Kayla M. Williams is a Senior Fellow and Director of the Military, Veterans, and Society Program at Center for a New American Security. She previously served as Director of the Center for Women Veterans at the Department of Veterans Affairs, where she was primary adviser to the Secretary on department policies, programs, and legislation affecting women veterans. Kayla spent eight years at RAND researching servicemember and veteran health needs and benefits, international security, and intelligence policy. 

Ms. Williams was enlisted for five years as an Arabic linguist, serving in the 101st Airborne Division (Air Assault). She authored the memoirs Love My Rifle More Than You: Young and Female in the U.S. Army and Plenty of Time When We Get Home: Love and Recovery in the Aftermath of War. Kayla graduated cum laude with a BA in Literature from Bowling Green State University and earned an MA in International Affairs from American University. She is a member of the Department of Labor Advisory Committee on Veterans’ Employment, Training, and Employer Outreach; a former member of the Army Education Advisory Committee and VA Advisory Committee on Women Veterans; and a 2013 White House Woman Veteran Champion of Change.

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

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Duane France (00:00):

Welcome to episode seven of the Seeking the Military Suicide Solution podcast brought to you by the Military Times. I'm Duane France.

Shauna Springer (00:07):

And I'm Doc Shauna Springer.

Duane France (00:09):

And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd also like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com.

Duane France (00:37):

Thanks again to everybody for joining us to listen to a conversation about service member veteran and military family suicide. Really appreciate how people have started to find the show and share it. If you want more folks to find the show, make sure to give us an honest rating and review on your podcast player of choice. We'd also like you to join our Facebook group moderated by fellow combat veteran Dee James. You can find the group in the show notes or by searching, "Seeking the Military Suicide Solution" on Facebook. And one of the things that we've heard is that a lot of listeners don't just want to hear from mental health professionals and today's guest isn't, but she has a lot of expertise when it comes to this subject. Shauna, what can you tell us about today's guest?

Shauna Springer (01:14):

Yes, so Kayla Williams is an Iraq war veteran who serves as Director of the Military Veterans in Society program at Center for a New American Security. I asked Kayla why suicide matters to her on a personal level, and she said this: when she was in Iraq, a woman in her unit died by suicide. She and this soldier had just spoken a few days before the death. Like many leaders who care about their soldiers, Kayla spent a lot of time wondering whether she missed the signs or could have said or done anything different that might've encouraged her fellow soldier to get help. She also shared that she has struggled with suicidal ideation herself on more than one occasion and also with trying to find the right response when her husband, another veteran, has expressed similar feelings. Kayla is an elegant writer who has given deep thought to this topic. We're happy to host her on today's episode.

Duane France (02:09):

Yes, the lived experience. We've also often talked about the fact that those of us who served have a number and that number is the number that we have lost to suicide. And sometimes that number is bigger even than the number of people that we lost in combat. And that's going to continue to grow. So I really appreciate Kayla's transparency and vulnerability and we'll get into the conversation. We'll come back afterwards to pull out some of the key points.

Duane France (02:45):

As a combat veteran yourself as a veteran spouse, dual military and all the work that you've done really over the last 15 years, from your point of view, what have you seen that is effective when it comes to ending in the military population?

Kayla Williams (03:01):

That's a great question. I think looking at the data, we have to admit that VA is getting something right because, while we've seen overall growth in the rate of suicide, that growth rate has been lower or even flat among veterans who use VA for their healthcare. We know that's true for women veterans in particular. So obviously VA has at least some protective effect. One thing that I noticed in several of the VA medical centers that I've been to personally is that they are willing to try to address the issue of gun safety. So the Pittsburgh VA where I used to go for care, they just had bowls of gun locks sitting out on counters to just make it really easy and simple to get a gun lock to enhance the safety of those who do own firearms. And because of the lethality of firearms, that is a really big deal. And anything that can help folks who choose to own firearms be safer when they're in crisis is a good thing. I think also that, like anecdotally, the power of personal connections is really important. Feelings of isolation can be incredibly detrimental. And having a close and supportive network of peers can be protective. And anything that can enhance that, organizations that can help folks get together, spend time with each other can potentially be really beneficial as well.

Duane France (04:37):

You know, that's a couple of great points. And and definitely the question about lethal means safety and firearm safety is something a lot of people want to kind of keep their hands off of. But it is part of what this issue is. I mean, you and your former role at the VA working with the center for women veterans, the women veterans suicide rate using firearms is higher, maybe nearly double what it is, the non-military female rate. I mean, it's critical. We don't like to talk about it, but it's the elephant in the room. It's there.

Kayla Williams (05:08):

That's absolutely right. And again, I'm not saying people shouldn't have guns. I'm a vet. I carried a weapon every single day for a year when I was in the Middle East. I'm very comfortable with having firearms and having access to firearms. But that doesn't mean that I can't, you know, say really honestly, that we know that because of that lethality and the comfort level that veterans have with firearms, we are significantly more likely to die by suicide that involves use of a firearm. So we have to be able to talk about it in a way that doesn't raise people's hackles and make them think that we're talking about taking away guns. We're not talking about taking away guns. We're talking about finding safe ways to store firearms and finding ways that, if somebody thinks to themselves, you know, I may be reaching a crisis point that they can find a safe place to store their guns temporarily until the crisis has passed.

Kayla Williams (06:09):

So in some States, that may mean that there needs to be like a law change that makes it possible to, you know, hand over your firearm to a friend temporarily. It may mean trying to find partnerships with gun ranges or stores or you know, other places where somebody could say like, Hey, I'd like to leave my firearm here for awhile and lock it up. Because, and this is one of the tough things. There's, there's this huge misconception that once someone decides to die by suicide, that it's going to happen no matter what. And there's nothing we can do. And that's just not true. The data is really pretty clear that restricting access to lethal means is very effective. You see bridges that put up chain link fences so people can't jump.

Kayla Williams (07:02):

Somebody shows up finds the fence, they don't go look for another bridge. They go home. Putting medications in blister packs, so you have to individually pop out every pill that is effective. Anything that slows people down, that puts a barrier between them and the lethal means that they are looking into at that moment drives down the rate of suicide. It's often this impulsive decision, you know, and made within an hour of making the decision that actually is taken. And so slowing that down and giving people the opportunity to to rethink and to, you know, maybe reach out to a loved one or reach out to a crisis line or get help in some way is really important. So we definitely have to talk about lethal means. And in our community in particular, firearms is a big one. So let's make it easier for people to get gun locks, to store their firearms safely, to feel comfortable going to a friend and saying, "Hey, can you hold onto this for awhile? I think I'm better off not having it around right now."

Duane France (08:06):

So the idea of the things that are working right, you know accessing care at the VA if it's available to you and you know, the frequency or working with some kind of treatment. Even the peer to peer and things like that. That's what's working. But maybe what might not be working is the messaging or, you know, you just absolutely busted one of the myths when it comes to suicide and means preference. What do you see that's not working when it comes to veteran suicide? Like it, before we started talking for 15 years, you first wrote your book in 2005, you'dve been talking about these issues and really banging this gong and it, and it hasn't seemed to change. In some ways it might seem to be getting worse.

Kayla Williams (08:46):

Some of the things that I find really frustrating include that pundits and sometimes even journalists and politicians aren't using best practices and talking about these issues. So it's been pretty well documented that there is a contagion effect. In many communities you'll see clusters of suicides. And so when we're talking about individuals who have died by suicide, there are some evidence based practices about the types of language to use or not use. And people just don't follow those. There are guidelines and include things, too. Like not calling it an epidemic. Not saying that rates are skyrocketing, not using inflammatory language in general, but you still see that. We think we know that it's really important that whenever you're going to be talking about or writing about suicide that you talk about and include information on how to reach out, which I'm sure that you'll be doing here, including the crisis line somewhere and making sure that folks know that there are places they can turn to if they are in crisis.

Kayla Williams (09:54):

So I think all of that is an ongoing sense of frustration for me that folks are continuing to not abide by those best practices. And another source of frustration for me is that, you know, I've talked a little bit about firearms. So if somebody's already made this choice, other lethal means, restricting access is important. The other direction that I think we should try to go is way, way left of boom, and addressing some of the issues that I think could be contributing to an overall sense of distress and unhappiness that seems to pervade our society. Like we're talking about suicide in the mil/vet community where it's been rising faster than another segments of society, but it's going up in all segments of society. The growth rate in suicide among 10 to 14 year olds has been dramatic.

Kayla Williams (10:48):

Like that is terrifying to me. My son is nine. Like, I didn't think I would need to worry about it that young, but you know, there is something going on in our broader society that that we should be trying to address. I don't have data on what I'm going to say next. This is just more of an anecdotal feeling, but my sense is that, you know, we have rising income inequality. We have you know, an environment that's really stressed. We have this ongoing trend of people, it seems like, spending less time with each other in person, face to face. I just feel like in a lot of segments of society, we're seeing hopelessness and loneliness and trying to address some of those issues where folks can live lives of purpose and meaning where they believe that they're doing work that makes a difference in the world and that they're connected to their communities and their family members. I think those could be really protective as well. But those are hard problems to tackle and they extend far beyond our community. But I think, again, no data on this, but I feel like that is important.

Duane France (12:00):

Oh, you're absolutely right. And you're a definitely singing my song and a former colleague of yours, Rajeev Ramchand, and he is coming on the show, and he says, yes, suicide awareness. But it would be a very bleak world if we just walked around thinking everyone that we come in contact with is about to take their own life. The goal is really to increase wellness rather than prevent suicide. And this, you know, always thinking that somebody in crisis. It can create a very negative view.

Duane France (12:32):

After the break, Kayla and I talk about how difficult it might be to implement and measure more upstream interventions that keep people from experiencing a suicidal crisis in the first place.

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Duane France (14:03):

That seems to be a gap that exists is, I mean, even talking about suicide, suicide is a symptom of an underlying issue to be resolved. It's not a problem to be solved itself. Is that one of the gaps that you see is just the lack of awareness of getting left to the boom?

Kayla Williams (14:19):

I think lack of awareness but also a sense of confusion or helplessness about what to do. Right? And how do you get funding for programs that feel that nebulous, you know? I think that's another challenge for folks who want to look at this. It's, we're in a time when I think legitimately, for many reasons, folks want to see evidence based programs. They want to see something that that you can see a noticeable change in numbers. You can have metrics, you can track outcomes and, and something that is aiming to change some more fundamental aspects of our society that's going to take years or decades to pay off. And you're not going to necessarily be able to see a nice clean metric to show that it's effective. And I'm not sure that we even know, you know, what, what would work?

Kayla Williams (15:10):

People, I hear people talk about wanting to get left of boom, but I'm not sure that folks know how to do that or what to do. Perhaps that's one of the reasons that VA can be beneficial is that VA, if you get into the VA system there are actually a lot of types of support within VA across it's different administrations and types of programs that you're not going to get from standard health insurance or at a standard doctor's office, right? If you ask and sometimes have to ask again, but you can get connected with not just medical care, not just mental health care, but in a growing number of VA medical centers have like medical, legal partnerships. So you can get linked up with pro bono legal services. If you have legal problems, you can get help with financial issues if you get disability compensation or access to your GI bill. Right? So these other things that are getting at your overall quality of life. I'm not saying the VA's always perfect and certainly it's a very difficult and frustrating system to navigate at times. But perhaps that's one of the other things that can make a difference. I feel like, I wish I had the answer for you. I'm sure everybody does, but I don't know that there is, like if there was one clean, simple answer, we would have already implemented it. Right,

Duane France (16:25):

Right. Exactly. And this is something that, that actually Shauna and I, you know, say is, if we, the mental health professionals, had the solution, the problem would be solved by now. If the employment folks had the solution, the problem would be solved. Right. And so that's really the premise of this series is to say, you know, each of us has an aspect of the answer. And if we combine them then maybe we will get a larger answer. You know, the whole being greater than the sum of its parts. The idea of, you know left to the boom in this wellness stuff. And not everything works for everybody. I'm not a yoga guy, but I've got a lot of friends who are. I'm a meditation guy. It is similar but very different. I'm not a massage guy, but I will swear by float therapy, I do it at least once a month. That's my kind of massage and it just makes me feel good. Right? I feel relaxed and good after I'm done. And it's hard to quantify an evidence based practice, that feeling of feeling good.

Kayla Williams (17:20):

Right? Right. My husband does a fly fishing with Project Healing Waters and that's really beneficial for him. I think both in terms of the socialization, being out around other humans and other veterans in particular and also being in nature right? Like on the water surrounded by trees and also the meditative aspect, I think of casting a line, right? Like the, the repetitive motion and the peacefulness that can come with casting. And then also, you know, he ties flies and feeling pride in accomplishing something and doing something and being good at it and doing, you know, complicated work. All of those things I think are helpful in their own ways. But as you say, hard to necessarily quantify,

Duane France (18:06):

Yes, from a clinical standpoint, the neurological development that comes with the concentration of tying flies and even a fly fishing in the constant motion. I mean we in the clinical space knows what works and we know that in the same way that the concentration in golf helps neurological development and things like that. You know, there is a scientific basis for why these things work. The same thing for float therapy or massage, meditation when it comes to calming down the amygdala and increasing prefrontal lobe and things like that.

Kayla Williams (18:34):

I feel like every week I see some new headline that's like "bee keeping helps veterans," "scuba diving helps veterans" and I'm like, yes. Getting out of your house and doing something, preferably with other humans, helps. Right. It isn't necessarily the one specific thing, it's what you're talking about that comes along with any of those activities,

Duane France (18:58):

You know? And maybe that leads into, you know, what can be done, what action steps can people take. This raising awareness or, even, you know, as you're talking about the reporting issues, which is really more like shouting fire in a theater and not really effective. But still all of this awareness, we've been banging the gong of awareness for years. What action steps can individuals take or maybe we take as a community to really make a difference.

Kayla Williams (19:24):

One of the things that I still see as a really big need in our community are organizations that can help service members, veterans and military families navigate the available resources because there are so many resources and the eligibility requirements for them vary dramatically. The way to apply can really vary dramatically. And when you're struggling, that process can be incredibly overwhelming. So for organizations to come together in a collective impact model or in some type of physical location or informal collaboration. So that if somebody comes in and you know, they express that they are having distress in one area of their life and then as it comes to light, they're actually having challenges across several different areas that they can get their needs met across a variety of areas from one starting point. Right? With coordinated care. And I mean care in a really broad sense there.

Kayla Williams (20:28):

I think that's helpful and important. You see some organizations starting to do this in various cities. I think Combined Arms in Houston is a good example. I think also Code of Support with their Patriot Link software is another good model that seems to be showing some real promise. So, you know, folks are trying different ways to do this, expanding those efforts and making sure that they they exist, you know, across communities I think is really gonna be important. And to me, something that shows a lot of promise to make sure that we don't have people slipping through the cracks in one area when they reached out in any way to try to get some needs met.

Duane France (21:11):

I absolutely agree. I describe it to my clients and, and even to others in my local community and elsewhere, starving at the feast, right? We have this amazing buffet of all of these different things. It's like the largest buffet in the world, but yet people are still starving in the middle of it because like you said, the barriers that exist. But also the barriers of, you know, leaders eat last, right? I'm just going to keep letting someone else, you know, it take advantage of the resources. They need it more than I do. I've got my 10 fingers and toes and so on. And so eventually you just have a bunch of thirsty horses that want to drink water, but they don't know where to start.

Kayla Williams (21:48):

Yup. Yup. Also mention, some of the work that we've done recently that may be of interest to your listeners. We identified and coded every state level benefit across the country. We found 1,800 I'm sorry, we found 1,814 discrete benefits offered by States. So service members, veterans and military families. It's more than I even expected. There's a lot of variation. There are a lot of States that offer discounts on recreational activities. So we're talking about the benefit of, you know, going outside, getting into nature and doing some activities. There are a lot of States offer reduced price or free fishing licenses or hunting licenses. Virginia also has peer support specialists that are offered at the state level, paid for by the state. And if my kids start to struggle because of my service or my husband's service, the state of Virginia will pay for my kids to get mental health care.

Kayla Williams (22:47):

And as you know, VA, that's something VA can't do. So the fact that the state is willing to step in and help with that. And again, talking about these stressors that go across life domains, if you're worried about your kids, that's another huge stressor. So encourage people to, when they're thinking about this buffet, as you call it, remember that States are another source of available benefit and support and they have a lot of huge variation between States and what's available. And with our new state benefit finder, folks can go online or on their desktop or on their phone and search by type of benefit type of beneficiary or state to find out what they may qualify for.

Duane France (23:27):

That's excellent. And I'm a definitely going to make sure that that's included in the show notes. As well as following my own advice is to see what...because even as I'm helping veterans here in Colorado, I'm certain I probably don't even know of all of the state benefits here. So we'll definitely recommend listeners take that step. Kayla, I really appreciate you coming on the show today.

Kayla Williams (23:50):

Thanks. It's my pleasure. In case you don't have it handy, just want to remind everyone the crisis line is (800) 273-8255, veterans press one. And I'll also put in a plug for Vet Centers. I don't know if you've had anybody from a Vet Center on to talk, but I feel like those are an under...they're a resource for veterans that not enough veterans know about that Vet Centers are more at the peer type support because such a high percentage of them are fellow veterans.

Duane France (24:29):

You know, when I first started thinking about people who could come on the show to talk about suicide, Kayla was one of the first ones that I talked about. I've had the opportunity to interact with her in a number of different occasions. What did you think about what we talked about?

Shauna Springer (24:42):

I thought it was another great interview from somebody who really brings authenticity to the conversation that comes from not only expertise but also lived experience. One of the things that I especially notice was that Kayla expressed frustration that people in the media and sometimes in political roles often fail to use best practice approaches in talking about suicide. And she gave the example of describing suicide as an epidemic or rates as skyrocketing. I've been thinking a lot about this too. Because in many of the suicide related briefings, talks and trainings and media pieces that I've heard, the all too common lead in is to start by raising a cry of alarm usually by citing a disturbing statistic. Now, I have no doubt that the intentions of the speaker are all for the good. I think this is designed to get people's attention in a world where our attention is terribly fragmented, but it occurs to me that if we wanted to engineer a way to increase complacence by habituating people to these statistics, this would be the way to go about it.

Shauna Springer (25:47):

Not that everyone is doing this in any organized, purposeful way, and they surely want the opposite outcome. But for the past couple of years, I've argued against this approach because I've also witnessed the impact of this strategy on those who have been impacted by suicide loss. For example, this last summer, I joined a group of Marines who came together to grieve the loss of their fallen, whether due to combat or suicide. In this gathering occurred during a time when there was a flurry of news reports about recent suicides in the military and veteran population, and I will always remember how many of the Marines in that circle expressed and showed such frustration and helplessness in regard to this barrage of news reports about veteran suicide. They told me that it feels so demoralizing and drives this false and damaging narrative of the broken veteran. So my thought is, at what point is our desire to bring awareness doing more harm than good? From my perspective, warriors need to hear that they are irreplaceable assets who can come back from war and contribute in meaningful ways. And I think the question for all of us to consider is this, how do we balance acknowledging the pain that suicide causes without leading people to feel helpless and hopeless, when in fact there's so much we can do to prevent suicide in many cases?

Duane France (27:10):

You know, this is a...actually, I'm not sure if listeners who have listened this far to have really picked up on it, but we're not using the numbers, right? We're not saying 22 or 20, or 17, or 17 and 6 or you know, 14 and...I mean this is one of the things is it goes beyond the numbers. I think couple episodes ago, Cecily had really, you know, she very clearly said not to talk about the numbers but brought up a statistic, but it's more than just the statistic. It's more than just a number. That's the awareness piece and part of the public health approach is to define the problem and people are using the statistic to define the problem. But moving beyond that is, how do we identify risk and protective factors? And that's what we're trying to do here.

Shauna Springer (27:55):

Right. Because in the last couple of years I've really switched to, you know, the messaging that one loss is the loss of one irreplaceable person to those that loved that individual. So really one is too many. And so zooming in on the impact of suicide for those who are affected by it rather than kind of increasing a sense that this problem has no solution, which isn't true, there are things we can do to prevent suicide. The other thing that she pointed out kind of at the end of her interview, which I really wanted to pick up on was Vet Centers are often overlooked as potential resources. I really wanted to emphasize this point. We're going to add in the show notes for this episode, a Vet Center locator, but many of the veterans I've worked with have been surprised to learn about the range and the depth of services offered at Vet Centers.

Shauna Springer (28:49):

They are typically smaller, more approachable treatment clinics that are often largely staffed by veterans, as Kayla mentioned. They offer general readjustment counseling as well as peer support groups, including often combat trauma support groups and they have specialized programming for people who have had military sexual trauma and those who are grieving a military loved one. They also do events and bring the veteran community together in social ways. For example, here where I live in my community, the Vet Center hosts weekend workout sessions and has a veteran led softball team. What is your Vet Center offer, Duane?

Duane France (29:28):

One thing it offers is an opportunity to not be in the big VA. Vet Centers or out in the community, righ? As you were talking about this and even as Kayla had mentioned, I am a huge proponent of Vet Centers in that it's an easy and comfortable way for veterans to access outpatient mental health, right? So when people think about, you know, going to see the wizard or seeing the shrink at the VA, it's not all about medications. That's a misconception is, Vet Centers don't do medications, they just do outpatient readjustment counseling. There was a study back in 2018, the evaluation Department of Veterans Affairs Mental Health Services, the National Academy of Sciences, and they identified that the Vet Centers, if we can make behavioral health clinics more like Vet Centers, more veterans would actually use behavioral health in the VA. And so it's not just going in some little narrow room with the doc. It's going to a comfortable place, almost a living room atmosphere in the waiting room and stuff like that. I mean we describe our clinic as a civilian Vet Center because it is designed and very much the same way.

Shauna Springer (30:37):

Yeah. I think a lot of times people think of the VA as the big medical centers and that centers are the VA. People don't know that VA Vet Centers are a whole series of clinics that began largely because of, frankly, Vietnam veterans standing up and advocating for this. The original history of it was that the Vet Centers were, as you said, designed to be in the community setting and a more streamlined, approachable way to get into care. In fact, the original tagline I'm told is "help without the hassle." And so they started by the advocacy of Vietnam Veterans who wanted these more approachable clinics and they're still around and they're offering a tremendous depth of services in different places and they're just an overlooked resource for many people.

Duane France (31:27):

Yeah. And as Kayla mentioned, a lot of the clinicians that are hired by the Vet Centers are veterans themselves. I mean, that is a priority focus when they're looking at staffing clinicians, master's levels and PhDs and even interns working there, that having military background, A veteran doesn't need much recent to avoid therapy and the Vet Center is really do reduce a lot of those reasons.

Speaker 5 (31:44):

We really appreciate everybody checking out the conversation that we just had a make sure to check out the show notes for this show veteranmentalhealth.com/stmss07. You can get the links to everything that we talked about on this episode. as well as finding the show notes on military times.com. As a reminder, you can ask us questions or let us know what you thought about the show by going to our Facebook group, moderated by the outstanding Dee James by searching, seeking the military suicide solution on Facebook.

Duane France (32:19):

While you're at it, check out our sponsors, milMedia Group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer (32:53):

Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with the licensed clinician.

Speaker 5 (33:11):

You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes. and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.