetically speaking, i've been given a second chance. simply put, i was too late. so we should really learn from that, and not only advice we use this, any sort of accolade to say that an attempt was, in fact, a success. back to the basics. you've heard that several timeshare this moment, and i'm sure you've heard that around the force. i know i have. i like it because it's a very catchy phrase. i have even used it myself. and i knew what i meant when i said, but you take it a step further that's not how it was necessarily receive. short answer, coming back to me, sergeant major, whose basics, yours? because i don't know what those are. i wasn't around during your basics. some of you, my agent beyond concern and relate to that. so when we use a term like back to the basics, let's just be

sure that we clearly define what basics we exactly me. so we don't just complicate matters. you heard on monday garrison leadership, or leadership in a garrison environment. that's going to be extremely important. this is the environment where most of the basics that we are all referring to would be applied to basics that can mean something different, recede, then projected. so i just been to your attention that words mean something, and people tend to take a path of its own when not clearly defined. what basics are we really stating with regard to suicide reduction? and i think we've touched on those pretty effectively. zero-tolerance. i think nice of you, you had mentioned that zero-tolerance. and serving up to poke at her, but here's a term that is been used even during the course of this conference through day one. and while i think we may understand the context of how it

was meant for the specifics of this particular conference, i believe that when one says or here's zero-tolerance, others tend to associate it automatically with suicide or some sort of crime, or in a similar matter with other zero-tolerance things that we had in our department, such as illegal drugs and sexual assault. those by far, no question about it, our zero-tolerance. and i'd like to suggest, for the sake of adding any further complexity to an already difficult problem we have, maybe we leave the label of zero-tolerance so it brings no confusion to things that are those heinous you see m.j. violations. lastly, let me touch on the va. you may have read. a, i will reconfirm for your first and that the relationship between our armed forces and veterans administration has never been better. in addition, i mean, i really

see it only growing stronger. the va and as critical linkage for continuity, not his life of medical benefit standpoint, sure, that's important but from acute and long-term care but i think it's larger than that. ucd community of military life that again the niece of such an early. and a feeling of remaining attached, and a sense of continuing to be long shouldn't stop at separation or retirement. when a service member leaves its military service. it's a point in one's groomer actual ownership of the service now transferred to the veterans administration but having the va and its centers and outreach clinics in cities and towns play a significant role in this connection to remember, the feeling of staying connected, not alienation. what really opened my eyes to this observation was veterans, sitting in the va pharmacies, not keen to this mail order pharmacy thing that we have been promoting.

and necessary in order to provide some efficiencies and savings of money. but just happy and content with the traditional brick-and-mortar system of acquiring one's medicine. and that's the forcing function which brought them to the hospital where other veterans hang out. for many, the waiting time was irrelevant and moved. male borders got to continue but let's not sell short the old waiting room process. again, back to the basic. consulting is branch off from the particulars over suicide conference have a positive impact in suicide reduction, you bet it does. so let me close out by saying we are definitely beating down statement. we will stay after it. it may not be as fast as we would like, ladies and gentlemen, but it has momentum and we will continue to chip away at it. you are a very intellectual group of folks out here who want no more than to make a difference. and within the confines of this conference, and in concert with our international partners, i'm

confident, and i think i share this with my colleagues appear, that we will develop some additional ideas, answers and course of action to the reduction of suicide within our formations. thanks to each of you and everyone for your stamina and long-standing commitment to our men and women. let me turn it back over. [applause] ..

>> that is why i am here; for duty, honor, country. [applause] my father was not a patriot. he was a bear. [laughter] in 1985 a group that called themselves the monsters of midway handily defeated the patriots of new england in super bowl xx. this group were more than just football players to the city of chicago. fans gravitated to their hollywood charisma, brute courage and team camaraderie. they epitomized manhood. every man wanted to smoke cigars like ditka, dodge tacklers like

walter and rally teammates like sing tear -- single tear. much like our servicemen and women, they embodied themes larger than themselves and protected strength even during times of weakness. i would like to share with you some experiences from my childhood. for those of you that have ever been in a football locker room, you may have insight into my early years, because my upbringing was filled with nfl-isms. for instance, when i was running late to church, he would say urgency, son, urgency. [laughter] when i received a poor grade in school, son, you're only as good as your last play. right now you're not very good. [laughter] and, of course, when i disobeyed him. son, do you want to be a part of this team? [laughter]

that was my father. a man that thought winning was the only option. his mentality to win served him well on the field, but off the field i'm not certain. his persona of perfection added a heavy burden, for a truth of life is that losing is a part of it. in time we all lose something; our youth, our money, our loved ones. i wish my father knew that off the field there is no scoreboard, that wins and losses come and go, but despite the day there is always hope. hope is a small word with a large meaning, for when hope is lost, all is lost. february 17, 2011, was the day my father lost hope. in a suicide note that he left for my family, he expressed regrets, apologies and love. also he wrote of his suspicion of a brain disease and listed

his symptoms. blurred vision, short-term memory loss, mood swings and depression. his final plea was to, please, give his brain to the nfl brain bank. despite my frustration, i followed the general's ordered and donated his brain to boston university. prior to this note my father did not share with my family his symptoms, nor did he tell us that he was depressed. you see, he hid his feelings, thoughts and words by projecting a persona of strength. i wish my father knew that in order to be strong, you must first be weak. in order to be fixed, you must first be broken. and in order to be found, you must first be lost. [applause] this past year for my family has been difficult.

it has been a year of healing and reflection. i have found comfort in the words of others, particularly one man whose family is no stranger to loss, robert f. kennedy. moments after the assassination of martin luther king jr., kennedy offered words of wisdom and love to a mourning nation by sharing his favorite poem which goes: even in our sleep pain which we cannot forget falls drop by drop upon the heart until in our own despair, against our will, comes wisdom through the awful grace of god. in times of despair, we search for an instant cure as if there is a magic wand, formula or secret. but the truth is recovery takes time. each of us has our own trajectory, a path that is filled with ups and downs leading us on a never ending

road towards perspective. for in loss there is no closure, only wisdom. we will never be what we were. and we must now focus on what we can be. over the course of my recovery, a major point of my healing came from the scientific findings of boston university that concluded my father, indeed, suffered from a brain disease linked to concussions. from the damaged areas of his brain, the neurologists were able to conclude that he suffered from short-term memory loss, inhibition, impresumption controls and loss of other executive functions. these findings answered many of my family's personal questions. but with suicide the question of what if is persistent. rather than succumb to what if, i am determined to help answer the question, what now. now i know we faced an enormous

and complex problem. suicide remains hidden in the shadows of stigma, myth and shame. the same people we wish to help will be our biggest obstacle. but in the depths of darkness, there are beacons of hope. suicide is preventable, and depression is treatable. if only those that are lost would seek guidance. for most refuse help because of fear, because of shame. in the battle with fear and shame, i believe the friend, sibling, son or daughter is the strongest ally for the depressed, and hope is the best weapon. wherever we reach out to our fellow man during their moments of despair, we send forth ripples of hope. in time ripples of hope will cross other ripples of hope and build into a tidal wave of love. a tidal wave of love can sweep down the mightiest walls of

depression. that is our hope. we must never give up, and we must never give in to the dark hands of depression. my father's last message to me was negative thoughts lead to negative consequences. he then left me with his favorite biblical verse from my own battle with life, and i close by sharing it with you. but they that wait upon the lord shall renew their strength. they shall mount up with wings of eagles. they shall run and not be eerie, and -- weary, and they shall walk and not faint. isaiah 40:31. thank you. thank you very much. [applause]

[applause] >> thank you, tregg. i'm mike turner, i'm the vice president of bottom for mental health america. for those of you who don't know mental health america, we are the oldest network of commitment-based organizations focused on mental health and momental health issues in the united states. we're 103 years old this year, and we are founded by a gentleman named clifford beers who himself was involuntarily committed for two years and was so appalled at what he found in the asylum system that he dedicated the rest of his life publicly to end stigma associated with mental health conditions. tregg, this guy's great, you've got to get him involved nationally, so as of this morning he's our new national

spokesperson. he doesn't know that yet. [laughter] [applause] and we are proud and fortunate to have him, indeed. we have concern let me tell you just a bit about our mission very briefly. it's to advocate, educate and serve. we advocate on behalf of those living with a mental health condition broadly defined. we educate the american public about the harm and often mortal marm that stigma does in this country about mental health conditions each and every day. and we serve the american public through our 240 affiliates in 37 states. and we're proud of that mission. our symbol is the bell of hope. it sits in our lobby. in 1953 when they shut down the barbaric asylum system in this country, our ceo at the time was prescient enough to send out a national call to send us the chains and shackles that were used to restrain patients in asylums to the walls and had

been for so many years. and we had those chains and shackles melted down at a foundry in baltimore and forged into this 300-pound bell that sits in our lobby. and we ring it on special occasions because the message of that bell is end stigma, end it now. and this population, the people in this room, understand that stigma kills. especially in the u.s. military. and we have to address it every day. i want to read you some excerpts from our real live web site very briefly. these are, we have a real lives web site. it's, essentially, you can go on and talk about what is on your mind. there's different categories, and i went into the section on suicide and suicide ideation. so these were people who actually attempted suicide. from a forgotten dad in washington, first and foremost, i am a survivor. i've had difficult times with relationships. i keep everyone at a distance. even those who i know i can trust. trust is a big issue. i can count the number of people i trust on one hand, and even

with those people there are doubts of trust. by charlotte in kentucky, a woman who lost her son in a boating accident. doctors wrote me prescriptions for medications. i simply refused to take the medication for the first few years. after that i just could not remember to take them. i couldn't even remember to eat when i was hungry. i lost all interest in doing anything fun, so friends stopped coming by and eventually stopped calling. by karen in missouri who planned suicide but was saved by an intervention. i would like to ask one thing of anyone who reads this: please listen. that's it. listen. listen to your kids when they say they're sad, never underestimate the importance of the topic. remember that we are all unique individuals. what is important to you may not be important to them and vice versa. listen to your spouse, listen to your friends, listen to your kids' friends, listen to your coworkers. listen. if i didn't have anyone to listen to me, no one would have ever heard my voice again.

the theme that tregg and i settled on if this talk today is from anguish hope. certainly his dad bent the curve of awareness in the nfl of the seriousness of traumatic brain injury in that sport. he made a difference. there is hope because of his life and the things that he contributed to the sport and to his family. similarly, nha believes right now there is a unique opportunity in american history in our society and in our culture that is an extraordinarily hopeful opportunity. you can go into any community in this country right now in the most informal setting and use the term ptsd, and americans know what you're talking about. that is an amazing transformation in the awareness and the sensitivity and the reaccepttivity of the american public to mental health issues. we can't blow this opportunity. we can't miss this chance.

we can raise the bar forever in american society. mental health conditions are the number one most debilitating chronic condition in the world today, and the united states leads the rest of the world. we can really make a difference. we have a metaphor that we like to use called the wellness circle. treatment, recovery and wellness. the reason that's an important metaphor and a symbol we like to use because if you are in the green wellness section of that wellness circle, it is ludicrous for you to point across the circle at somebody in the blue treatment section with a finger of stigma because you are exactly one life's event away from being on the other side of the circle x. the really hopeful aspect of the circle is because it's a circle, if you ask the right person and seek out the right help, you can always find

the path back to wellness. the wellness circle, it's a powerful symbol we like to use. i'm a retired air force colonel. i worked at wounded warrior prompt before i came -- project before i came to nha, and it was clear to me with the breadth and depth of experience in this country i said, david, we have to be in this space. there's amazing white noise out in the civilian community across this country about mental health conditions and how to respond in an effective and efficient way. we're not effectively addressing that issue. and we've been trying for ten years as a country to do it. we have to figure out how to do this. and mental health america is uniquely positioned to do that, but there's so many players in the space so much white noise in the space, we cannot simply be yet another program and yet another effort and more noise that takes up more resources. we have to do this in a smart way. so we said let's have a conference, as everybody always does to start these kinds of

things. we had a one-day conference. we brought everybody together we could think of that had any stake in this game. we put 35 national experts in the room. the white house was represented, va was represented, dod was represented, the nypd peer assistance program was represented, new jersey had the vet to vet program there. larry fritz, one of the national acknowledged experts in peer coming was there. we started off with what we thought was an effective model to begin to bridge the gap between this dire need and now what we thought were enough raw resources after ten years of war to meet that need and the gap in between. but we said we don't have a hidden agenda at this conference, and we really meant it which was good because by lunchtime all 35 people at that conference had told us this is the dumbest idea we've ever heard, forget it. and so after lunch i talked to david, and i said, what are we going to do here? he said, let's start over.

so we started the afternoon with what we all agreed on, and we came to a consensus, and i'll share that with you in just a second. but after that conference i hit the road and traveled around the country, and we visited or talked on the or examined or studies what we -- studied what we thought were 11 very successful national programs addressing this issue. with an eye towards what are the best practices, and how can we bring our national network to bear in a community way. and the results of that year of travel have resulted in what we are now calling the bell of hope project which is going to be our signature project in the military community for as far forward as i can see. let me give you some conclusions, though, based on that analysis and based on some of the things we've seen at this conference. we believe there still remains a gap between the population's need and the service deliver, the services that are being delivered.

and what's interesting here is i personally think that the need is growing and the service, available services and resources are growing. so these circles on either end are getting bigger and bigger and bigger, and that's good news. except while they're getting bigger and bigger, the center point of those circles is moving further apart. there's a larger gap between our military community at the local level and our civilian community than i think i've ever seen in my lifetime. so the gap, the absolute gap between the edges of the circle is roughly the same after ten years of war. we have to bridge that gap. this piece in here is where we need the help. let me give you a couple stories to illustrate that gap. i was in charge of the caregiver conference, a team of three or four of us at wounded warrior project were fortunate enough to have the caregiver legislation in may of 2010 as our principal project that we spearheaded. and i put together a summit. we brought 18 caregivers with

severely disabled vets into washington. we had a session that was supposed to last for an hour and a half, and on one side were all the service representatives, the white house, va, dod, all the individual service representatives that were familiar with all the programs that were available for caregivers of severely disabled vets, and on the other side of the horseshoe were the 18 caregivers. and for an hour all of those government representatives talked about all the programs in place to help those caregivers, everything they'd done and all the progress they'd made to help those caregivers, and at the end of of the hour one of the caregivers raised their happened and said thank you very much. i'm sorry, i think i speak for all thecare givers in this room when i tell you we don't have a clue what you're talking about. [laughter] so for the next three hours, and some of the senior officials that were in that room canceled meetings, they talked about how can we begin to bridge this gap. second story happened last october. we took the bell on a mini tour, and one of the places we went was the indiana, the

indianapolis national guard armory. many of you may know that the va medical center's in indianapolis, and it has one of the top behavioral health care facilities there. the armory's about five miles up the highway around the beltway, and we had a slot for david and i to explain the bell of hope project to about 200 guard members and their families. and the slot was #k on a sunday -- 9:00 on a sunday morning. and i kind of leaned over to david and said, david, this could be a huge thud. this is probably a mandatory formation, it's 9:00 on a sunday morning, and there may be no engagement at all, so i don't want you to get your hopes up. so off we go. they kept us 45 minutes after the scheduled one hour talk, and let me give you some of the comments. the first person that stood up said, look, we know we have mental health issues. we're not ashamed to say that. we talk about it all the time. but what i really need help with is daycare because i can't find any, and i don't know where to turn to get daycare help.

one of the comments was you are the first civilian organization in ten years to talk to us about mental health. now, this illustrates the gap that we have to address in order to make practical reality the kinds of wonderful projects and programs that i've seen evidenced in the last three days at this conference. we feel very strongly the solution is not a top-down solution. i was in wounded warrior project, i went to a lot of congressional hearings. i don't know how anybody works in va. you guys are walking around with targets not just on your front and back, all over your body. you're just covered with targets. [laughter] and it's not right, and it's not fair because every person i've met in the va is dedicated, professional, world class. they're topnotch. i don't think -- [applause] thank you. thank yourselves. i don't believe that va and dod can or should be charged with the principal

responsibility of solving this problem. and we are losing this generation and the last generation of heroes from the military community because we're not yet solving this problem. we must bend this curve in a significant way, and we have to do it now. point in case. i went on the va web site last night. there are 22.7 -- as of 2010, there are 22.7 million vets in the united states. this is not dependents, this is vets. of them 8.3 million or 37% are enrolled in the va health care system. of the ones who are rolled in the va health care system, 47% avail themselves of outpatient care. if you combine those two numbers, that means that 17.39% of veterans are seeking va care. 17%. that number does not even begin to address the dependents and families that aren't eligible for care. i'm not sure of the current

regulations, it may have changed, but i'm pretty sure that the majority of people in that armory on that sunday morning in indianapolis were not allowed to use the best behavioral health care facility in the va five miles down the road. how do we solve that problem? their dependents couldn't use that facility. how do we solve that problem? i think it's incumbent upon the civilian community to stop simply putting yellow ribbons on their bumpers and actually stand up at the community level and start to solve this problem en masse. [applause] an interesting side note, 21% of the enrollees who were enrollees didn't know they were enrollees. that's an amazing statistic. but remember, if the va and everything that we've talked about over the last three days worked perfectly, you'd reach 17% of the affected veteran population and that, again, doesn't count dependents.

we think, another conclusion that we've reached over the last year and has been reinforced at this conference is that integrated care is the answer very early in the process. we think that the best way to respond with a suicide prevention protocol is not to respond effectively when suicide ideation is perceived within the chain of command or at the va hospital. it's when somebody calls up and says i need daycare on thursday so i can go to my job interview. do you know how i can get that? that's where we have to begin to address suicide prevention. only america's communities can solve this. and believe me, i've been out since 1997. america's communities are trying desperately to do exactly that. they just don't know how. and they're competing for ever-dwindling resources. let me tell you, i've been in the nonprofit community since

'97, and it's pretty bleak out there. so here are the conference findings that came out of that one-day conference in february 2011. peers work. four lessons. number one, peers work. did everybody remember undersecretary pets el's story, that very compelling story he told of the crisis intervention line and its success in the very first day? how many people heard carefully that that sequence started with a peer connection? it didn't start with a call directly to the line, it started with a peer connection. peers work. they need to be trained, they need to be certified to a national standard. we think we are -- i hope, i was going to get word sometime today but maybe not, we're hoping by next week we will have, hopefully, full funding from a foundation that asked us to design and implement the first national peer training and certification program. i know the va just issued an rfp for exactly that. we've talked with the va, and we've said if we build one as well in the civilian community

that's completely not attach today the va would you guys certify it, they said, absolutely, go for it. so that's what we're going to do. so peers work. number two, peers navigate. their principal function is to navigate at the community level. it isn't just about mental health and being a peer specialist for mental health. it's about navigating and answering every single need which means they need to know what the community has available in all the sectors of service. when that person calls and says i need daycare next thursday, the peer says, got it. i heard that, i listened, i'm going to go find you daycare, and i'm going to call you back, and we're going to continue to follow up until you get that daycare. number three, effective local community resource directory. the community blueprint is a terrific program that is trying to collaborate and create a blueprint for how you collaborate with community services. a very important function. we think that military family

members, military community members which is veterans and caregivers and dependents, it's a whole gamut, retired, active duty, they need to have access to an online resource directory at their community that really rates the services that are available. it tells them what insurance plans should they accept, how much is it going to cost, what's my point of contact, are you accepting new clients. i've had 25 people rate this three stars out of five. those functions have to exist at the local community level so there's an easy way for people in the military community to find what community resources are available. and last and it was touched on before we need a really aggressive outreach program. let me tell you a tragic story about outreach. colin bean took his life in 2007 in new jersey. he was pretty famous, the congressman from new jersey got a bill passed. i went and talked to linda bean before we started to do this for mha, and i said i want to make sure we don't duplicate effort

and basically don't just turn around in circles like a lot of us tend to do when we start these things off. and she really appreciated the visit. the next day i went to the university of medicine ministry's vet to vet program in new jersey, a ten minute car drive from coleman bean's front door. and they didn't know each other. that's the challenge, and it is only going to be solved by organizations that exist and have name recognition at the community level. so aggressive outreach. based on our conference findings on our examination of these 11 programs over the last 11 years, we believe that a solution should be based on four principles; peer navigation has to lie at the heart of it, we're absolutely convinced of that. peers can overcome stigma. the first line of defense. peers can overcome stigma. delivery of integrated services. you can't just be this sector or this sec sor. you have to say what do you need

and be able to answer that question at large. number three, measurable outcomes. i'm a stickler on this. if i can't measure it, it is not a success. you hear about a program in a community and somebody says -- and we get this all the time. oh, you know, people are already doing that. we already have that program going on. i ask three questions. one, how many clients have you helped? two, what are the long-term outcomes for that client of your assistance? three, what does your client feel about the help you provided? if you can't answer those three questions, you cannot claim success. so anything you do has to have a measurable outcome. and finally, and this is really important, local flexibility. it is not one size fits all. it's one size fits one. but there has to be some structure, some skeletal structure that will enable the butterflies to fly in formation. that's what we're trying to do. we want to get everybody moving in the same direction in a way where you can pour the unique community reso