you. >> this afternoon president biden will be visiting arlington national cemetery for a wreath-laying ceremony and will also give remarks at the memorial day observance ceremony. you can see live coverage on c-span starting at noon and also watch online at c-span.org or watch coverage on c-span now. our free video app. >> there are a lot of places to get political information, but only at c-span you get it straight from the source. no matter where you are from or where you stand on the issues, c-span is america's network. unfiltered, unbiased, word for word. if it happens here or here or anywhere that matters, america

is watching on c-span. powered by cable. >> joining us on this memorial day is frank larkin, the chair of warrior call. we will talk about those organizations in just a moment. thank you for joining us. guest: thank you. host: what is the troop first foundations? guest: it was an outreach established in the late to thousands to connect with our warriors overseas. it was a number of personalities, david fair eddie, number of other pga alumni who went forward into the iraq combat theater to interact with the troops and subsequently were so moved by that they came backd decided to establish a

foundation that would help outreach to those warriors who have served. host: and then the warrior call? guest: the warrior call is an evolution of the initial troops first initiative. we are trying to connect with active duty and veterans, who are struggling, those who are disconnected or isolated. host: talk about that disconnection. guest: you've heard a lot about posttraumatic stress disorder. not enough about moral injury, which is a key factor. substance use disorder and so forth. we refer to this as a rubric of invisible wounds. many times you will see veterans come home, they will have visible wounds as a result of some disfigurement or amputations, but the majority of them are posting what we call

invisible wounds, those on the inside that we cannot see, that are just as damaging. what we try to do is make a connection with them, especially if they are disconnected from services that may be available to them, or they just don't know how to navigate into the system to get help. host: that invisible wound you talk about, as far as how that expresses itself, how does suicide factor in? guest: when somebody gets into a dark place, isolation is one of the key factors we have seen in a lot of these suicide cases, where they become disconnected from their tribe, so they left their military unit, in many cases they have disconnected from family, friends. they get into a dark place, a position of hopelessness and then bad things happen. host: according to the statistics from veterans affairs.

6200 suicides last year. they say that is 400 fewer since 2019 and 2018. in 2019, the average suicides decreased to 17 per day. what does that tell u.s. far as those going down and those overall trends? guest: i'm not exactly confident that those figures are correct. as an old homicide detective, i know from doing many death investigations, deaths occur in the gray zone. in our times of opioid crises and substance abuse challenges, we are having a lot of deaths we cannot rule as a homicide, or clearly as a suicide that is unintended. i believe there are a number of veterans who fall into that gray zone category and are not being counted. just like any statistical reference, depending on how you manipulate the variables,

numbers can come out different ways. i believe our numbers are probably up, not down, and we have not seen the worst of it yet. after 20 years of consistent conflict, we will see the wake of the servants to the nation. a lot of these men and women have stepped forward and volunteered to protect our security, protect our freedoms, and this is what this day is all about, to honor those who made the ultimate sacrifice. to include those who have died from suicide, potentially as a result or a consequence to the service to this nation. host: it takes on a personal meaning for you. can you tell our audience about that? guest: from a personal perspective, five years ago, my son took his life. he was a highly decorated revered navy seal.

after he came home from his last deployment to afghanistan, two hard, deployments to iraq, afghanistan, lebanon and other points of conflict around the world. like many of our veterans that we hear about, especially those with invisible wounds, he started having sleep disorders, problems with anxiety, depression. he became short fused. his whole personality changed. he started spiraling over the course of two years. as he stepped forward to get help, the system really did not respond. it failed him. he fell through the cracks. it was not an easy solution. it became ugly. the v.a. and defense health

agencies that we depend on to kate -- to take care of them failed. subsequently, he took his life. he had said to me before the day he died, if anything ever happens to him, i want you to donate my brain for traumatic brain injury research, for breach or syndrome research. all along he said something was wrong with his head, but nobody was listening. they kept telling him he was crazy. we tried to rescue him over the course of two years. he was prescribed over 40 different medications. over-the-counter creams and lotions, even to psychotropic drugs that made him feel like he was not not even in his own skin. as you go and talk to other veterans, you hear the same reflections over and over again. we've had this pattern that has

really been illuminated as growing, but we still don't have a lot of answers as to why we are dealing with the number of suicides we are dealing with, and why they continue to go up. my belief is that they are going up, not down, despite some statistical references that the v.a. has put out. host: let me invite the audience into the conversation, if you want to ask questions of our guest, you can do so. for those of you who have questions in our veterans, (202)-748-8000. if you are active duty, (202)-748-8001. all others, (202)-748-8002. -- all others, (202)-748-8003. traumatic brain injury, this idea that it is something you need to look at more closely, especially when looking at the aftereffects. can you expand on that? guest: there is a growing body of evidence connecting traumatic brain injury to suicide, a very clear line.

i am an evidence-based individual. there is a growing body of research and evidence as a result of that research that is pointing to undiagnosed brain injury at the microscopic level. this is what my son suffered from. two months after his death, we were able to get his brain donated to a research project at will reed, the national military medical center, into a study that was researching traumatic brain injury from blast exposure. two months later, they called us in and said your son had an undiagnosed severe level microscopic brain injury, uniquely related to blast exposure. this is not unlike what we see with our contact sports players

with cte, but a distinct pattern of injury with blast exposure that is different from cte, but both of those conditions are handicapped in that we don't have the diagnostics to see it in the living person yet. i believe we are starting to get there, but this is where we need to research. we need good science to tell us what is going on, which may explain why some of these cases, this complex rubric of ptsd, moral injury, substance use disorder, is so hard to deal with and why the traditional approach of treating the symptoms with drugs is not working. i don't want to be irresponsible and say that the drugs are not -- do not play an important role, but time and time again, we hear stories about how the overuse of drugs, off label, prescribed by people who don't have the background in

psychiatry or rental health, our prescribing drugs for depression and other behavioral health conditions that are just turning our veterans and active-duty folks in distress upside down. we need to find a better way, and i believe science can help eliminate that path -- illuminate that path. i did not have confidence that our defense health agency or the v.a. will solve this problem. we need to partner with nonprofits, with academia, with folks on the outside that have parts of this effort and pull them together for a unity of effort and sharing of data, that i believe will illuminate the path forward as far as traumatic brain injury and the solutions that can potentially help the men and women who have served this nation. host: how specific -- how set up

our the centers to help with suicide? guest: i will say the v.a. is getting better. my initial contact with them in support of my son was not a good one. it was very bureaucratic, it was hard to navigate, and as i am trying to help him navigate through the system, i'm thinking, how do somebody who doesn't have assistance navigate through this, especially when they are upended with a number of these conditions? i think we have a long way to go, to be honest with you, and we've been in this for over 20 years and we really have not moved the ball very far. i find it distressing, two immediate reports came out, one where i believe the army

secretary was referencing the fact that recruitment is getting harder because the gen z generation is concerned about the rate of suicide, military sexual assault, and hazing. it is turning them away from service. the other is the report that came out yesterday, where the department of defense is offering up $3 million for novel ways to control suicide. i see that as not a positive sign, but a sign of desperation. host: $20 million -- up to $3 million. guest: and then they formed a new commission which is going to be led by a mental health expert , heavily pop elated by mental health experts -- and again, i

don't want to criticize the panel, they are all very notable people who have a great passion to solve this very difficult challenge, but i don't see a cadre of folks with a neuroscience background, with the research background to either confirm or deny whether we are dealing with a level of traumatic brain injury or other biological root causes that could be influencing the problem, not solely mental health. host: we have some calls lined up for you. this is gerald, a veteran from north carolina. you are with our guest, frank larkin of troops first foundation. go ahead. caller: hello sir. i believe that the answer to our gun problem in this country is to not amend the second

amendment, but to offer an additional amendment to the constitution, whereby any state, city or county can opt out and make its own rules for the people living within their jurisdiction. host: i apologize caller, you may be referencing our previous segment. but to the point he is making overall, access to weapons as far as mental health is concerned, especially amongst veterans. what do you think needs to be done? guest: it is important when you have a veteran getting into a critical stage of behavior or -- where they may be having suicidal ideations, talking about suicide, may exhibiting signs of severe isolation, depression, so forth. access to those weapons is a real concern.

any time we can either with the insist -- with the assistance of law enforcement, family, friends, teammates, remove those guns from easy access because a lot of these suicide incidences are very spontaneous. if they don't have immediate access to weapons, i think at times, it does prevent a horrible act from happening. part of our mantra at warrior call is to make a call, take a call and have an honest conversation with a veteran or active-duty warrior, with the idea of connecting to them, and sensing whether or not they are in a bad place and if so, get them connected to a warm handoff , to resources that potentially can help them pull out of that dark place, pull out of that position of desperation, which too often we see ends in suicide. host: andrew is next in new

jersey, also a veteran. caller: hello, mr. larkin? guest: hi andrew. caller: good morning on this memorial day. we must remember your son and all the others. my question, we've been dealing with this traumatic brain injury for years, with the soldiers, the navy seals in afghanistan, with multiple deployments like your son. why is the veterans administration treating them with drugs, which is masking the problem and not get to the root of the problem? first of all, the data they are saying about veteran suicide is inaccurate because have you ever heard of mission 22? guest: yes, i have. caller: mission 22 estimates that a veteran commits suicide every 22 minutes. i personally believe -- i may be wrong -- the government sends

these kids off to these long-term multiple deployments, they were overwhelmed, they never expected this to happen. thank you for the work you do, because we need people like you to pick up the pieces so that this can be prevented. guest: let me pick up on that, if i may. this is where we need the research. we are going to continue to default towards a mental health diagnosis that refers to the dsm -v diagnostic chart which is very often tied to how these clinicians get reimbursed for their services. they have to come up with a diagnosis according to this chart to get reimbursed. we need the science to prove that the world is round and not flat. until then, much of this, if not all of it is going to continue to default toward a mental

health diagnosis, incorporating these very heavy drugs and other options that have not been working that well. i want to clarify, it is not to say that this is not a hand and glove relationship but if there is an underlying biological injury, then these people are not crazy. they very well might be injured, injured as a result of service to this nation and this is how we should be approaching this. the fact that we cannot see it is not an excuse for not moving in this direction to confirm or deny whether this exists or not, and that is all i am asking for. for five years, i have been pushing the department of defense and the v.a. to tell me through research, what is the level of blast overpressure that starts to cause this microscopic

injury? we have collected a lot of data off the battlefield and training and it is interesting because much of this exposure, we assess 80% or more, is coming from the training environment, training to go to combat as opposed to being in combat. when you are in combat, it is anything goes, but if we can develop a sense of where our risk thresholds are, as they relate to weapon systems that we use, as they relate to explosives, improvised explosive devices that we confront on the battlefield, then i think we can buy down the risk of exposure and tbi, if this proves to be a significant component into why this is so difficult. host: is it only veterans affairs doing the research you have talked about or has it expanded to any other research bodies of the federal government?

guest: all of them play a role in different ways. nih is doing some interesting studies on imaging, trying to detect changes in the brain, following blast overpressure exposure. the department of defense has put $1.5 billion towards tbi research, but not a lot to show for it. the other thing i will say is since 9/11, there has been a lot of legislative action that has been put in the pipeline, and having been the former senate sergeant at arms for four years, i got an eye on that but when you look at the amount of legislation that has been written to address tbi, moral injury, substance use disorder, ptsd, other combat related or deployment related issues that

affect our military, very little has come out the other end. there needs to be accountability for when this legislation and direction is given to the department to do x. is somebody following up, to verify that has been done or has been done to the level of expectation? this is part of the problem that we have been experiencing on why we have not moved closer to the end zone on this. host: let's hear from john, in virginia on our line for veterans. you're on with frank larkin. caller: can you hear me? host: we can, you are on. caller: thank you for your work. i know you probably don't get much praise working holidays but we do appreciate it in the general public. i know you would rather be home with your family. i have post-traumatic stress

disorder when i came back from korea. i understand what it is like to go from these experiences. i also knew a veteran, i was living in nebraska. he did take his life. somewhere between five and 10 vietnam veterans take their lives each day in this country. let's not forget us, even those vietnam era veterans. i work for the department of defense. these are the issues i see here as well. there are other groups that should be involved like the american foreign legion and the veterans of foreign wars. that is all i wanted to say. host: john in virginia, thank you. guest: you bring up a valid point. this is about unity of effort and sharing data. this is about putting a level of urgency on this. it is not because we lack

intellectual ability or capacity. we just need to organize, like we did against cancer, against hiv/aids, against covid. we've got the ability to solve this, but we've just had all of these boutique disconnected efforts that have been going on for the past 20 plus years and we really need some leadership and that leadership needs to come from an individual who's got skin in the game, who understands this problem, not a doctor or researcher, not a mental health expert, but somebody that has got a business acumen, understands organizational dynamics, project management and can drive this thing to get results. it is really the veterans and our active-duty warriors, if it does not connect with them, if it doesn't impact their quality of life, you've got to ask the

question, so what? host: the president last year put a series of initiatives into take a look at the topic of suicide, and when they released those ideas or concepts, they wrote, and the coming months, agencies will collaborate to raise awareness among service members, veterans and families, evaluating the effectiveness of existing and new programs that may reduce access to lethal means. this will include designing and launching a campaign to increase the safe storage of firearms and medications and the use of safety planning and intervention by providers. how do you think the white house is doing on this issue? guest: if it is not resonating at the deck plate level, the ground-level with the veterans, our warriors and their families, then you have to say where are the gaps? very often a lot of these initiatives sit at the national

policy level, much higher in the stratosphere and it is not connecting at the local level. this is really a community level challenge. to be able to put the training and education in the hands that are closest to the people that are struggling. for active duty, this includes leadership from the top down, giving them the tools to be able to deal with these situations. this is very often where inside the uniformed services that we see the problem. this is a leadership issue for dod and without the education, without the training or the ability to remove the stigmas and barriers of entry, you will have people like my son fall through the cracks as a result of the service to their nation because you have to remember, when they voluntarily enlisted or were commissioned into service, they were deemed to be

healthy and 100% ready to serve. something has happened in between that date and the way we see them now. we've got to understand that. without the tools and education and the points of entry that we can effectively get to these folks early, with good diagnostics, good triage processes, then we will continue to see these suicides. i don't think we have seen the worst of it yet. if we don't get on top of this and make it a national priority -- and when you look at the calculus of what brain injury costs us in our health care system and impact to our society, it is trillions of dollars. host: do you know of any trends that have occurred for those that are from afghanistan it comes to suicide, maybe even going as far back as iraq, overall what we are seeing? guest: transition is very

difficult, this issue of isolation. i have asked this question before, bringing up korea and vietnam. as i have been told from prior campaigns of war, it took many months to get those folks home, and there is a belief that during that time, they went through some levels of decompression. they were with teammates, they talked about their experiences and they were able to offload a lot of that stress, whereas the further we have advanced to modern day, we are removing people from the battlefield and they are home in the states within 24 or 48 hours. they are walking through the front door of their homes and everybody expects them to be normal after the experiences they have had. especially when we have talked about moral injury, we raise our kids to value human life, respect the law, respect each

other, and then we train them up to be these warriors and send them places around the world where that is not exactly how things operate. they come home burdened with these moral challenges. host: there was a recent hearing from the senate side, angus king talking to the army about how they develop transition programs and make that transition you spoke about and suicides over all. i will play a little bit of the exchange and we will get your thoughts. [video clip] >> i work with a lot of veterans in maine. one of the problems we -- that keeps coming up is the weakness of the transition from active duty to veteran status. the handoff from the defense department to the v.a., i believe i don't have the data in front of me but many of the veteran suicides take place in

that relatively short period of time between active-duty and civilian status. i believe that you should put as much resources time and effort into transitioning people out as you do with recruiting people in. can you address that problem because from everything i've learned on the ground, this is a serious issue. >> certainly. i think there is data that shows that transition out of the service into the civilian community can be a critical time. we do try to work closely with the department of veterans affairs to ensure that there is a warm handoff and with the transition programs that we have from folks getting out of the army, we try to make sure that they have the resources to know what to expect, to be able to link them to employment resources and things like that, but i think that is something we can continue to work on and

frankly, i've heard some folks say the transition programs helped me learn how to tie a tie and do a resume, but psychologically making the adjustment to going back into the civilian world isn't something that i've heard people say that they get as much emphasis on. i think that is something we can work on. host: mr. larkin? what do you think of the questions by the senator but also the response from the army secretary? guest: they are valid. transition is an important part. we've seen too many times where our veterans have left active-duty service, jumped out of those planes, so to speak without their parachute. they have not thought about their transition. they have jumped out with a parachute but have not identified where they are going to land. you have to support yourself when you come out. they've got to think about this

in advance of stepping across the line and going through the exit door. as far as the transition programs go, it depends on where you are and how serious that command is taking the transition. you've got to remember, our military operations, army, navy, marines or air force, it is about operations. they are looking out the windshield, not in the rearview mirror. when somebody transitions out, it is almost like it is not our problem anymore. the issue with transition is a factor in i would say the downward spiral of many of the veterans we have seen, if they don't have a good place to land. this means, how do you take the skill sets we've had in the military and cross them over into the civilian theater? very often, there is a

translation issue. definitions or job descriptions in the military side are not exactly well understood on the civilian side. we need to do a better job of that. transitioning is very important. it needs to be a holistic approach, not only from the military, but also the catchers met on the private sector side, on the civilian sector side, how they help receive. and it goes hand in glove with mental health resources, with being able to respect them and provide them with a sense of dignity once they separate service, and to maintain that momentum so that again, we don't get that tribal sense of separation which so often leads to that destructive isolation. host: we are having a conversation of frank larkin with troops first foundation and warrior call.

ron in michigan, on our veterans line, thank you for waiting. caller: yes or. i am trying -- yes sir. i am trying not to fumble this. you sound like you know what you are talking about. what i would like to know is what do you do about people like me? i've lived 50 years in perpetual depression. i'm not going to kill myself. i don't want to make a mess like that. i don't want to die with a sour look at life. a little bit of help right now would go a long way. three times i sought help from the v.a., and basically end up with a kick in the ass. the mental health care i have

gotten was stuff i paid for out of pocket, no insurance. i'm 75. at $125 a session, i can only do that for short periods of time. it worked but i can't get it without paying for it. a little bit of physical help to cut the grass or something, that would go a long way with me. does anybody do anything like that? host: thank you for calling. guest: ron, we've heard other reflections like that from other veterans, and i would say my recommendation is locally is to tie up with your veteran service organizations, vfw, other groups that are local, and talk to

veterans like yourself. some options that may exist locally in your area. i go back to the local because if it goes outside that local geographic parameter, then it is very hard for a lot of these folks to connect to. they have to travel 200 miles to get to a level of services, that is not going to be something that is of great utility for them, unless there is a very specific need that only that facility can address. i would say the vfw and others. the american legion. they are great organizations with great resources and can potentially help with other options. what a lot of us try to do is partner together, not reinvent the wheel. warrior call is pretty much a broker to try and identify those resources that we can do more

handoffs, with these veterans who are struggling, like ron. host: from wisconsin, this is our line for others. we will hear from dennis. caller: hi there. this is dennis from wisconsin. guest: good morning. caller: good morning sir. i would like to bring up the aspect of -- being used for tbi. i was in a car accident at the age of 14 in the 1970's and my dad was in the military, so i was at a military hospital. they installed these cochlear implants that send messages over negative decibels, and i was not fully apprised of it until 1990 when one of the wires decided to exit from inside of my mouth when i was driving.

there is a technological aspect and a natural aspect to kinesis. i've had brain injuries since then, and i've been able to recover. one way was learning a different language. learning latin alongside the king -- the king james version helped a lot in those gray areas that pharmaceuticals love to map out. it just helps rewire the brain by learning another language. host: thank you for your input. i suppose outside of medication, there are other ways to deal with the issue, like mental counseling and things like that. guest: this goes back to the holistic approach. we have to listen to these folks. that is the number one task, listen to them and understand their challenges instead of trying to put a round peg in a

round hole with a cookie-cutter approach. there is no silver bullet, but it really is understanding that individuals' challenge and then guiding them to the appropriate options, with the understanding that it may not work and you may have to pull them back in and cast them back out. but it is a holistic approach. there is another piece of this. we have some tough love conversations with our >> president biden will take part in a wreath-laying ceremony at the tomb of the unknown soldier and give remarks. live coverage on c-span. >> order.