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NATIONAL GUARD ON-THE-RECORD ZOOM/TELEPHONIC 

MEDIA ROUNDTABLE

October 1, 2021

TOPIC SUBJECT MATTER EXPERTS

National Guard Bureau’s Response to 2020 

DoD Annual Suicide Report: Partnering to 

Reduce Suicides

§ Army Maj. Gen. Eric K. Little, director, National 

Guard Bureau Manpower and Personnel (J-1)

§ U.S. Public Health Service Rear Adm. Matthew 

Kleiman, director National Guard Warrior Resilience 

and Fitness

Background:

The health, safety, and well-being of our airmen, soldiers and family members is essential to the 

readiness of the National Guard. Every death by suicide is a tragedy. National Guard Bureau senior 

leaders provide an update on National Guard efforts to reduce suicide, strengthen readiness and build 

resilience among the nearly 450,000 men and women who serve in the Army and Air National Guard. 

Media attendees will have the opportunity to ask questions.

Dialogue:

[Name] [QUESTION/RESPONSE]

Wayne Hall [00:00:23] Good morning, thank you for joining us for today's 

media roundtable focusing on the National Guard 

Bureau's response to the 2020 DoD annual suicide 

report. Before we begin, I want to remind everyone 

that this event is considered "on the record." The 

roundtable will last approximately 45 minutes and 

begin with opening remarks from Army Major 

General Eric K. Little, Director, National Guard 

Bureau, Manpower and Personnel, the J1; followed 

by remarks from U.S. Public Health Service Rear 

Admiral Matthew Kleinman, Director, National 
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Guard Warrior Resilience and Fitness. And with 

that general little, I'll turn it over to you. 

Maj. Gen. Eric K. Little [00:01:04] Thank you, and good morning to all, and first of all, 

I want to take you, thank you all for taking time to 

cover a very important issue facing us not only in 

the National Guard, but the entire nation. This is a 

big deal for us. Suicide is the leading cause death in 

the US not only in this vein, but in those military 

populations. As you all know, our young males and 

the use of, lethal use of, firearms is the leading 

indicators for us right now. In 2020 our suicide rate 

was 27 deaths per 100,000, which is comparable to 

2018, which did follow a short-term decrease in 

2019. Currently, there's no evidence of a long-term 

increase or decrease in suicide rates since 2015. 

Now, as we all know, the pandemic brought all 

sorts of stressors to the National Guard. The 

National Guard was busy fighting not only COVID, 

we had civil disturbance, we had fires, we had 

hurricanes. The National Guard was very busy in 

2020 as it is and going into and still in 2021. This 

unique dual mission to support a federal and state 

mission does pose increased risk factors for us that 

we're aware of. We're going to talk about a little 

later on today some of the things that we're doing to 

try to help with the mental health and fitness for our 

soldiers and airmen across the 54. We're very 

widely dispersed across the 54 states and territories. 

We cover almost every community. And that means 

we have service members coming from every 

community and every type of risk factors. So that is 

a complicated problem for us. But we do have some 

things in place to address those issues. The 

challenges in 2020 and challenges in 2021 with this 

pandemic continue, so we continue to assess. We 

did not see a huge spike or a huge indicator due to 
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COVID, but it is still too early to say probably too, 

that some of the things that we do. So General 

Hokanson, our chief, in the end of 2020 directed us 

to establish a Suicide Prevention Task Force and 

this task force was to identify some gaps that we 

have and measure the effectiveness of our current 

initiatives that we currently have; educate leaders at 

all levels and reduce stigma; and then also increase 

access to care. This task force met for six months. It 

met with members from the 54 as well. We also had 

some key elements from other agencies as well as 

inside the National Guard. Again, the intent was to 

establish and create ideas that we can use to help 

reduce suicides across the board inside the National 

Guard. So, with that being said, we had the 

Independent Review Commission. So, some of the 

things coming out of the Independent Review 

Commission as it relates to violence carried over 

into this task force and some of the things that 

we’re turning into 2021 and into 2022 to move 

forward. We know that a prevention, violence 

prevention workforce is key to that. So, we are 

looking at options for that. We also have currently 

27 pilots across 34 states that we're currently doing. 

And some of those pilots, for example, is a thing 

called springboard. And what we're using 

springboard to do is is assess risk factors and it can 

go down to the community level. This tool will help 

commanders identify key risk factors they have in 

their specific communities and for our mental health 

professionals to be able to key in on certain things 

that we're seeing as trends. And more importantly, 

apply the appropriate number of resources to 

address these issues. Some other specific pilots we 

have out there include something called Star 

Behavioral Health and what this pilot does is bring 

in civilian doctors and train them on specific mental 
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health issues that our members are dealing with, 

such as PTSD. We've worked with over 1,000 

doctors to bring them in and our medical 

professionals to bring them in and teach them these 

types of things. We have another program out there 

that is bringing in the members and families to help 

recognize when they're in need of help. The 

families recognize, or even the service members 

recognize, some of the risk factors that are out there 

and they're in front of them. Another one we're 

looking at is taking new recruits come in because 

again, we're representing society to screen them and 

say, "Hey, do they have any risk factors that we 

need to look out for?" Again, a pilot that we're 

taking a look at a big success to, and this goes into 

partnerships is working with the vet centers, getting 

access to care. Access to care is a huge, it has been 

and continues to be a huge challenge for us. But we 

are getting better in those areas and we're seeing a 

huge increase in our members going to vet centers. 

So, we see that as a big plus in reducing stigma. I 

mentioned as quickly, but stigma is something the 

military is facing. And what we're trying to do is to 

have our members understand that if you have a 

sprained ankle, having a mental health issue is no 

different than having this sprained ankle. And we're 

reviewing policies and any programs out there to 

reduce that stigma, to say it's OK to come get help. 

It's not a bad thing to come and ask to get help. 

Start reducing that stigma. So, we have several 

programs going on out there and we will continue to 

work these pilots that we that we talked about. We 

are in coordination with our services, the Army and 

the Air Force, with OSD also, to where they have 

their pilots to make sure they work for the National 

Guard. Also, lots of things that we're doing. This is 

a very complicated problem. Our number one, let 
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me be clear. One suicide is too many for us. Our 

goal would be zero. Our goal is zero. It is. It is very 

stressful for us when we see or are notified of a 

suicide within our ranks. And we take that very 

serious, and our chief and our senior leaders, our 

adjutant generals. We have seen enormous amounts 

of support. Our adjutant generals out in the 54 are 

working this hard, even individually working with 

their community partners to see what they can do 

inside their state, to also provide those resources to 

our members that need help and the resources 

identified. Those resources, identify the risk factors 

and the first line leader, ensuring that our first line 

leaders have been trained to understand what to do 

if someone comes and needs help or to understand 

that that member is feeling down and what they 

should do with that. So, those are some of the things 

that we're doing, just a high overview, the things 

that we're doing in the National Guard. I am going 

to turn over to Admiral Kleiman to let him let him 

address that.

Rear Adm. Matthew Kleiman [00:07:53] Thank you, sir. So, I'll be very quick. That was a 

really comprehensive overview of a lot of what 

we're doing and what our focus areas have been 

over the last year. The one thing I just wanted to 

add in terms of my opening remarks, so working 

kind of in the integrated prevention lane, we're 

really focused on a comprehensive public health 

approach to suicide. The Guard has really kind of 

focused its efforts on kind of recognizing that, you 

know, mental health care is really important as it 

relates to suicide prevention. But suicides can also 

be the result of, you know, individual and broader 

community and societal factors. So really, to 

improve our prevention efforts, we're focusing on 

those evidence-informed practices and including 
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those from not only within the National Guard, but 

outside of DoD as well. So, our partnerships are 

really critical and our purpose is to really try to 

enhance protective factors while addressing risk 

factors for suicide. And you'll see as we go through 

our discussion today that all of our programs are 

really focused on those two primary issues. So, I 

really look forward to the opportunity to answer 

your questions today and talk a bit about some of 

what the Guard is doing to try to prevent suicides. 

I'll go ahead and put my mike back on you and take 

your questions. 

Maj. Gen. Eric K. Little [00:09:14] Hey, wait. Let me just add one more thing. I'm 

sorry. One thing I wanted to discuss, and I failed to 

do that. I mentioned this earlier the use of firearms, 

so the use of firearms is one of the leading methods 

that our members are using. Lethal means safety is 

something that we're keen and on to, and I guess I 

wanted to address this because we know the time, 

the space, is something that we need to focus in on. 

We can have one barrier in place if one has to open 

up a door or open up a drawer, find ammunition, 

something to that case, we know that will make a 

difference. So that was the other thing that we're 

really focusing on. You will see more and more on 

this as we get into to FY22 is focusing on lethal 

means safety. That's a very key element for us that 

we recognize. 

Wayne Hall [00:10:05] Thank you, sir. So being respectful of time, we ask 

the media to stick to one question and a brief follow 

up. We'll allow for additional questions should time 

permit. If we're unable to answer your question, or 

we'll take a note of it and work to get you an answer 

as soon as we can. We're also putting the panel 

member bios and they as well as the Chief of the 
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National Guard Bureau's Suicide Prevention Month 

letter to the force in the chat window. We also sent 

these out with the advisory this morning. So with 

that, I'm going to go ahead and start with questions. 

Do we have NBC, Courtney Kube on the on the 

phone. Nothing heard. Do we have a reporter from 

Fox News? Nothing heard Natalie Brophy from 

USA Today Network, are you on the line? You 

have a question. Natalie, are you with us? OK, we'll 

circle back. Stars and stripes, Caitlin Doornbos, Are 

you on the line? You have a question. OK, moving 

on. Steve Beynon from Military.com, I believe you 

have a question. 

Steve Beynon [00:11:20] I'm here. Yeah, so seems a lot of these suicides. I 

mean, it's just not necessarily related to combat 

trauma as a lot of people probably think. It seems to 

be more like maybe relationships or finances. How's 

that sort of guiding any sort of treatment or 

programs? Does this say? Does it say anything 

about the type of people? We're bringing in the 

Guard and has any outside the box sort of 

treatments been thought about? Like, you know, 

there's programs the VA is looking into, like yoga, 

jujitsu, service dogs or anything like that, if anyone 

could discuss some of that stuff. 

Maj. Gen. Eric K. Little [00:12:02] So, Matt, I'll kick that over to you on those 

specifics. 

Rear Adm. Matthew Kleiman [00:12:07] Thank you, sir. So, yeah, really good question. So,

you're right there. What research has shown across 

the DoD services, not just the National Guard, is 

that there isn't really a statistical link between a 

combat deployment and suicide. So, what that 

means is that, you know, we know our population, 
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it represents the broader U.S. population. So those 

same factors that you discussed - finances, 

relationships, legal issues, behavioral health issues -

those are all we consider, all of those to be risk 

factors for suicide. And so, our approach really has 

taken that kind of upstream focus on trying to get 

after those kinds of issues as part of our suicide 

prevention program. Specifically, you know, you 

mentioned looking for novel approaches and best 

practices. We set up about three years ago, we set 

up a program called the Innovation Incubator, and 

this was our way of acknowledging that we have 54 

states and territories that all have very unique 

populations, and they're all doing really innovative 

things out there in the states. So, we wanted to take 

that approach to really learn from what the states 

are doing and how do we incorporate that into our 

broader strategic approach. So, the innovation 

incubator allows for states to propose pilots that can 

be run with assistance from NGB, some funding, 

some technical support so that we can measure 

what's effective, what's working at the state level. 

What are those novel approaches, you know, such 

as, you know, providing relationship support, 

providing, you know, embedding behavioral health 

within units. We have some states that are looking 

at developing mobile apps to help provide support 

through smart phones and computers. So, so all of 

that is happening. We have 27 pilots right now that 

are running across 34 states. So, I would say I don't 

have enough time today to talk to you about each 

one of those. But what we're doing is looking at 

those is a three-year cycle and year one is kind of 

proof of concept, year two is can we expand it? And 

then by the time we get to year three, for some of 

these pilots, we're looking at ways that we can 

leverage that across the broader National Guard. 
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And we do have a few pilots that have made it to 

year three and and do show promise. So it's it's 

pretty exciting and it allows us to support the states. 

It also allows us to see where we may have some 

best practices, as well as maybe some gaps that we 

need to fill. 

Wayne Hall [00:14:49] Thank you, sir. I'm going to circle back to Caitlin 

Doornbos from Stars and Stripes, I think you might 

have had some trouble un-muting, do you have a 

question, Caitlin.

Caitlin Doornbos [00:14:59] Yes, right, sure. Can you hear me now? Yes. Okay, 

good. Oh, great. Thank you. Yeah, I just saw one of 

the elements is that I think since I was reading the 

report yesterday was just the why behind it? Do you 

have any dissertations about why the rates are 

higher within the Guard? 

Maj. Gen. Eric K. Little [00:15:25] So I would you mean, as far as why they're higher 

than the DoD or why they're higher or higher in 

society, I mean, just for clarification. I guess we can 

answer both. So, and I'll let Matt jump on the DoD 

specifically, but as far as the population goes, we're 

actually a little lower than the general population. 

When you match the same type of people. So as far 

as DoD, Matt, can you jump in and I thought we 

were actually lower or the same way.

Rear Adm. Matthew Kleiman [00:16:02] So, yeah, it's a very nuanced question, so I want to 

take a little bit of time to try to answer it 

comprehensively. So, our rates in 2020 did go up 

when you compare them to our rates in 2019. 

However, when we're talking about suicide rates, 

what we want to do is look for trends over time. So,

when we look at our five year rates and the National 

Guard, our 2020 rates were comparable to what the 
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five year average is. So, while we did see a dip in 

2019, when we look at the last five years, the guard 

rates have been consistent and they haven't gone up 

or down. Statistically, when you compare our rates 

to DoD. Actually, when you adjust for and this is 

with the U.S. population as well, when you adjust 

for age and gender, the National Guard does is 

comparable to the US population and to the broader 

DoD. So, you know, there are some misconceptions 

about the guard rate being higher. And certainly, 

you know, one suicide is too many. But but when 

you're looking at the per 100,000 rates that we 

calculate based on the CDC guidelines, we've been 

consistent over the past five to 10 years, whereas 

the US population has been kind of steadily going 

up. So, and of course, the Guard is a reflection of 

their local communities were a reflection of the 

U.S. population. So, a lot of the issues that we see 

across the US population, we're seeing with the 

National Guard as well, because that's where we 

recruit from. And you know, again, most of our 

service members in the National Guard, you know, 

they're drilling once a month, but they're also living 

and working within their local communities. So, it's 

tough to compare the two, really, because we're all 

part of the same overall population. 

Caitlin Doornbos [00:17:57] I think I guess part of my question was if there's 

anything different about being in the National 

Guard and being part of the local population and 

whether that factor sets that apart from those of in 

the Army, Marines active duty. If there was 

anything there that led to that, sure, sounds like 

you're saying, but. 

Maj. Gen. Eric K. Little [00:18:18] So I just want to add a little bit to that, to me, that's 

a great question. I appreciate that. So, you 
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mentioned that. So, what's different between 

National Guard and the active duty per se? You 

know, so our challenge is we only see these soldiers 

and airmen one weekend a month. Twenty-eight

days, they're on their own and, you know, go back 

to their communities where they came from and our 

our challenge and our leaders challenge is to make 

sure we stay connected throughout the month as we 

had to do through COVID. And those are some of 

the things that we continue to focus leaders on the 

drive. The culture is the key for us and establish that 

that feeling that sense of safety inside, inside the 

military. And that's and that's what the guard has to 

continue to do. Not only on this issue with all issues 

is to stay connected and have our leaders stay 

connected and understand. And understanding that 

culture and climate mean a lot is those soldiers and 

airmen come to drill. But I just want to add to that 

Matt do you have anything else you want to add to 

that? 

Rear Adm. Matthew Kleiman [00:19:18] Yes, sir. Yeah. And again, appreciate the question 

because I think it really gets to the heart of why 

we're trying to set up unique programs for the 

National Guard because we do understand there's 

some kind of unique challenges that that we face. I 

mean, anyone who's watched the news in the last 

year understands kind of the the role that the guard 

has been playing, you know, the the activations that 

that have occurred over the last 12 to 18 months or 

at a higher level than any time since World War II. 

And so being on the front line, you know, you're 

talking about set separations, you know, family 

separations, you're talking about having service 

members have to balance their job and their home 

life with their military service so that that's a little 

bit different. You know, when you think about the 
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active component, who their job is there, their 

military service, whereas the guard is, you know, 

they're dual hatted. And so, a lot of the programs 

that we have are designed to provide support to 

those members, not only when they're activated, but 

also between those activations, when they're at 

home and when they're kind of in their civilian role. 

And that is one of the really unique issues that we 

have to account for as we look to provide strategic 

support and prevention programs, knowing that our 

population is very geographically dispersed and 

wear multiple hats and we don't always have those 

touchpoints that the active component does, you 

know, 24-7, 365. So, so those are just some of the 

big, big challenges that that we try to think about as 

we provide prevention support. 

Wayne Hall [00:20:58] Thank you, sir. We're going to circle back to 

Natalie as well. I think she may have had some unmuting issues. Natalie Brophy, are you with us? 

Natalie Brophy [00:21:05] Yes, I am. Thank you. I was wondering, what 

guidance does the National Guard Bureau give to 

individual states regarding suicide prevention? 

Maj. Gen. Eric K. Little [00:21:16] So there are specific policy policies, programs that 

we can, we actually provide resources to the states, 

we provide suicide assets to the to the adjutants 

general. We also obviously will follow the service 

guidance that goes from the Army or the Air Force 

down to the state. Lots of these pilots are driven 

from the bureau, but mainly they're resourcing the 

policy. That's what's provided out in the 54 in 

conjunction with the Army and Air Force. So again, 

those where those suicide prevention coordinators 

are sitting out there right now in the in the in the 54 

our resourced by the by the National Guard Bureau 
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and knows the direction and the what their task are 

come from the direction of the National Guard 

Bureau based and then also the adjutant general 

based on what they need. Additionally, the services 

provide their type of training, their suicide 

awareness training. There is specific to the army, 

has specific training, the Air Force has specific 

training. Those members have to also go through to. 

Matt, you want to add more on that? 

Rear Adm. Matthew Kleiman [00:22:27] Yeah, thanks. So, we actually this this past year, we 

understand that, you know, given the that the there 

are additional stressors that our service members 

face this year, that we've developed some very 

specific things that have gone out to the states this 

year that I just wanted to highlight. We began a 

resilience newsletter that we're sending out now, 

which has leadership talking points. It has tips and 

tools on lethal means safety, firearm safety. It 

provides resources, so it has available resources to 

to those that need support. We also develop 

resource cards that went out to all 54, like pocket 

cards for commanders to basically be able to, you 

know, it's a pretty nifty card because it has all the 

different areas that a person may be dealing with 

some stress, whether it's financial relationship, 

work, stress, legal stress. And with a comprehensive 

list of resources that that are available kind of 

across the country. And then we developed some 

very specific tools, which I'll just touch on briefly in 

the interest of time. But we did a survey with the 

New York National Guard this past year to try to 

understand the impact of COVID. And from that 

survey, what we found was leadership support is 

really critical in terms of our suicide prevention 

efforts and our efforts to support members while 

they're being activated. So based on the results of 
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that survey, we developed again information 

packets that went out to all 54 that really talk about 

how leaders can engage with service members, how 

they can provide support being transparent, 

recognize when someone may need assistance and 

how to direct them to care when they do so. That 

was very specific from kind of what we learned by 

interviewing all the members of the New York 

National Guard. There's a lot of others as well. But 

but on a regular basis, we're communicating with 

the 54; we have 113 DPHs in the Air Guard, 

directors of Psychological Health, and almost 100 

in the Army National Guard that we're meeting with 

regularly and we're sending them information. And 

they're the ones who really have their fingers on the 

pulse of what's going on at the unit level. So it's a 

it's a challenging role to be in a strategic role when 

you have 54 distinct states and territories. But we've 

really developed a lot of strategies to make sure 

we're getting resources down to that E-4 to that 

enlisted member who may need support. And just to 

circle back to add to that. 

Maj. Gen. Eric K. Little [00:25:10] So Admiral Kleiman just hit it, part of our challenge 

is across the 54, so we're dealing with, you know, 

all aspects of the country. And so, all aspects of risk 

factors. So, we have so many programs and so 

much, so many resources is now trying to get that in 

the right areas into the right person. That's a 

challenge for us. I would be not saying something 

correct otherwise. It is a challenge to get the right 

resource to the right soldier or airman because we 

are so spread and so geographically dispersed. So,

but that's what we that's currently how we're doing 

it. We are seeing some, some successes there. These 

pilots are a good test for us, too. We continue to 

exploit that springboard, as I talked about earlier, is 
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getting down to that community so we can actually 

focus on the right resource. If it's a financial issue. 

We know that's one of the leading indicators of it's a 

marital issue. We can get the right resource down to 

the right areas. Thank you for that question. 

Wayne Hall [00:26:04] Thank you, sir. Federal News Network Scott 

Marcione. Have you joined us? So, nothing heard 

Kari Williams. Are you with us? Do you have a 

question? Kari I see you out there, I'll give you a 

minute if you kind of want to un-mute. Morning 

Kari, do you have a question? 

Kari Williams [00:26:31] No, I don't think you. 

Wayne Hall [00:26:32] OK. All right. We'll move on next to Katelyn 

Farrel. Katelyn Farrel from the Milwaukee Journal 

Constitution, are you with us? You have a question?

Katelyn Farrel [00:26:40] Yeah, hi, thanks. One thing I'm wondering is given 

all the resources that do exist, I'm wondering if you 

have if there is any that you're aware of, like onestop shop where folks and their family members can 

go to within any of this before. If there's an 

apparatus and structure for that and whether you've 

heard any, I guess, concern at all that sometimes so 

many resources are kind of allocated in different 

places. When troops are spread across any one state 

can sometimes be overwhelming and a challenge to 

figure out where to find what? 

Maj. Gen. Eric K. Little [00:27:21] So, thank you for the question that you nailed it. I 

kind of was highlighted earlier is our challenge is 

just that there are so many resources out there and 

then we're so geographically dispersed that does 

create a challenge. We actually are looking into 

one. One idea is to have a one-stop shop, as you just 
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alluded to, but that's not realistic since if you're 

living in the state of Montana and the one-stop shop 

is the other side of Montana, that will not work. So,

we're starting to look at some, some ways to do that. 

I believe COVID is really helped in this case 

because we know now that virtually things can be 

done, such as we're doing today. So that is one of 

the aspects we're taking a look at. And I would 

probably spill out over to you and over to the I.R.C. 

recommendations, too, that we're looking at doing 

that is having the resources. There were some we 

can call in or contact, and that's kind of a one stop 

shop for them. But it all may be virtually or inperson, but it's most cases for us would be virtually. 

Matt, you want to add to that? 

Rear Adm. Matthew Kleiman [00:28:23] Yes, sir. So really good question, actually. So, we 

kind of understand at the strategic level that not 

everyone's going to access care the same way. So to 

some extent, we do want to be strategically, I would 

say, intentionally redundant in some cases and have 

multiple ways a person can get help. And that's not 

to dismiss your question by any means, but but we 

do understand that there needs to be some, some 

very clear guidance on what are the main resources 

that we're highlighting, for example, Military One 

Source. I'll just use that because everyone kind of 

knows what that is. Given the virtual nature of a lot 

of our population being spread out, not having 

access to brick and mortar, a Military One Source is 

a really good option for individuals who need 

assistance. They can access that through the phone 

over the internet. There are ways that they can get 

help that don't require them walking into a to an 

office building. So that's something we highlight a 

lot. The vet centers are something I want to 

highlight, too. We partnered with the VA last year 
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to start bringing mobile vet centers on to drill 

weekends as another way for our service members 

to be able to walk in and get assistance right there 

through a weekend. Since we started that 

partnership, the number of unique visits from Guard 

members to vet centers have increased at the brickand-mortar vet centers by 158 percent. And then at 

the mobile vet centers by almost 60 percent. So,

we're seeing a lot more of our folks being able to 

walk in and get some type of support, whether it's 

behavioral health or financial or relationships 

through the through the VA vet centers. And then 

the last thing I'll say just kind of is to foot-stop 

something General Little talked about earlier is our 

Suicide Prevention Task Force. So, when we 

convened in January, we pulled in representatives 

from across the 54 to be part of this task force. And 

one of the things that they highlighted was exactly 

the question you just asked How do we how do we 

streamline what we're doing in terms of referring 

someone to help so that they're not confused and 

overwhelmed by the number of resources out there? 

So we are actually working on that kind of as we 

speak. We had over 40 members of the task force 

representing all types of specialties, from the 

operational community to the suicide prevention

community. Really looking at this issue and 

developing strategies that we can send out to the 

states on how to streamline resources. But so, it's a 

work in progress, but we do recognize it's a 

challenge and we are working very diligently to get 

after that. 

Wayne Hall [00:31:01] Thank you, sir. We're going to go to Alex Horton 

next from The Washington Post. Alex, are you with 

us? Do you have a question? Alex. 
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Alex Horton [00:31:13] Yeah, you got me.

Wayne Hall [00:31:14] Yes. 

Alex Horton [00:31:15] Thank you for that. Yeah, I'm kind of curious about 

the numbers here compared to the rest of the force. 

And I guess one way I look at the longer-term

breakout of 2015 and 2020, I guess one word I 

describe it as as Sisyphean. It seems like there's 

some sort of relief that there hasn't been any 

statistical change up or down. But I'm curious about 

what that tells you about the impact, if any, your 

prevention efforts have been seen. You know, if 

you're able, even able, able to measure how well 

you're doing, if those numbers don't change and 

that's not to beat up on the Guard. No one's numbers 

are are getting better, but they're not moving in the 

direction you want. You know, and I think reporters 

on this call, you know, we've all heard the lines 

right, like when suicides too many we take too 

seriously. But the data doesn't really show evidence 

of that. So what evidence do you have that it is 

working? And I have a follow up question.

Maj. Gen. Eric K. Little [00:32:13] So great question, so, you know, as the J-1 director, 

Admiral Kleiman knows this, I ask this question 

often is how do we know that what we're doing is 

working? I will tell you that we have been stable 

over the last five years where the US population has 

gone up. But what does that mean? I mean, we 

haven't gone down. I would agree. Our efforts, how 

do we know they're working and are we focusing on 

the right efforts thus part of what Admiral Kleiman 

just talk about the suicide task force is that's what 

they're asking is how do we know that our 

investments are paying off? And do we have the 
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right, the right resource going to the right place? 

And is it the right resource? Part of what we're 

using these pilots for is just that part of it as we 

continue to mature spring board to identify those 

risk factors so we can zero in on applying the 

resources in the right place. We hope that makes a 

difference. We also know that we have to train our 

first line leaders better to better understand these 

risk factors and better understand and establish a 

better culture. Stigma is a huge deal. We know if 

we don't get stigma changed, if we don't get our 

first line leaders trained, you can have a million 

resources in the world. So those are the things that 

we really this task force is zeroing in on. This is the 

some of the things that we're wrapping in a 

prevention of violence prevention workforce. We 

believe that will help be the constant to identify and 

people think about prevention that also we're 

hoping to be key. We're hoping it will make a 

difference also this year because I agree with you 

that that is something that I that I asked the same 

question every day is is I want to make sure what 

we're doing and the resources we're expanding are 

they are they making a difference? Matt, I'll let you 

jump in on that. I know you get something out of 

that.

Rear Adm. Matthew Kleiman [00:33:59] Sure, absolutely. I really appreciate the question 

because it is something we struggle with, not just it 

obviously in the National Guard, but I would say 

anyone who's in the suicide prevention field 

counting the number of suicides you have on an 

annual basis is not necessarily the best way to 

measure the effectiveness of a prevention program, 

and I can give you some examples of that. So, when 

we're talking about getting upstream of suicide, 

when we're talking about identifying someone who 
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has problems and trying to get them support before 

those problems become a crisis, there are a lot of 

ways that we can measure success there. We can 

measure it by the number of individuals who are 

being referred to a provider to get help. So if we see 

those numbers going up, that's encouraging to know 

that we got more people who are feeling confident 

and comfortable that they can go, ask for help and 

get it. We also some of our pilots have have

developed metrics to look at very nuanced ways 

that we can provide support. I'll give you one 

example of a pilot that has really given us some 

pretty good data so far. It's our New Mexico pilot 

that looks at screening for adverse childhood 

experiences. So, what this does is when someone 

comes into the National Guard, they are screened to 

see what types of issues they may be bringing with 

them to their military service. And those individuals 

that volunteered to be part of this program get 

regular follow up support from day one. So,

someone calls to check to see how they're doing, 

see how they're adjusting and coping. And the data 

coming out of this program shows that when we 

provide that preventative support early, the number 

of mental health referrals actually goes way down. 

In other words, the number of individuals who are 

needing to talk to a licensed provider goes down, 

and the readiness of those individuals actually goes 

up. So, their ability to do the things that the guard 

needs them to do. Again, that isn't necessarily 

measuring suicides, but when we think about a 

public health approach to suicide, we don't want to 

get to a point where someone is suicidal. I mean, if 

if they do, we have to get them care. But there's a 

lot of upstream measures that we can take to show 

that the things that we're doing either work or don't 

work, that may not reflect in those annual numbers 
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that that that you're referring to. So, I know that's a 

bit of a long answer, but it is a challenge that we 

have, and we are really trying to standardize our 

metrics so that we can show program effectiveness 

without necessarily tying that to actual suicides.

Wayne Hall [00:36:36] Okay Alex, I know you mentioned you briefly had 

you had a quick follow up. If you can be quick brief 

with that, please.

Alex Horton [00:36:41] Yes. Well, it's a new follow up now. I'm kind of 

curious about, you know, if you think you're getting 

the low hanging fruit of prevention. You know, if 

you're if you're saying our appointments are going 

up in, referrals are going up and that's a sign that it's 

working. Is that also not mean that it's possible that 

you know, you're bringing in people who are sort of 

receptive to this idea and not the people who would 

be dismissive and reluctant to seek help. And 

they're the ones taking their lives like, how are you 

reaching the people who need to be saved versus the 

people who can, who are fence sitters and go either 

way? But it seems like the latter.

Maj. Gen. Eric K. Little [00:37:20] Matt, go ahead and I'll let you know. 

Rear Adm. Matthew Kleiman [00:37:23] Yeah, I mean, yeah, so I think you're right. I mean, I 

think we want to really focus on working with first 

line leaders on messaging around. It's OK to seek 

help early. And I mean, this is so obvious to me that 

this is something that that we need to be doing. But 

this isn't something that's always been part of the 

military culture. I mean, if you think about the 

military culture, you know, going back 20, 30 years 

ago, there's this idea that you know, you don't want 

to get pulled off the front line. You know, if you are 

broken, you need to be fixed. And that can really 
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have a direct impact on stigma. So, no one wants to 

be considered mentally broken. So, what we've 

done is we've really changed how we frame this. 

So, everyone is expected. We're all dealing with it 

with a lot of stress and being in the military is a 

stressful job. We're, you know, it's really more 

about your performance and the analogy that I 

would use is looking at like a sports psychologist, 

right? So, if you if you're an elite athlete and you go 

to talk to a sports psychologist, you're doing that 

because you want to get an edge. You want to be 

able to perform at the highest levels. And no one 

sees that as your broken and need to be fixed. And 

this is sort of how the military needs to look at this. 

So, directing someone to to get support is not about 

being broken and needing to be fixed. It's really 

about doing everything that you can do to improve 

and increase your resilience and your performance. 

And so, to your point, I mean, I think we have to do 

both. We have to be prepared when someone does 

develop a true mental health disorder, they need 

treatment. But prior to that, there's a lot of things 

that we can do to support that individual to be the 

best versions of themselves. And that, you know, 

that involves getting help, you know, before a 

problem becomes so severe that they may have a 

diagnosis. So, it's really doing both. 

Maj. Gen. Eric K. Little [00:39:18] And just to add to that, that's what I was going to hit 

on was the first line leader, deal. I can't stress 

enough being on being a commander several times 

here, and even on the battlefield, you have to ensure 

that that that first line leader is understanding and 

can recognize that that that, as you mentioned, there 

are some people that will help and some people 

down in those people that don't are the ones you 

have to watch out for. And you have to be able to 
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recognize that they're struggling and have to give 

them that resource and tell them it's OK. And that 

goes back to that stigma issue. That stigma in the 

military is an issue has been an issue for many, 

many, many years. That's the issue. That's if we can 

break stigma, we will make a difference. Great 

question. Great follow up question. 

Wayne Hall [00:40:00] Thank you, gentlemen. Scott, Maucione, I notice 

that you're on do you have a question for our 

leaders? Scott. OK, so nothing heard I'm going to 

move on next to Drew Brooks National Guard 

Magazine Are you online? Do you have a question? 

Drew, question. All right, nothing heard I'm going 

to cause you to press forward Ellen Mitchell from 

the Hill. Are you online? Do you have a question? I 

know I don't have a question, thank you. Thanks, 

Ellen. National go to Karli Goldenberg from Army 

magazine. Are you online and do you have a 

question? 

Karli Goldenberg [00:40:50] Yes, I have a question. First, good morning, Major 

General Little and Rear Admiral Kleiman. So, my 

question has to do with the sort of things that you 

both touched on previously in terms of the unique 

challenges that our reserve component personnel 

face as they try to seek mental health care access. 

So a study that was released by RAND in early 

September identified two key issues, especially for 

people living in rural areas, and also that people 

who served in the National Guard experience a 

higher rate of non-combat stressors, which I think is 

something that Steve was alluding to previously. 

So, I know that you've mentioned some of the 

programs that you're working on to ensure that 

we're reaching National Guard members when they 

need mental health care access. I was curious if you 
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could speak a little bit more in depth about that, 

about what the guard is doing to ensure that mental 

health access is accessible to everyone, but 

especially for our reserve component personnel who 

tend to live in more rural areas that are straddling 

that civilian-soldier identity. 

Maj. Gen. Eric K. Little [00:42:02] So I'm going to hit that big level, and I'll let Matt 

get into it a little bit more so the vet center. Admiral 

Kleinman already kind of talked about, and I'll let 

him talk about it again. But I will tell you, at the 

OSD level, this is something that not only in the 

mental health fitness, but also and I'll talk a little bit 

a little bit about sexual assault. That's the same kind 

of same issue. It's just the resource having those 

resources available. If you're an act that you're on 

your own, you're an active-duty installation. Can 

that reserve or National Guard member go to the 

active-duty installation for help? That's some of the 

barriers that we're trying to break down because we 

know that's a problem. Having those community 

partnerships, we want to continue to expand those. 

We have several now, but we are working with 

OSD to continue to expand those community 

resources just for what you just highlighted, 

because we know that's a problem, again, I'm going 

to use the I'm from Illinois. You're in southern 

Illinois, and there's a reason we're all the way in 

Chicago and you're not going to go all the way up 

there. So, we have to we have to figure out how we 

can get those and those community partnerships. 

And there's several avenues general out there that 

are doing that right now and setting up those setting 

up those community partners. For us, for the 

reasons you said in not very many active-duty 

installations, even if we can break that barrier. But 

we have to get those partnerships established in 
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getting at least in the lease so they know who to call 

so we can get some type of even a virtual 

appointment set up. But Matt, I know you got some 

specific stuff. I want to give the overall comment. 

Rear Adm. Matthew Kleiman [00:43:21] Yes, sir. Thank you. Really good question. So when 

I started several years ago with NGB, I quickly kind 

of developed what I kind of came up with as as 

almost like my mantra, which is the things that we 

need to do up here have to be able to improve the 

quality of what we do, expand access to care and 

reduce stigma. Those are the sort of the three 

overarching areas that that I felt needed to be 

addressed because even if you have really good 

quality programs, if nobody has access to those 

programs, you, you fail. And if you do have great 

quality programs that everybody can access, but 

nobody will do it because they're afraid of what it 

might mean for their career, you fail, so you have to 

have all three. So, there are a number of things that 

we've done to try to expand access to care. Just to 

answer your question directly, we have directors of 

psychological health and at every wing, at every 

Joint Force Headquarters and many of our units to 

really understand what those local resources are and 

to be kind of that conduit to make referrals. We 

have a pilot that and I say it's a pilot, but really, this 

has been a fairly expansive program. I think in over 

20 states now and it's continuing to expand. It's 

called Star Behavioral Health, and we've trained to 

date about 2,500 community-level providers on how 

to provide support to our population. So. So we 

bring civilian community providers in, provide 

training to them at no cost. To really familiarize 

them with our culture with the treatment protocols 

that are effective with our population, 

understanding that our members go to community 
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providers to get a lot of their care since they don't 

have access to military treatment facility. So that's 

another program. We've developed a partnership in 

an MOU (Memorandum of Understanding) with 

Give An Hour, which has a service provider 

network across the country that provides free 

mental health counseling. So, we see a number of 

referrals every year to Give An Hour. And we also 

have other resources like Cohen, Veterans Network 

and other clinics that we partner with at the state 

level to make sure that we're directing service 

members to those resources. So again, I could go 

on, but it's really critical that we understand what 

are the local resources. So that and then telehealth is 

a big option for those that don't have anything 

within, say, 50 to 100 miles of where they live, so 

we've greatly expanded telehealth. Just last year 

alone, I think we had over 3,000 telehealth visits 

just in the Air National Guard alone for follow up 

care and over 2,00 for new visits. So that's over 

5,000 contacts that are just receiving telehealth 

through the Air National Guard. And you know, 

again, it's being kind of intentionally redundant 

having all of these options so that someone who 

wants care can get it. And if all else fails, there's 

Military One Source. There's, you know, other 

resources that DoD provides that that members can 

access as well. 

Wayne Hall [00:46:29] All right, sir, thank you. Ladies and gentlemen, I'd 

like to thank you for joining us. That's all the time 

we have for questions today. I'm going to offer 

Admiral Kleiman and then General Little brief 

opportunity for some closing remarks. Any last 

words they'd like to leave you with? And so, with 

that Admiral Kleiman, any closing remarks from 

you 
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Rear Adm. Matthew Kleiman [00:46:29] Yes, just wanted to thank everyone for their time 

today. I mean, I really do appreciate the opportunity 

to talk about some of our initiatives. And I hope 

what came across is just how seriously we take this. 

I mean, this is a a calling and a mission for us. I 

mean, as General Little stated earlier, you know, we 

get the every time there's a suicide, we get that call 

and we deal with that as a not just the individual 

who's lost his or her life, but the impact on the unit, 

on the family and loved ones. It's really 

immeasurable. And so, I mean, we take it to heart 

and everything that we do from a prevention 

perspective is trying to save lives. And it can be 

frustrating because we can't always make that direct 

one to one correlation. But it doesn't stop us from 

trying, and we continue to look at ways that we can 

get upstream of suicide and provide again that that 

support, whether it's through expanding access to 

care or providing resources down to the 54 down to 

our leaders, and we'll continue to do it. But again, I 

just really appreciate the offering to highlight some 

of the things that we're working on right now and 

that will continue to work on as we move into next 

year. Thanks

Wayne Hall [00:47:59] Thank you, General Little over to you. 

Maj. Gen. Eric K. Little [00:48:01] Yeah just trying to echo what, Admiral Kleiman 

just said. I do want to thank you all for taking your 

time. I know you're all busy taking time out today 

for this to let us talk about what we're trying to do 

and what we're doing and the things that we that 

we're continue to push to do because one life is too 

many. I know you guys hear that, but I also want to 

tell you, I appreciate you pushing us and I 
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appreciate you pushing the DoD to make sure that 

we continue to try to be the best we can and provide 

every resource possible to our to our soldiers and 

airmen out there and also for reporting on it. This, 

again, is an awareness piece. This will help the 

awareness to our soldiers and airmen out there. 

Maybe someone read your article and ask for help. 

So again, I thank you all and thank you for what 

you do, and we're really appreciate it. And again, if 

you ever need anything, please reach out and we'll 

answer and make sure we can answer whatever 

needs you have. Thank you again and appreciate it. 

Wayne Hall [00:48:49] Thank you, General Little. All right. Again, thank 

you for joining us today if you have any additional

questions for us afterwards. Please feel free to 

contact us by email and we'll try to get you 

responses as efficiently as we can. Thank you very 

much. 

Duration: 00:49 minutes and 5 seconds

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