Career Paths in Military Psychology: Navigating Professional Roles and Lived Experiences

4:09PM Sep 25, 2023

Speakers:

Patricia Zapf, PhD

Dr. Nicholas Grant

Dr. Deonte Williams

Keywords:

deonte

work

military

psychologist

people

folks

years

navy

mental health

experience

air force

palo alto

care

program

patient

sharing

research

service

lgbtq

nick

I'd like to start by saying hello and thank you so much for joining Palo Alto University and the Division of Continuing and Professional Studies for our talking Mental Health Careers podcast episode featuring military psychology. My name is Patricia Zapf. And I'm the Vice President for Business Innovation and strategic Advancement at Palo Alto University. I am very fortunate to be joined by our experts today, Dr. Nick grant and Dr. Deontae Williams, both with the distinction of being alumni of Palo Alto University. Thank you both so much for being here for this important conversation. I'd like to start by giving our listeners a little background information on each of you. And then really just leave it open to you to kind of tell us a little bit more about yourself and your career. Dr. Nicholas grant is board certified in Clinical Psychology and serves as a Lieutenant in the United States Navy. Lieutenant Grant currently serves as the embedded mental health officer for commander, Naval Surface group middle Pacific, where he oversees the mental health program for all surface ships homeported in Joint Base Pearl Harbor Hickam Hawaii. His leadership roles include department head of the embedded mental health department, and mental health advisor to the commander. Additionally, he serves as faculty in the Tripler Army Medical Center clinical psychology postdoctoral residency program, supervising an inter service clinical rotation between the army and navy in 2022. Lieutenant Grant was selected by the Office of the Chief of Naval Operations 21st century sailor office as a fellow in the international career advancement program, and in 2023, he was selected for the global Atlantic fellows for Health Equity Program. Dr. Deontae Williams is a clinical psychologist and serves as Captain in the United States Air Force. Captain William serves currently at Aviano Air Base Italy. He completed his pre doctoral clinical residency at Wilford Hall Ambulatory Surgical Center, Joint Base, San Antonio Lackland, Texas, and he is a 2018, recipient of the United States Air Force health professions scholarship. In 2021, he received his Doctorate in Clinical Psychology from Palo Alto University. While in Italy, he has served as an the officer in charge of family and couples treatment at his local installation. And he is the host of DNA of love with Dr. Williams, which is a weekly podcast on dating and romantic relationships for couples and singles alike. So really distinguished guests, thank you both so very much for being here. Nick, I'd like to start with you. Please just tell us a little bit more about your career path and the professional experiences you've had.

Sure. Well, let me start by also saying thank you so much for having us here. today. I'm really excited to be a part of this conversation. The thing that I will say to kind of frame my career path is that I have jumped around quite a lot and it took me or I went many different places before finding my way into the Navy. So I graduated from Palo Alto University back in 2015. And I specifically wanted to go to Palo Alto University to work with Dr. Peter Goldblum, who ran the Center for LGBTQ Evidence-based Applied Research and LGBTQ plus mental health concentration area. After completing my PhD, I went on to do my first fellowship, a postdoc at the San Diego VA where I helped develop and then run the LGBTQ veterans mental health program in the San Diego VA, which has been a program that has now been modeled and other VA systems across the country. During that year, I applied and was very, very fortunate to be selected to become an American Psychological Association congressional fellow. So the year after San Diego I actually moved to DC, and did a fellowship in the office of US Senator Kirsten Gillibrand from New York and in her- during that year, I worked on the teams that managed her legislative portfolios around military health care and a few LGBTQ policy items that were occurring at the federal level. After that, I really didn't know what I wanted to do. So I spent a little time soul searching and ended up being a government contractor for about a year and a half. I worked at the Uniformed Services -Uniformed Services University of Health Sciences, specifically at the suicide care prevention and research lab of Dr. Marshall Holloway, doing suicide research with active duty service members. And then I moved on to the psychological health center of excellence at the defense health agency, where I supported the PTSD, depression and transgender mental health portfolios. During that entire period is when I worked on my application to commission into the Navy. I'll share a little bit more later I think about that pathway, but I was a direct obsession and in the Navy, so the application took a very, very long time, and then in 2019 And I believe it was I finally commissioned and had my first duty station and Naval Medical Center San Diego, I got there for arrive there and was there about for three or four months before they said, Oh, somebody needs to go join this aircraft carrier in the Middle East to help the psychologist on board and plus up their mental health resources. And I will share that my department had called me and asked me if I wanted to go, but I was really under the impression you're not allowed to say no, in the military. I have since learned that it is okay to say don't be honest with folks. But I said yes. And then I ended up flying literally halfway around the world to join that aircraft carrier, and spent three months on board with a few other mental health folks, including two psychologists, just providing additional support because the crew had had multiple extensions to their deployment. So the leadership really just wanted to bolster their support. I then had the fortune of literally sailing the other halfway around the world across the Pacific Ocean and coming back to San Diego, where I was there for about two months before the pandemic hit. And then I was assigned, I was pulled from the hospital again, and assigned to the USNS Mercy hospital ships we went to wasn't even a three hour voyage. It was like a 90 minute voyage from San Diego to LA to provide additional support to the civilian sector. As the hospital systems were still trying to figure out how to manage the pandemic, morale on that ship was really the primary mental health provider for the crew to make sure that they had the support that they needed as the entire world was trying to figure out what was going on with the pandemic. After that, again, with this bouncing around, I came back to the hospital and they assigned me to an external clinic. So I worked at the Marine Corps Recruit Depot, specifically as the division officer over the mental health unit. So I manage the mental health team, providing care to the Marines on that base, as well as running the mental health program for the recruits. The San Diego depot and the Parris Island depot. This, too, is session points for Marines in our, in our country. I was doing that for about 1111 months when the specialty leader of Navy psychology called me and said we have this physician that's going to open up it's called a hot fill, because it's going to open within the next 12 months. So they have to assign someone relatively quickly. And it's in a hole. Why would you be interested in taking that position? I told her that I know the right answer is to like sleep on it and call her back the next day. But I felt already like I couldn't say no to her why so like to plan it. Yes. A 95%. Yes, for tomorrow morning. And I did touch base with her I think the next day and said yes, I will do that. And so two and a half years ago, I PCS'd, started a military move from San Diego to Hawaii. And I have now been here supporting the ships that are homeported in Pearl Harbor and working with the Army and the Air Force and just really enjoying island life. But yeah, that is a quick summary of kind of my bouncing around today.

Thank you for that. Deontae What about you? What was your career path?

So I'm from DC originally I came at an interesting trip to California to begin with, because I drove across country from DC to California, originally wanted to just experience the country and also attend school. So it was a way to knock out two birds with the same stone. Um, before getting to Palo Alto University in California, I was I did a I did everything from working in a shoe store to work at multiple facilities for research, graduate or graduate, undergraduate and government worked at the National Institute of Mental Health for a year as a research assistant, as a postdoc. For a laboratory where we focused it's kind of cool, even then, but more so now because the studies are actually starting to come out. But I'm ketamine treatments on treatment resistant depression. So I actually got to be on the front line of like that wave of treatment, or at least the attempt of treatment on multiple patients. And in the context of research. I worked at George Washington University as a researcher, Stanford for a little bit. I once I got to California, and then a University of Maryland, in a lab, the HUBZone couples actually, which was kind of foreshadow into the future I was gonna have because when I got to California, I chose Palo Alto U and I narrowed it down between two schools, one in California, one in Seattle. And the only reason I wanted to go to Seattle Pacific, other than the research opportunities was because I play college basketball and I knew one of the players, famous player in the NBA, Jamal Crawford. He runs a program out of that school in the summer. So it was a massive perk on top of the academic benefits, but my academic mindset, you know, going to be 30 soon, so I'm not going to dunk a basketball forever. So I should probably choose the academic route. out in Palo Alto, you gave me the opportunity to, to sort of grow in fashion pretty blunt with me, they said, If you come here, we'll give you the opportunity to build your research directly that couples in the age range that you're hoping for with their West Coast research perspective with a few professors locally who were, like really excited about the idea of doing so because it had them up into that point, I had many, many research studies specifically on couples in the context of social media and their ethnic background. So it was a massively cool and interesting intersection. When you throw COVID on top of it, that was one I didn't plan for. But now the research is actually valuable. I'm looking to publish. I've been working with division 43 in the APA, I'm trying to get my dissertation published over the next year or so. So that's a pretty big, exciting thing in my life right now. I went from Palo Alto U to getting my lab health professional scholarship from the Air Force in 2018. It was really cool. I was incredibly thankful for it, because it helped me start my on boarding early into a military career that I wanted at the time, and I was super excited for and just like also, the academic and financial perks were massive, like they took care of literally everything. It was like, like basically, I was being paid to professionally be a student, which made my life a lot easier. It helped me get my dissertation done much more quickly because I didn't have to worry about too many things. Graduated in 2021, as a year residency or internship at Wilford Hall in Texas, served as an active duty intern, which is a another interesting intersection where I'm in uniform serving as a Captain in the Air Force. But no one sees me as a Captain yet they see you as a baby psychologist without a license at the time. But because they were so helpful in providing the scaffolding, I ended up getting license pretty quickly, within two months after graduating because it was, I had so much time to study that I was able to take the HLP during my internship year, which was really, really convenient and got me to Italy, my first duty station, they Airforce made a promise that if I can get licensed before everybody else, they'll send me overseas, I thought they were serious. Apparently they were kidding. And so I showed up with my paperwork. And they're like, Well, we're gonna send you to Italy, that you held up your end of the bargain. So we're gonna hold the virus. So that's how I ended up stationed at Aviano, where I'm 45 minutes north of Venice. Other than that, I'm here locally as a practicing psychologist, also head up ended up a clinic that was focused on family advocacy, so couples and family treatment, who are at risk or potential domestic violence incidents, in addition to folks who were at risk in the context of having new first time, children, for their family, that parlayed into an opportunity to become a radio host, which you mentioned in my intro, which I'm I love doing so much. And I actually just posted a video today on the show's Instagram, highlighting an episode that we did last week, where the radio show pretty much is an anthology series that we'll talk about maybe a little bit later, but it hits one different relevant topics for dating for people of all walks of life and military or otherwise. And it's just a lot of fun, as it literally is the coolest thing I do, aside from you know, singing in the shower and dance around the house and no one's around. So I'm very much very thrilled to have gotten that opportunity. I'm appreciative that the Air Force gave it to me.

Amazing. You both have had really interesting, really interesting, amazing kind of career paths different great, you know, opportunities. Deontae, I know, you started to tell us a little bit about this. But, you know, you're both clinical psychologists, we both work in different branches of the United States Armed Forces, but like many psychologists who have other professional interests that you spend time on, so you talked a little bit about podcasts. Tell us more about it. How did the idea come about? What do you do on the podcast? And it sounds like it's an you know, a love for you. So tell us more? Yeah, so

My dissertation at Palo Alto was basically it was on couples at 25 years old who were dating in the context of the pandemic and overlaying their relationships satisfaction with their reported self esteem, and their capacity to their capacity to connect with each other over social media. So that was the sort of genesis of it from a research standpoint, but I've been into relationships all my life like this is kind of embarrassing. Before I met my wife, I went on like 44 dates before finding the person I was supposed to be with it. Most of the dates were horrendous. They were terrible. I got water thrown in my face once I was chased to the zoo in DC. Don't ask why. I was I someone left me at a at a yoga place. And then there's a very odd date or took someone to a cupcake place called Georgetown cupcake. And it was we're having cupcakes and I kid you not I don't know why this happened. But while she was eating the cupcake, she scratched her nose. And then as her she had longer nails as her finger came down, she likes like clawed her face and started bleeding on the date. It was really awkward, because I'm like 22. And I don't there's no playbook for that. So it started out with me coming home and telling my brother some of these stories. And then it built from there, too. He told me to start writing them down. So I did and now I have a cache of stories from the last 10 years of me being young and not really know what I was doing. And that sort of helped me because now I was granted this radio show opportunity here where I started out where I came in as an interviewee, as a psychologist. He thought I was funny. And they were like, well, you explain things well, and you do have the clinical background like, well do you want to come back? And I was like, how much and they were like, oh, it's free. And I was like, I'll be here tomorrow. Sign me up. So I show up. And then from there, I started the weekly DNA of Love Series, where it's a series where we take research, like research driven perspectives on certain anthology topics like finance conflict. Truly, like date formation, reintegration after a breakup or after a conflict. We did the DNA of the romantic spark last week, like matches how to cultivate that spark, but like, when you have it, like how do you hold on to it for extended periods of time, if you believe you found the person you're supposed to be with. But that for an 18 and 25 year old can be very boring. So I'm mixing in all of these terrible dating stories, which with each concept, so I always give a little nugget, like a factoid that's research informed and clinically based. And then I throw in a story that applies that particular concept. And it's been it's been working for us. And I love it. It's the feedback has been really good locally, the general has actually, he took that he heard one of my awful stories while he was driving home on the radio. And he mandated and you know this, if a general says you have to do something is going to get done. And he told me that he wants me to do the first term airman course, which is pretty much a class for every new airman that shows up to base following their permanent change station. Usually they're 18. So they don't know. Not to be be disparaging the 18 year olds, but when it comes to the dating world and living overseas for the first time, very limited knowledge base in this area. So he's he's actually been the reason why I've been teaching that class as a part of a extension to the DNA of love series on the radio, in the classroom. So it's been really fun.

Awesome, I love that. And I'm going to call that out for our listeners near the end of this episode as well, because I think everyone should check that out. So thank you for sharing more about that. Nick, I know you also have some other interests that are professionally related. So why don't you tell us a little bit about those.

I'm so curious, though, which dating story the general heard before he made this mandate.

He this was kind of it's not I'm embarrassed about it, because it's true. And I was a teenager, but I was I went on I went to the movies with this girl that I knew when I was in high school. And she was at I went to Sherwood High School. I won't say the high school she went to because she might listen. She went to a high school down the street. And we went to the movies. And we were like, watching I think it was it was get smart with Steve Carell. And we're sitting there and she was laughing at almost every single joke, which is not a problem. But she laughed. She had a really obnoxious laugh. Like, it was like, it sounded like she was banging pots together in the kitchen like it was. And she would she would laugh and grab. So she would laugh and she wouldn't just let me enjoy with her. She had to make me feel her enjoyment. And I'm like 16 so I don't have a playbook for this either. So after like the third or fourth laugh and grab, I just said to myself, like, I can't be here anymore. So I just, I whisper, I'm gonna go to the bathroom and I get up and I leave. I ponder my situation in the bathroom for like 10 minutes. And then I just think like, she's not in here so I can just kind of like leave. So I remind you, I was 16 I was nothing In the 11th grade, so I just left, I went outside, I stood at the bus stop. And then I realized, like, we took the same bus. So if she comes out side, she's gonna see me at the bus stop. So I go across the street and I hide in the library, like a little teenage coward. And I sit in the library, literally in the study stance. And I'm just kind of like huddled up behind the chair, where I can see down from the second floor into the bus stop area, so I can at least see when she gets on the bus. So of course, she comes out, she's mad and terribly angry, and she should have been, and she's sending me a lot of text messages that I probably can't repeat. And she gets on the bus and she leaves. And then I walk downstairs, I go stand on the bus stop, and I kid you not. It starts raining. Like I'm standing there by myself. So I come home and my mom, she I'm home early, and I'm soaking wet. My mom's like, what happened? I just hugged her. And I was like, it wasn't a love match mom. So my general heard that story. And I'm thinking he would think I was a 16 year old jerk, but he actually thought it was funny. And like he thought it was worth discussing. So I met with him, I only have five minutes with him. You give very, very small time with someone like that. But it was five minutes of him just wanting to hear what happened. Like if I still knew her, and she's happily married, by the way. So she's it worked out for her. She has kids, she I was not the one. She dodged a bullet with me for sure she didn't marry a psychologist.

That's amazing. I think it's such a good example of like, right, like, you can be honest with your leadership in certain situations. And you don't have to say yes to every deployment. That's awesome. Thank you for sharing that. That's so cool. One of my so I would say two of my big passion areas outside of like the clinical field of psychology are really policy and then more service for and with the LGBTQ plus community. So the APA congressional fellowship is definitely for me what like, got me that policy bug, I think is how people usually describe it. And what I like to share with folks about that is applying for the APA congressional fellowship is really was a really interesting experience. Because it was my first time like networking in the sense of I was reaching out to folks who had applied before who had been fellows before and the what they say, and I said this on their website, like, no two days as a congressional fellow are the same. And like, I can verify that that was my experience also. So you're getting all this anecdotal, all these anecdotal examples from everyone. And everybody that I've ever spoken to has loved the experience, I loved the experience, but they're just really saying, like, you're gonna be thrown into something that you've never had never experienced before, kind of similar to I think what Deonte and I have shared about our military experience so far. So the application process for me was really focused around finding that theme of where my, what my story was, and what my narrative was around, like, why it was important to me to go and learn about policy as a psychologist. And what I did for that was I reflected back at my time at PAU. And then my time in my postdoc at the VA, and how all of my training had helped me develop, like higher levels of skills as wrong around program development, and specifically program development for LGBTQ plus, folks. So I really got my initial advocacy experience within the VA system advocating for resources to make sure the program that I was clinically running was adequately resourced, like the only staff resource is me. So I just needed like other resources, like spaces and rooms, and you know, scheduling and all of that. So it's very successful. My application was successful, I got selected. And then I went to the Senate. And basically for a year, they told us at the beginning, your first three months or four months is you like just asking a million questions. Your second four months is you like thinking you kind of understand but not really understanding and your last four months is like, well, you will understand the processes of the United States government. But at that point, you're looking for a job because your fellowship is about to be over. So that was a that has truly been a highlight of my professional career. And the way that it has been described to me is that experience is very seminal. And it really advanced me professionally, like my platform and my experience a number of years further along than I was post post PhD by any means. But what's been so great about that experience is it helped me build a reputation and a skill set for the intersection of psychological research and policy and really pulling that in. I think there's a lot of conversation around health care in our country and mental health care policy. And a lot of the healthcare research is very descriptive in a lot of ways. But I think the psychological research is contextual and we're able to tell a better story in share more about the importance of the impacts of policy on people and this is at every level, not just at the federal level. As a as a share. I think it was last week I was at actually on a zoom panel, that was through multiple divisions of APA, it was through a [inaudible] grant that was talking about how to increase the participation of psychologists, specifically researchers in the policy prop track process at every level. So that was a really a great experience. And I think an example of just the work that I've been able to carry forward in that in that regard. And then like kind of topically or like my area of focus has really been LGBTQ plus community. And so the area where I would say I've had the most experience in the last few years is on the board of directors for GLMA health professionals advancing LGBTQ plus equality, which is a national, LGBTQ plus health focused nonprofit organization. We've been around for 41 years now actually take that back 42 years, this year. Next week is our 41st conference. But there wasn't a conference that first year, I joined that board or applied for that board when I was an internship. So right when I was finishing up my PhD and have served on it since 2015. Next week, or in 11 days, I will end my two year term as president of GLMA and I was the first psychologists to ever be president of the organization. And the first person who was not of a physician background, because the organization for its first 20 years was a physician and medical student, only kind of organization and then they expanded to become multidisciplinary in order to expand the reach of the organization. So I've got to do some really cool things with the organization on behalf of the organization. As it relates to policy as it relates to working with other organizations and being consulted by different members of the government. As a as my last kind of share around this last week. My the executive director and I were contacted by Senator Hirono, who is a Senator for, for Hawaii, where I'm located. And they specifically wanted to reach out to learn about glamours work around protections for gender affirming care for transgender folks. And so it was really interesting to have staffers reaching out to us as an organization. In my experience, when I was a fellow like 75% of my job was taking meetings with constituents I'm like, very familiar from being on the other side of the table. But it was a really wonderful experience, because they just wanted to know like how to build power and collaboration across organizations and the impact of different folks in different communities here in Hawaii. So it's been a really, it's the the intersection of psychology policy and service to community has been like a great passion of mine. And I think the reason that I would get up at 4am, every Thursday for a 90 minute meeting with our Executive Director, just to make sure the work gets done, because I don't want to be somebody ever who's in a position for the title. And I'm sure Deonte knows what I'm talking about, given the context of our organizations, but somebody who's really dedicated to doing the work. So I think, I think what comes across is I'm really excited and passionate about about that nonprofit work and that policy work.

Thank you for sharing that your enthusiasm definitely comes across congratulations on the presidency. That's a big kudos to you and appreciate both of you sharing more about your experiences, kind of a little bit outside of military psychology. So that's, that's really cool to hear about. I'd like to talk a little bit more about how you became interested in military psychology and then specifically how you became involved in the armed forces. So Nick, can you start by telling us a little bit about how you got involved, how you were like, how you became interested, and then how you became involved in the field?

Absolutely. So similar to what Deontae had shared earlier, when I was in grad school, I looked at the internship program because there was so much financial financial resources associated with this training and career field. I have a small family background related to the Navy specifically, but it's not I don't generally say like I'm motivated by that it wasn't super primary in my life. My great grandfather did one tour of duty in the Navy as a, what is called a CS now, but I think it was an SD back then. So culinary specialist, so he was a cook on a ship. And so he was a he was a leader within my family, behind my great grandmother who was really the matriarch of the family. But I think that that kind of tie like originally motivated my interest that my stepfather was in the Navy when he and my mother married and later became a recruiter. So again, I had that exposure piece. And then when I was in grad school, I worked at the Palo Alto trained at the Palo Alto VA for practicum. And then, of course, my postdoc at the VA. So I was interested at different points and what is this? What does service look like in a military context? And I think that it's very in line with my personality. I'm a very curious person. So I always want to want to know how things work and how and why they are the way they are. So when I did do that congressional fellowship with Senator Gillibrand's office, my primary duty was on her military legislative team. And so we were doing work to inform the Senator and inform policies around military legislation. And it just made me even, like re sparked in me the interest of like, how does this work? And what does this look like? So, following the fellowship, I was kind of soul searching, as I'd said earlier and looking for, like, what would be next for me? And I was like, well, let's just see. Let's just see if it's possible. Like, can I can I get accepted, so to speak, like, are they going to play hard to get and they didn't play hard to get it took me 18 months as a direct accession to commission into the Navy. And because of the because I am the way I am, I was like, Oh, you want to make it hard? Like, I'll show you how to do this, like I'll stay patient. And so I really just, I mean, I had those contractor jobs that I spoke to earlier, and just stayed kind of like working in collateral positions around the military. And while I awaited that process, and I will share there are different points where I was like, maybe I'll just give up and do something else. Because there were other opportunities that were in line with my clinical interest or my policy and LGBTQ plus interests, but hard to get works on me. I don't know what that says about me that maybe Deonte I will learn that more as I continue through Deonte's podcast, which I've been listening to.

Thank you for that. Deonte, How about for yourself? How did you become interested and then get involved with the with the military?

For me it was simple. I'm a huge fan of major pain have been my whole life. Saw for the first time when I was maybe seven, which I think is way too early to watch that movie. It was a it was I think my dad showed it to me, because we had so many military folks in my family like aunts and uncles who primarily were Army and Marine. So when leaving the East Coast and coming to Palo Alto and being on the West Coast, I'm having that military perspective, I play college sports and like ran track and basketball. And like, it was very, very like discipline already. Getting up at five o'clock didn't seem that bad. To me, it was seemed like a matter of course. So, which was my mindset at the time, like, if you're in the military, you have to get up at five o'clock. Like, that's just normal. I know now that that's not the case at all, especially for the Air Force. Like, I'm surprised with people making it to work on time, let alone like getting up at 5am. But when I got to California, working in the San Jose and the Palo Alto VA, truly like, it started with me taking an interest with some of the Well, I would say most of the veterans complaining about their previous service. And you know, the first couple patients you hear it's like, well, maybe these are anecdotal stories that apply to these individuals. Respectfully, like appreciating their stories, but maybe it's not a trend in the whole system, until you get maybe 30, 40 patients deep and you start hearing the same stories over and over and over and you're like, why did why did their experience with military medical suck? And why? Why is it shaping the way they're seeing me in treatment now as a practicum student, and that's where I kind of sort of connected the dots. For me, I didn't really know too much about the financial benefits. I was pleasantly surprised when I found out that they existed. I was like, Well, I don't mind if I do. If you're gonna pay me to just do what I was gonna do anyway, then cool. Like, I'll take that. But it was, that's where it started. For me. It was I was at the San Jose VA with Dr. Gary Miles. He's since retired and bought, uh, this is he said this openly. So I think I can share this. He said he's gonna buy a massive RV and move to New Zealand and do the Lord of the Rings tour for the next 20 years after he retires. Hopefully, that's what happened. I haven't spoken to him since 2020. But hopeful for that. But he sort of as my neuro psych adviser, he helped me get in in the VA. And he started that journey for me in more than one way. So since then, and it was just applying it didn't take me 18 months. I got in pretty much within the first five or six months. But it was a brutal five or six months because I think I mentioned this a little while ago but just say it again for for new listeners. But I was I applied for the health professionals scholarship program, was happy to like be a part of it was everything was rollin like application processing really smooth. And then I went on a conference in New York. And while I was there in New York, my tech sergeant who was my recruiter calls me up. I'm in New York and I get the phone call. I'm like, Oh my gosh, this is it. And I leave the conference. I step outside during her presentation. So it's like, I'm going out of my way to leave this room to get this great news and answer the phone. And the tech sergeant and I won't say his name because he probably would hate that I'm sharing the story. I answered the phone and he goes, Hey, are you sitting now? I'm like I don't have a chair. So no, just get on with it. He was like, want to say like you did your best, and you're really good guy, but the Air Force is gonna have to do without you, you know, going forward sorry. We just didn't win this fight. And I'm like, thinking I'm planning out the rest of my life at this point because I'm like, Well, now I lose a scholarship, I lose the opportunity. Am I even going to be around the military VA system anymore? Like, I'm only at the time, second year in grad school. So hangs up. And I'm like, thinking it's over. And then like, almost immediately called me back. And he's like, Ah, I was just kidding. You guys. And he was like, in tears laughing and I was really mad. I was like, why would you do that? And he was like, well, welcome to the military. This is how we have fun. Congratulations, you got it. And like, Don't hate me. We're gonna go to lunch when you get back to California. And I explain all the details and but they pretty much onboard me from that day forward to everything financially and academically, I needed to be able to get to internship, because of the HPSP scholarship program. It was really easy getting into the internship, obviously, you had to apply and you had to to be qualified and had to present well, when you when you interviewed and like take care business. But as far as like the expectation when I got there was pretty like, well, he's an HPSP student. So he has had an interaction with the military for roughly two and a half, three years at this point. He knows all the ranks already. He's like, culture, he's not lost. I was but they didn't know that. But he's, he's he's he's a real Captain to some degree more so than someone like a direct accession, because my wife is a direct accession. And she was her experience was not that she was treated like, you were a civilian yesterday, and you're you are wearing this rank. I was treated more like a well, he commissioned three years ago. So he's okay. But I went into internship was pretty much matched with my next duty station right after that, and the rest is history. But truly my joy and love and passion started with those veterans, I'm actually still wearing the rubber band. I got this at Menlo Park VA. This this is maybe in 2018. I haven't taken it off. Which I shower with this I it's clean. I haven't taken it off since around 2018. Because a veteran actually sadly passed before he passed like he he he bought it like, well, he didn't even buy it. He got it from the little tables that they have by the little shop in the downstairs area. Have you ever been to that research building out there? I think the Institute of Research owns that building. And he graduated and he had too so he took one and handed me one. And I was like, I'm good. Like, we were actually a part of the organization giving them out. I was like, there's plenty, we're good. And he was like, no, no, I want you to have this one for me. And I was like, Well, why? And he was like, cause you're a good dude. And I like you. And I think like, if you're the kind of person that this kind of organization can bring here, then this is a place for me. And I remember thinking like, wow, like, that's really cool. I definitely can't measure up to this hero standard that he's setting for me. But I'll wear it every day to remind myself that that's my aspiration. If I'm ever going to be that guy. I'm still falling short of it now, because I'm not perfect. But it's it's a cool reminder to have and that was at the VA.

That's awesome. Well, none of us are perfect. So you're all right there. Thank you both for sharing more about how you became interested and then got involved in the military. I think that's really interesting to think about the different types of ways that people can get involved. I don't have to tell you this, the topic of military mental health is incredibly important and you know, just very relevant in the moment. A recently published book entitled Veteran and Military Mental Health Issues, which was written by Inoue, Shawler, Jordan, Moore, and Jackson highlights some of the concerns about the mental health of veterans and service members. These authors note that, as the United States endures two decades of ongoing warfare, the most widely publicized mental health challenges encountered by veterans and service members or post traumatic stress disorder, PTSD, and depression. Research indicates that approximately 14 to 16% of US service members deployed to Afghanistan and Iraq have been affected by PTSD or depression. Although these mental health concerns are prominently highlighted, it's also crucial to acknowledge that other issues such as suicide, traumatic brain injury, substance use disorders, and interpersonal violence can be equally detrimental in this population. These challenges have far reaching consequences significantly affecting service members and their families. Although combat and deployments are known to be associated with increased risk asks for these mental health conditions. They're all timeframes in which these conditions can be particularly stressful, especially during periods of close proximity to combat or when transitioning from active military service. As per the recent reports released by the United States Census Bureau, there around 18 million veterans and 2.1 million active duty and reserve service in the United States. Since September 11 2001. The deployment of 2.8 million active duty American personnel to Iraq and Afghanistan as well as other areas have resulted in a growing number of combat veterans within the population, over 6% of the US population has served or is currently serving in the military. And this number also does not consider the significant number of relatives who are also affected by military service. Suicide rates in the US Armed Forces doubled between 2002 1012 Current estimates are that they're about 19.74 deaths per 100,000 service members each year. And suicide rates among veterans have reached the highest level in recorded history with over 6000 veterans dying by suicide annually. So these statistics are staggering. And they really only serve to underscore the importance of your roles and the necessity of having mental health professionals in the armed forces. So I'm curious as to how this plays out, like what does a typical day on the job look like? Deonte, you want to start us off?

Sure. So it's, it's ironically, not to use the military metaphor too much, but it's a day in the life of being like hilariously, and sadly, how outgunned by the amount of patient need that exists. And the massively short staffed that like not just we have here at Aviano, but like the military, at least speaking for the Air Force, like there are not, as in the civilian population, there's not enough of us around. So defense health agency just actually took over and there, they now own our treatment standards. And for psychologists and social workers alike, we're expected to see about five patients a day. Really, with no deviation and to treat people for how was explained to me by in layman's terms by my internship was, your job is patchwork. Unfortunately, your job is doing what needs to be done with the patient in a very short amount of time to get that member back in the fight. Which sounds great on paper sounds awesome as a slogan, and if you can fit it on a t shirt. Cool. But in practice, it doesn't work that way. Because as a provider, you're seeing five patients a day, in addition to writing notes for those patients, and then dealing with commanders likely for each one of those patients. So that's, that's a massive workload on the provider. But then for the patient, there's a they recognize they're squeezed, or they understand that they're coming in as patient number three or four for the day, maybe patient number 16 or 17 for the week, and that there's a machine behind them, keeping them in care and then moving them right back into their active duty position with a goal of not needing care altogether. So it's a massively it's a, it's a heavy burden for the provider, it's 40 hours a week is what they told me an internship, which is cute. It's about closer to 60. And like that's primarily because of the workload. But I'm also at a PRP place, which is a personnel reliability program. So essentially, folks who touch nuclear bombs or nuclear assets, because they tied to nuclear assets, and then we have arm use of force folks who are the Security Forces members who guard the base and who are essentially our police force. Our administrative burden is huge, because we have to document every single thing we do, and there's massive regulations that we have to follow as we engage with each of those members. Ironically, the Security Forces members of police on the base are our biggest customer. And that's pretty consistent across many air force bases. And I say that like as a colloquialism, because it's pretty well known but from from a provider standpoint, imagine if you have five patients and then of those five patients three arm up or use weapons, or or touch nucs. That means there's three people who you see for an hour and that's the, in my opinion, the fun part, I could do my job as a psychologist. The hard part is then now, every engagement with command thereafter, where I had to ensure to command administratively and sometimes over the phone depending on the patient or the circumstance, that the member who's returning to duty with a firearm or returning to duty around nuclear assets is fit to be there. That's a part of the job that I don't know is advertised as well. And it's the hardest part In my opinion, because it comes with the the massive like, like, what's the word I'm looking for? Essentially, it's there your responsibility to ensure that that person is safe. And if something happens, someone has an incident of self harm, or there's other harm or what has happened at this base. And not too long ago, in the past 10 years, there was a seminal incident where a wrench was dropped because a member was tired. And that's the psychologists job to even acknowledging the members overworked this member was overworked they dropped a wrench it hit a particular item, that item exploded and killed several people. So imagine being the psychologist who signed off on that number of saying they were fit to return to duty that day. And that's it. That's a that's, to me, it's it feels like a heavy professional liability, but then the emotional liability because we're still people. And the end of the day, and I don't, as much as I like people to think a psychologist has magic powers. We put our shoes on one foot at a time like everyone else. So it's that's that's been the life of being a psychologist at Aviano. I'm curious to hear what your experiences, Nick.

Sure. So I have the I don't know if gift is the right word, but I don't work. My work does not fall under the defense health agency, which is a government organization that right everything in our government is policy based. So there's a lot of influence and expectations Deonte was talking about about policy and like how we practice and what those expectations are. And I think that the policies are based in good intention. But I don't always know that they're executed well, which is true of policy broadly, I'm not just talking about the defense health agency. But two pieces that I wanted to speak to specifically where the fitness for duty piece that deontae was speaking to, I do not think in my experience of bouncing around the Navy a bit that there is a lot of dedicated training on understanding this, this psychological assessment that this component of it for the military population, this we really pull this from, like the police and public safety work of psychology. And so there is a whole field and research and evidence around this. But it's not as integrated into the training for psychologists generally. And then I don't even really see it integrated into military psychology. To the degree that I that I wish that it would like this is a very this is a passion area of me because I'm curious, right, so I've done a deep dive into my nerdy reading around all of this. One of the things that I think that comes up a lot, which is difficult is when you go to an internship program within the military. And I can only speak for like a little bit of the army working with their program here at Tripler. And in the Navy is you have supervisors some are active duty, some are not they're still military psychologists, they're just civilians who work in a military treatment facility. And if these folks don't have robust experiences in the different communities of the larger organization, and what I mean by that is, for the Navy, as an example, is a huge organization. We're very small compared to the Army, but we're a huge organization. And there are different communities. So I work with the surface community, there's the submarine committee, community, there's the seal community, there are various communities. And as psychologists, we have to gain cultural competency into working with those communities A to connect with them right in order to have that interpersonal connectedness, but also to understand the policies and the actual things that come into their fitness in order to be competent as psychologists providing fitness for duty assessment to them. This is a really broad, like complex topic, but I think it's one that is so important, I'm really glad that Deonte brought it up. The other piece is the targeted care model is I think what defense health agency is calling it now. And so that's what my program is really built off of as an embedded mental health officer for the service lead in the Navy is not everybody who is seeking out mental health support needs to see a psychologist or psychiatrist. We what I tell my folks is we have more resources, we have a mental health roadmap that outlines all the different resources that are available. And my job or my, my focus for the last two and a half years has been socializing the heck out of this map to make sure that everybody in the communities and the ships that I serve from leadership down to sailor Timmy who's just arriving do his first command understands that all of these resources are available. And then of course, folks aren't going to understand that it is a bit complex, like most people don't know the difference between a psychologist and a psychiatrist. It's just most people in general. But my work has been really focused socializing that so folks understand when I am making recommendations to work with some of our non medical counseling counterparts. I have four counselors that work on my team, that that is based on an assessment of what is going on with them. And they may not necessarily be suffering from a psychological or mental health condition as defined by the DSM that needs evidence based treatment. That doesn't mean that they don't need care. And so this is one of my big passion points also is I think everyone could benefit from mental health support or mental health care, right? Like we could all go to therapy and do insight oriented work, but not all of us need mental health treatment. And the way that I talk to folks is like I actually really love relational work. And I've been like working on my EFT certification to work with couples for like, years. Well, it was all before the Navy, of course. But I love dynamic work. But my job is to provide treatment for folks who are experiencing mental health disorders or conditions that need an evidence based treatment. And then I run my programs such that I've really plussed up our, our primary care mental health so that there there are pieces of mental health along the continuum for patient care, I am in a unique role where I have, I'm gonna use the word control that might be telling, but it was there an emphatic control over the program and how I get to integrate and educate around mental health services. And again, one of the different dynamics for my population is I always tell folks like, because I work with our hospital, here's an Army hospital. I'm like, the ships are like buildings when they're in Port, but then the sailors have to go to sea. So we need to make sure that we are like educating them and making sure they have the foundational understanding, had a general population or layman's understanding of mental health. When they come to the hospital. We can't overdiagnose or expect them to be like, we hear from the Army a lot. Oh, just don't go back to the ship, you'll be fine if you don't go to work. And so I I get on them about that a no. Like we're going to provide them support, the embedded model is based on being as close to the environment as possible, providing as much care at the appropriate level as possible, and having the expectation that people are going to be okay. Now that's not true across the board. Right? Just Deonte's example was folks are not okay all the time. And it's not possible for us to to know that it's not possible for any provider to know like, right, like we see someone today. And tomorrow, tonight, they don't sleep well enough. And tomorrow, there's some sort of incident. That is a huge pressure that I think that Deonte highlighted really well, that that is a pressure that is felt. And that's an expectation of us. But it's not truly possible. Like we're not trained to predict the future. And I am so proud because I have gotten some of my ship CEOs to repeat that back to me. I know, I know, Nick, you can't predict the future. I'm like, Okay, so as long as you do understand. So I say all that to really amplify everything Deonte said, and the one addition I would give is, in addition to being a military psychologist, we also have to be a military officer. I am not the model person for that by any means, but I like talking about it. So and so I will share that when I went to a couple of leadership courses earlier on. They always start with is your primary job being an officer is your primary job being like, whatever your profession is for us psychologists. And then they say they like do a little exercise. And they say it doesn't really matter which one you say like, we're just trying to get a sense of your priority and your personality, I do think there's judgment around it or whatever. And I always tell them as a director accession, I was a psychologist before I was a Lieutenant. So I don't think that's going to change, because I'm gonna be 40 next year, and like, I'm like who I am. But I highlight that because in addition to those clinical duties, and 60 hours is a very accurate estimate of the work week, we have other things that are for us called collateral duties. So some of those, for me include the supervisory role that I hold with the Tripler Army Medical Center residency program, I also have the title of Senior Advisor for our diversity and inclusion committee for my command. And then I serve on a few other committees, committees that are focused on like wellness and overall health, for our command and then the command that I'm at is really focused on providing support to the ships. So it's kind of this trickle down effect of I invest in those ways, because it does circle back on wellness overall then integrates with mental health.

That's fantastic. Thank you very much for giving our listeners just a little bit more information about that it's important to understand the different roles that you both play both as healthcare professionals, but then also as officers. So I think that's, you know, something to consider and, you know, I, I appreciate you highlighting the sort of great weight of responsibility that falls on both of your shoulders. So thank you for that. For someone who's thinking about wanting to enter this field, you know, what are what's your advice for how they would get started? Deonte.

Um, think of their nickname for when they go to basic training. You're gonna get one either way. But I would say find a really good recruiter, Officer recruiters are very difficult to find. They're even more difficult to pin down and to sort of I in certain areas, I hate to say it, but to get them to do their job sometimes like they're given that role and certain commands, because they were on Jomo, for lack of a better term and I was fortunate enough to get a recruiter and Suisan city north of Palo Alto, I think is north by geography might be off, but it's it was a tech sergeant who was motivated and young and he had a Lieutenant with them and they really they saw something in me and I came to visit Palo Alto and met some of the professors and they were in their dress blues and very much like very military I felt bad for them. It was like 85 degree day in their in their dress blues soaking up the inside of their their white button up. And I would say that was the pivotal part for me was if I didn't have that recruiter, I could have been doing all the research in the world online for forms packets, all this stuff. But there's so much so many government websites that are not updated on that are like painfully painfully, geo cities level by very, very bad. And they they mislead you sometimes. So you, you do all this work and filling out these forms and all these packets and thinking like I had the thing that's needed to get in the service. And then you actually meet a recruiter, and they say, Well, none of that matters. And we need you to do this stack of documents, and then sign over your life and your multiple times over and over again. And because of that, the next point with 18 months, like, get on it early, like if you get on it late and think it's gonna be 48, 58 onboarding, you're gonna put yourself in a bind, because you may miss a deadline. Or you may end up just getting forgotten. If you have a bad recruiter, I hate to say bad recruiter, but like, give a recruiter who's not very interested in you. If you're really tight on the deadline, you're not going to really follow up because there's no incentive, because you're not gonna make it. So really make sure you watch those deadlines pretty closely.

Nick, what do you have to offer for anyone who's thinking about wanting to enter the field?

I would, the only thing I would add to that is tapping your network. I think that if you are lucky enough to find somebody that you know, or you find somebody on LinkedIn are somebody who has gone through your program who has served in the branch that you're most interested in, they will be able to connect you most likely with other folks who are in those positions to direct you to the correct website. And hopefully the correct recruiter everything Deonte said is totally accurate. In my experience as well. I feel very fortunate, I think we should note, for the Navy, at least we only have I think it's between 240 and 250 Psychologists for the entire navy. So it's not like a wildly large community. And of course, there are people coming in and coming out at all times. But you'll be able to access that network. So when I came in, I actually did informational interviews like 30 to 45 minute calls with I think, like eight different psychologists when I was picking my first duty station, which was a privilege opportunity as a direct accession. And so doing that, I think, really helps plug you in. And the other piece, I would say is if you can find the information for the National Training Director, each branch has a national training director. And they will be I think, I think they're usually civilians, but I don't quote me on that. They will be like the hub for finding out who to connect you with because they are they're aware of like all the scholarship opportunities, all of the training directors for the specific programs, like they are kind of like that main person in the chain of command bars as far as psychological training.

Great. This is the thing that I learned from a senior NCO when I first like I think I was I was at Milford Hall for maybe a week. And he caught me being too nice. And he I remembered he he was a master sergeant. Now remember thing am I am I not allowed to be a nice guy. And he was like, no, but he just heard the way I was talking about my contract and about the things the Air Force would give to me and he said that I was being too comfortable with the Air Force in the Netherlands. And I was lost at what he was talking about. I was so green, but he was like, don't forget that you are here. Because you bring it out, you're an asset, you bring something to the table and nothing the Air Force is giving you is free. Don't treat it like they're giving you this beautiful opportunity it is a great opportunity but don't treat it like they're giving you an opportunity that you haven't earned. So when you're coming on and you're brand new, know your contract specifically and there's a million acronyms like get to get familiar with all of them know that every single detail know your pay structure. Know your your obviously your rank and in the rank structure around you also know your your pay structure and the pay structure of the members that you're speaking to enlisted and officer because you've you speak with too much privilege from an officer's standpoint. I've even a little things like you start complaining about your paycheck to a senior airman. Like that's a that's a no no, because this Senior Airman knows that you're an officer knows you're making vastly more than they are so like these little cultural things. But then, for your own edification, like as a psychologist, you're likely going to apply for bonuses and other things that adds on to your contract. If you don't know your contract very well. You're just signing and signing and signing and their adding years every time you sign typically unless it's a concurrent signing, which is specific to that grant or, or part that they're offering you. But know that stuff very well, because in my mind, I was like, well, the military is the government. So the government just knows. And they'll just give it to me, and it will be accurate and everything. It's like, it's not true. Unfortunately, the government is full of human beings and human beings make mistakes. And if you lose your contract, and you count on the government to reproduce it, it may have an additional year on it, you didn't expect. So like, these are things that you want to kind of keep a file for and hold on to because it could mean the difference between knowing 10 years or six.

Great advice. What do you think is the most important personality trait or strength or characteristic to be successful in this field? Nick?

I don't know if this is generalizable. But if it were up to me, I would say Humility is the number one. And that is because the folks who I have, I've interacted with a lot of people, they're not all humble. But the folks who I have interacted with, who has been the most influential on me, who have provided me the most meaningful mentorship and of course, that's because right like, mentorship is two ways. Like I will You gotta let them in if you feel that comfort level. Those are the people who have been truly, truly like humble and servant leaders. I think that the military because of what it represents, and it's right, the missions of the different branches are very important, does attract people who are in it for various reasons. And so the ones who again, the ones who are have been made the biggest impact and been the best leaders are the ones who have done it, to serve others and not to serve themselves.

How about your thoughts Deonte?

I completely agree with I mean, my I think about the worst times I've had in my military service, it's been the plague of, I would say the, there are several, several things in life that I despise. I despise Manny's, I'm quite impartial to cheese because of my lactose intolerance. And I really cannot stand unreasonable humans. And I feel like the hardest times I've had in life is when there's been a person in the command structure, who is a gatekeeper, who has fallen into a position where they have hubris, and no degree of understanding of like, I hate to quote Spider Man, but with great power comes great responsibility. And when you're in a position where you have great power, and it goes to your head, it can be very disastrous for the people around you. Even if you're not a like tremendously high rank. Even if you're a senior NCO, you can be have a terrible, terrible, create a terrible experience for the younger airmen or enlisted members beneath you, or around you as your peers. And same with officers. I've seen many Majors who've just for lack of a better term wanted to promote, and they made clear that they wanted to promote and they didn't care, like what they had to do to get there. And if you're in the medical field, like that's not a great place to be, because you might start doing squirrely things involving patient care that can now obviously make you look great on paper for your performance reports, and possibly promote quicker, but for the patient, you lose the humanity of the individual you're dealing with sometimes, and I've seen unfortunately, I've seen people with their let's say lack of tech in their care, resulting deployments being canceled for members. I've seen them result in like, permanent change of stations that were unfavorable when they think they're going to like Korea. They think they're going to Japan, having it affected by a misdiagnosis or poor diagnosis that ends up with them going to like the Dakotas. I mean, put yourself at the age of 21 and you think you're going to Tokyo, and then you end up in the Dakotas. It's like what happened when my provider wasn't communicative and open with me they're more concerned about their career and promoting, etc. The biggest character trait I would say is like, super necessary is like courage. I feel like to do the right thing in the military. It's you are respected after the fact like think about the amount of like war heroes that exist Who are these like small stories that like this airmen who you know, sacrificing him or herself for XY&Z. Or this sailor who did this very, like courageous or brave thing on a ship like they remembered but they usually remember 100 years later. The hardest thing is to do the right thing now and there's no recognition for it and I think a lot of your career as a psychologist is kind of that that like in the shadows work or you have to do the right thing sometimes and sometimes against the the opposition of a commanding officer, I was telling you to do some things that are like, not the most kosher. And you are. I remember my first time going up against Lieutenant Colonel who he called me some really bad names in an email. I didn't believe it until I saw the email. And I was like, no, like, you can write that. Like send it to someone. And then like, that person still has a job like it was pretty. I'm not gonna repeat what he said was pretty egregious. Like he was it was directed at me. He called me Deonte. Like he didn't call me by my rank. He didn't call me by my title. He's like, basically, in lack of a better term, get away from me. And I don't ever want to see him again on this base. And this was a this was a Colonel. Luckily, my Colonel and my squadron he didn't necessarily defend me, but he didn't allow that person to continue, I guess. So I put a stop to it in a way where he didn't, it didn't continue, but the damage was already done. And that was a hard pill to swallow because I was only in Aviano for about a year or a little bit less than that. Now, I was under the impression that if you made it to Lieutenant Colonel, you're a good person. And that's not true. Unfortunately. Also, like contextually, no, like branches are different. But me and Nick were the same rank, which is like weird, where he's a Lieutenant and I'm a Captain. But if I were a Captain in the in the Navy, I'd have a lot more gray hair for sure. But I would not I wouldn't be at this stage of my career. I think that's one of the like, interesting things that are just different across the branches is like there's so much like, unevenness with names or just like, like word soup with names. And so much of our stuff is like, like, unnecessarily complicated, like, I don't know why you're a Lieutenant and I'm a Captain, or vice versa.

Confusing. It's all everyone, everyone, even though we make fun of like everybody, the Army and the Air Force is the same. The Navy likes to be special and seagoing.

I'm sorry to throw that in there. But I was thinking of it.

No, I appreciate it. I think it's helpful to put context. And you know, one of the things that I wonder about are some of the challenges or barriers that future military psychologists, you know, should be aware of what would you want to tell them? What are some of the things that you deal with in your own branch? Or maybe, you know, just in general, Nick, what are your thoughts on that?

Sure, I think that Deontae really described this very well, but there is a significant amount of like, autonomy and independence that is forced upon you, right, that's not necessarily communicated to you. And so that comes very, very early on. And even coming in as a direct a session, a licensed psychologist, having completed all my training and having had a little bit of a civilian career before my service. It's not, I think it's difficult to understand until you've experienced it. And I cringe saying that, because I remember being told like, it's, oh, it's there's so much OTJ are on the job training. And I was like, that's, that's a cop out. That's an excuse. I don't want to hear that. And like, truly, in reflection of me being in my current position for the last two and a half years, the things the way I ran my program, the first year versus now are so different. And I don't know that anything was wrong, but I just had to learn along the way. So there's some truth to it, which is why why I cringe, so be prepared for a lot of responsibility very early on. And then I think that it's important to think about your why, like, why you want to serve, in addition to the great benefits that we've talked about today. But the why is so important, because I think it will connect us it will help folks connect to their integrity. And that will inform how they serve, right like how they're going to how they're going to be as a psychologist within their service. I've seen folks who definitely lean into the some of the examples that Deonte's given of like, I'm gonna do all the things that my leadership wants to see and not care about my actual like day to day duties, inclusive of patient care, and get away with it and promote right so the system is so complex and confusing to be quite honest, that it allows for a lot of diverse behaviors. And those aren't necessarily monitored or, or curved, not to say that people are acting like wildly all the time or anything like that. But I think that really being in touch with your why and knowing what that motivation is for you and what you want to get out, get out of it. And also give into it is really important because you there's really no way of describing it. Like there's no way of describing we've shared our anecdotal experiences and I've like really enjoyed learning of Deonte's experience and sharing my own but the next people that are in our positions are going to do it differently and be with different people because everyone's rotating all the time. So it's just very, very challenging. And the last thing I would add is that I think it is important. And I've learned this along the way to pay attention to international politics and international news to have a sense of like what's going on, going on in the broader context of our organizations. Being situated situated in Hawaii, like I didn't really realize how much activity happens in the Pacific Ocean. But I've learned a tiny bit of that over the last few years. And knowing that I think helps give context to some of the pressures that like leadership is making again, I don't without even knowing the details, but just having like, some awareness of what's going on globally, is extraordinarily important for these organizations, even a psychologist.

Deonte, thoughts on challenges or barriers for future military psychologists.

Yeah, I agree so much with honestly, like, but the two biggest things that I've learned is, be respectful, like, be careful, maintain your customs and courtesies, maintain your bearing, but know the regulations, like know them very well, like, and they're boring, they're very boring, and they're very long. And there's almost a step for every single thing that you might do, which is why they give you so much autonomy early on, for better or for worse, because what I was given when I first landed here was my own office, desk, a computer and a giant book. And they said, This is your AFI your Air Force instruction for this particular duty. And it was like 400 pages, and it wasn't Harry Potter, like it was, it was awful. And I initially I'll be honest with you, I didn't read it, I was like, I'm gonna go play video games, like, I'm not gonna spend all my time reading this. But I at least attended. So I can treat it like a little learner's menu. And I'm so glad I did. Because I ran into some trouble early on, because I was trying to just kind of wing it. And you wing it a little bit until your former commander had asked you a question that's very specific. And you don't know, like, I love that I was fortunate enough to deal with another officer who didn't know and they covered for me, it was a I was lucky. But like, in that circumstance, like I learned right off the bat, like, it's time for me to go read this, because I never want to be in that position again. And when you actually know the regs by heart, as daunting as that may be, you can be courteous and respectful with your customs and courtesies and disagree with commanders and command in a way that's like completely fair game and legal where you can actually stand up for the things that you believe in, based on the support and the strength of the regulation, and so on. But if you don't know the regulation, you're not going to let us flip through it. While you're talking to a commander, like I said, with a general you have five minutes. So if I knew the regulation that I want to, quote, I know the standard that I wanted me to want to meet in that particular context. And as long as I'm saying, sir, ma'am, and you know that depending on who calls the room to attention, I'm standing out like a number two pencil, like I, for sure, like, can speak my mind, as long as I'm within those left and right bounds. If you do that you at least gave yourself a fighting chance at the very beginning of your career to come off as a person who's very knowledgeable and eager to grow as a as a professional, versus someone who believes they know it all because of what they saw in the movies.

Thank you for that. Let me ask you a little bit about socio cultural identities and how this, these may or may not be relevant to your work. So Deonte, you're a Black man. And I think you said that you're the only Black male psychologists in the Air Force in Italy. Does that identity come into play at all in the work that you do? And if so, how?

Very much, I believe don't quote me on this, but I think there's five of us total in the world, in the Air Force, and I know ones in Germany and three dispersed around the states. I think we're hit every corner, except for Florida, which I was on my way to so they tried to get the Four Corners filled up, but it does I'd I'd be lying to you if I said didn't most people when they see me like I'm an officer, I am a psychologist with a PhD when I'm not in uniform. That's not how I'm treated. I'm most people assume I'm a maintenance worker, which I don't want to disparage anyone who works in maintenance or who does anything with planes because maintenance, you know, folks don't do their job and the planes don't get off the ground. So like they're obviously needed, and they're treated like valuable assets by the pilots because the pilots like being alive, I would too. But as a Black male, it's difficult because there there's times I've literally said like what I do and people start laughing and then go no really like what do you do? I said no I'm a psychologist and I'm a Captain and I'm I'm actually working in the mental health clinic. And having to reiterate like, my position based on disbelief, like was a weird thing. Ironically, I came to Italy thinking that like, well, being in another country, I've been overseas before, like for basketball and stuff. And I was pretty comfortable being overseas but never been to Italy. And I thought the Italian nationals, they may not like us, because we're military, and then you add my wife on top of that, like, maybe that's gonna cause some problems. And I've been treated incredibly well by the Italian nationalists, like they're very welcoming, and excited to hear that I'm trying to learn that language. And they're comfortable with me being different, because most of the Black folks they see here are immigrants from Africa. So seeing someone of my skin tone, and like, six one, like, I looked like I play basketball, like, people have asked me if I do play basketball, and I'm like, Yeah, I'll sign an autograph if you want, but I guarantee is not gonna net you any money. But, um, unfortunately, I have noticed a bit of a good old boys club as you go up in rank. And that, to me has been kind of like, an obstacle that's actually made me reconsider, like how long I want to do this, like military wise, because I noticed, like, once I started dealing with people at the Colonel and general level, like, it gets really, really scarce with people of color really fast, and is primarily White males to be honest, and not to not disparage any White males, like I think white males can and have done tremendous things in history as have everyone else. But when you're in a situation where you're walking into established culture, and established, I guess, a color palette in the room, and you're the only person kind of like, changing that, it's hard to not be noticed. And I've had mixed responses to me being in the room, I've had commanders who are really cool and like, open to hearing everyone's opinion. If you're in the room, they view it, if you're around the table, you can have a kind of an opinion. But I've also been told to shut up. Someone I'm my worst experience in a meeting was Major punched the punched of the table. And you know, Captain Williams, I have the floor now be quiet. And I remember like, Oh, like this is not a movie like that's, that's a movie script line like that. That couldn't have just happened. And I wasn't the crazy thing is I was answering a question that another Lieutenant Colonel had asked me so I was answering their question, and the Major jumped in, because the answer was not satisfactory to their situation. Because it was exposing like that there was a there was a ball that was missed. And it was their unit. I wasn't trying to throw anyone in bus. But my Captain and Lieutenant Colonel was asking me, I had to answer him, I lie and I get caught in a lie, then I'm now the Black guy who lied. So I want to be that either. So it's, it's been interesting to say the least. But I have gotten pretty good at Italian.

Thank you for sharing those experiences with us. Very much appreciated. I'm glad that you're learning Italian and getting better at it. That's, that's a bonus. Nick, you are an openly gay male. You're an activist for LGBTQ plus health equality and your policy experience proposing legislation for retention and service of transgendered individuals in the Armed Forces. So tell us a little bit about how your identity comes into play in the work that you do.

Sure, I, I have not had any overt the discriminatory experiences that I've been aware of at least similar to kind of in comparison to what Deonte has shared, I believe, based on my background, my research background coming out of PAU my work with GLMA, all of that I don't think that I think that it is well known that this is an area that I work in. And so my own identity or being out is kind of associated with that and comes organically with that. That's not to say that it's comfortable all the time by any means. But obviously, just comfort and discrimination are very different things. I always tell folks, this is my personal life. I tell them this all the time. Like I'm six three, I'm a gay guy. I run around the ships in Pearl Harbor, Hawaii, like warfighting ships. And I don't think the Navy was expecting me or knows what to do with me. But I use that to my advantage, right? Like I am very over. At this age, I'm very secure in who I am and how I operate in this world. And so I definitely lean into that when having difficult conversations, especially like with people of superior rank, as Deontae had given us examples of I think that also one of the things that has made has helped me feel secure is there are within the Navy psychology community, officers of senior rank who have been in the community for many, many years who are also part of the LGBTQ community. And so that, that modeling and being able to look up to those folks, even if I don't have relationships with them has been very, very beneficial. I also being leaning more on the extrovert side of things, I'd often tell folks like, I'm very mouthy and I was 34, I think when I commissioned, so like, again, like not, not like, so rigid that I can't change or grow, but like pretty fully formed in my personality, at least by the time I got here. And so I do lean into in the Navy, we call them instructions rather than regulations, because again, we like to be different, but like knowing those and leaning into those and having those difficult dialogues around stuff such as like transgender care. So when I was at navels Naval Medical Center, San Diego, one of those collateral duties I had was the co chair of the Naval Medical Forces Pacific Transgender Care Team. And that team is in charge of coordinating the care for trans sailors and marines across the western half of the world. And based on my back my background, as a psychologist who has done work in LGBTQ mental health, I have kind of turned into the subject matter expert for LGBTQ mental health and trans mental health through the Navy. So I take consultation, or offer consultation to folks from all literally all around the world who are in the Navy or Marine Corps, I had someone reach out to me last week, who was just trying to figure out what the process looks like and engaging that that work from the system, like really using the system to support that service member who wants to initiate initiate gender affirming care. So to me, it's so integrated in my experience, and my professional I know, they often say in psychology, like your research is your research. And that's not necessarily my experience, because I don't do any research at this point. But I do feel a lot of my work is based on supporting folks within my community. And so I always think about, especially in the context of doing work around gender affirming care, any position that I take on or any role that I take on, I want to do to the best of my ability to advocate for these folks, because I think it's my responsibility to do that with the the power and the privilege that I hold at this point. But then it's also my responsibility to get out of the way. So when there is somebody who is trans or from community who is ready, and in a place to take on this leadership, like I don't need to hold on to or shouldn't be motivated to hold on to those positions. So that's like kind of my internal reminder that I always, always try and remember, like, I'm doing this, and I'm using my identities and my outness. And sometimes my height, because height works. To make sure that I'm furthering my mission, but my mission is always tied to kind of like those values around community that I have.

Thank you. I appreciate both of you being so open and candid about your experiences. I think that's really it really kind of peels back the curtain a little bit and gives listeners more to think about. I'm curious what your thoughts are about the landscape of your field and how you think it might change over the next five to 10 years, Nick.

Sure, so specifically for military mental health, I think that as Deonte had shared earlier, the defense health agency is now taking over, basically health care for all service branches. And so all military clinics and hospitals are going to be ran by this new organization, not a new organization. This is just the stage that they're at at this point. And so we're gonna see a lot of transition. And I don't know what that exact is exactly going to look like. I had mentioned earlier that in my current roles as an embedded provider, I don't work at a clinic like I'm not, I don't, don't have that resource like a clinic, it's myself and one behavioral health technician. And then we have other folks within our care model who have different levels that like were the primary needs for the program. So we don't fall under that. And so that's been really helpful because it's offered flexibility in order to develop our own programming based on instruction or policy that is like really clinically focused, right, that targeted model of care I was talking about earlier, I think that we'll see broadly across the services, but within the Navy, specifically, because that's my context, that as this defense health agency transition comes through, we're gonna see a lot of changes in the training of military psychologists, because now it's going to be we'll see mostly civilian folks at the clinics and MTF, where the training actually happens. And then folks will move into embedded type positions as I'm in and I'm sure the entree will be in at some point. And then it's going to be there's going to be a gap there that needs to be filled in. And so I'm really curious what that will look like moving forward and how we'll do knowledge sharing and community community knowledge sharing like basically, within the services like within the Navy psychology community with the Air Force psychology community, because this is a huge organizational restructure with a focus DHS focus is on being a all service health care entity so that they can really maximize I think resources and people to provide care to everyone. So more more to follow, but I think we're gonna see a lot of transition that we can't predict quite yet.

Received those thoughts Deonte, do you have thoughts on how the landscape might change over the next five to 10? years?

Yeah, so DHEA took over for us in the last 12 months, and it's been as smooth as forming line structure on Black Friday, I guess, is really, it's such a culture shock in Italy, because it's a turn in new safety, which is, they'd say, the major command of Europe, essentially, for the airport, we pretty much been having the luxury of like things like the for example, family days, right. So every national holiday and Europe, you were getting the Fridays and sometimes Thursdays off. I have a Monday Holiday, just because you live here in Italy, the DHA they stepped in and they said, Well, how is that helping our clinical bottom line? No more Thursdays and Fridays, like they want they just took over and nixed all of them for the year. So if you are a person who was promised, like you get to go to Italy, and also get all these extra days off throughout the year, that's one of the perks of being here, you have a company who no one told you was taking over, like just taking over, if you're 20 years old, like you're just a person who's just now lost all those days off. That's from the quality of life standpoint, but and then closings of the clinic versus closing the base, which is a whole other thing. Sometimes the base is closed and the clinic is open. And if you're a parent who has your psychologist, as a family, and the child care, because your spouse is still active duty and they're deployed, now you lost a care for yourself. So for the quality of life of the psychologist here, with DHA taken over it's it's taken a massive hit. But to me the biggest hit is that we the some are switching over to a new system from from one medical system, I guess, VA will be the CPRS equivalent to this new ish medical system in the military, which is Genesis, but some use in the civilian world pretty commonly, which is terrible. I guess it's it's effective. But the military transition program has not been the best like it's been kind of a base by base standard. And we are actually the last base in the Air Force to get it. So we were like the end of the rope. And we were not prepared for it here in Aviano, and actually rolling it out next week. So cross your fingers on that one. Overall, from a psychology standpoint, and I guess social workers too, were just massively massively undermanned in the Air Force. And their last time I checked, there are 226, open billets around the world, where these are open positions in multiple clinics, no operational positions. So Nick's position would be in the Air Force an operational position, or pretty much he's not in clinic, he's embedded within the unit. He's doing the direct hands on work, and he has the autonomy of his own program. There are so few of us in the Air Force that there are now pulling members out of those programs and then stashing them in the clinic, because the clinics are so barren, which is why many psychologists are just leaving, because they can make more money in civilian. DHA now mandates five patients a day, that's 25 a week and you have three weeks in a row, where there's no holiday imagine like that's a lot of patients in one month, to see and then to keep up on notes, and then also do your other duties. So the burden of the job itself is crushing like our providers and is making it very difficult for you to have a positive quality of life while serving as a psychologist or social worker. But then the Air Force framework on your DHA, the silver lining, which is a very thin silver lining, or there is some is that they had been more receptive to pretty much what that impact is for the providers. So in the first one to three years is probably going to be pretty tough. But in the next three to five to 10, I would say if providers continue to speak out, like they have been pretty loudly like psychologists really, really like to talk, which is great, because when there's a problem, they let the command structure know loudly, that there's a problem and they had been, at least in the Air Force, I would see that in five to 10 years beginning to swing the other way. Because this model currently is not sustainable. I don't think you can see five patients a day 730 to 430 every day, like for a year, let alone three to four years at a particular base where you're at a small base where I've been here two years and I feel like I can't go anywhere without seeing a patient anywhere and this is before DHA. Imagine doing that for four years. You'd be surrounded by your job and your quality of life would massively take a hit. And you can't really you can but they have like Fourth of July celebration, it's just down the street at the field. It's everyone on base. If you've been here for three years and you're saying five patient of the day, you're in theory, potentially you want to run into these 30 or 40 people, you you've known intimate details of their life. And now I'm with my three year old, I guess, like quality of life wise, like these little nuanced things people don't necessarily talk about, but they really, really matter when you're just trying to be a human being and not a psychologist 24/7 Which technically you are, because you're active duty. So if they call you right now, you better have your uniform, because there'll be a problem if you don't.

Thank you for sharing some of those nuances. And for sharing a silver lining, that's always helpful to have a positive outlook, but much appreciated. Deonte I'm gonna start with you. What is the one question that you wish I'd asked you today? And how would you have answered them?

Oh, I'm a cancer. No, I'm just kidding. I, I wish I wish you would have asked what's my what's one thing I really loved about my military service I couldn't get anywhere else. Because that's truly been the only thing. This has been a tough year. And like, my mom passed away back in late June. She had stage four cancer and it just like she fought, but it was 18 months of really, really long fight. And she, I'm happy that she's no longer in pain. But this year has been like, terribly difficult in 2023. And some of the things that the military has provided, has negatively contributed to that year. And then some of the things that they've provided have actually helped to salvage what I can salvage or 2023. Yeah, I think that's like, that's one of the things we're in the duties of the job is like, in the like structure of being an officer, obviously, like there's perks and downsides to being in the military. But one thing I do want to give the military credit for is like, trying to the humanitarian programs that if you do have a sick family member, like a direct family member who's possibly either dealing with, let's say you had a child who had like, serious educational academic needs, or potential psychological or in many cases medical needs, there are programs in place to get you move to a location where the child or the family member can have the treatment they need while you still are close to a base where you can do your job. Like for my mom's situation, she was in Florida, unfortunately passed, they told us your mom has 12 months to live their military. Like To their credit, I worked at programs that tried to get me to Florida, to be able to be stationed at MacDill Air Force Base, which would have been 90 minutes from my mom's house. And I would have been able to take her physically like personally to all her appointments for her chemo and kind of lung treatments and everything. The Air Force, really, really like, at least at the command level back at Match com stepped up tremendously. Like they were true to their word, they tried to get me home, they tried to make sure I was there for my mom. And I got to spend almost four weeks straight with her before having to come back to Italy. And she she passed away a week after I left. And I'm thankful that there's two Majors, the General on our base, they heard everything was happening. And they gave me emergency leaves. They paid for my flights and everything they sent me to Florida. And I got to be with her for three and a half, four weeks, anticipating I get to see her again. But that was the last time I got to see my mom. And it was my she's about anyone who knows me knows that she's my best friend. So like, that's an that's an aspect of the military. We're, obviously you pray that that doesn't happen to anyone. But you will never seldom read something like that being a perk, outside of like the financial benefits and the duty requirements. But that's like, there are aspects of the military where there are people who are in positions of power, who actually do care, have the tools to care and to help you if you need. The rub is making sure that people in those positions actually want to use those tools and are like willing to be helpful. But let's say you had that prerequisite. You had people to support you and the tools to do so. And I can't be more thankful because I value that time with my mom very much.

Thank you for sharing that. And I'm very sorry to hear but your mom. Nick, what is one question that you wished I'd asked you and how would you respond to that?

I want to just echo the I'm so sorry for your loss Deonte. I also lost my mother during my time at PAU. So I know the impact and I can not imagine it during all the things that you've shared you've experienced in the last year so thank you for being vulnerable and sharing that with us. I um, the to answer the question. I think that one of the things that I thought would have been well could I can I can share now is that what's the best piece of advice, or what's an important piece of advice that someone gave you as it relates to your military services psychologist in the Navy, there's a lot of there historically has been a lot of expectation around the dynamics that are built within commands, because for the surface fleet, at least, right, because people go to sea like you go to see on these ships and you're in the ocean. And so there's a lot of organic like mentorship and like a family of choice development, like in these contexts. And so what mentors used to be called on ships was sea mamas and sea daddy's now I have gone to sea before, but this is like an old school term that I absolutely love. So my mentor and my type commander who really designed the embedded mental health model for the surface Pacific Fleet, is Captain Tara Smith. And she is like, literally an icon in my eye. She's such an amazing, amazing woman, she's our only Black, female, She's our only our only Black, O6 senior psychology officer in the Navy. And she's just truly does everything from a place of integrity, and everything replays of like thinking about each person in the process, from the patient, to the provider to the technician to the command, like she's very, very brilliant. And so I had recently had conversation with her around kind of what's next for me and what I was thinking about as far as continuing service and what that might look like. And what she shared was at multiple points in her I can't remember now I think she's at like 26 years in the Navy. But multiple points points in her career, when she had thought about separating or resigning her commission, she thought, if I get out, who will take care of everybody else. And that's based on some of the things that Deonte and I talked about today of folks who are who are there more for themselves than for the mission. And that has always, always stuck with me, because there are really terrible days and really terrible times. And of course, just like anywhere else in the world, there are really terrible people. But that's not everybody. And I just kind of I reflect on that a lot specifically, because I recently in the last couple of months, did re up and will PCS and do a military move in this coming spring, and I'll be going to DC and I'll be placed at the Psychological Health Center of Excellence doing research management. So a little bit away from clinical work. But bringing in all of my experience that I've gained working with the surface fleet to kind of represent the Navy's psychological research needs. Towards not for but towards defense health agency.

Congratulations, how wonderful for all of us, frankly, before we end today, what advice would you give to someone just starting out in their career, Nick.

I would say talk to as many people as you can, again, everyone's experience. I think, as we've kind of highlighted today, Deonte's and mine have been so different different branches. And even if we were in the same branch at different times, like everyone's experience is going to be so different because everything is always constantly changing within commands as personnel transitions over within the services is things like DHA, and just programs turnover. And I think the more that you reach out and look for those informational interviews, or those interpersonal connections, the more you can inform your own your own decision making right of whether or not this is something that you want to commit to. And then always, always, always remember that like you are signing up for a certain amount of time. And it is very, very common for the cults that is the military. Just as all things in the world were a cult, it will talk about the career and how you should do 20 years and that should be a goal. But like, I just don't think that's true, I think you should do whatever is best for you and your people or your your family, your community. And that might be what other people are motivated by but don't let that. Don't let that inform what you want to do. Because you can be happy doing whatever it is you're doing. We're trained as psychologists, we are the PhDs that do all the things, most PhDs do a deep dive into one subject and we leave or we at least we left PAU with such a wide skill set that like, take, take your experience in military if you decide to do that. And take it to another area and just continue to follow your passion.

Deonte What advice would you give someone just starting out in their career?

I would say know your motivations and your values as best as you possibly can first before anything else, because those are going to be the things that sustain you when things are really tough. Like those really hard days. Like just know why you're doing this. Like if you're if your motivation is like strictly for money, then be honest with yourself about that and then maybe see yourself as a non 20 year person if you're potentially because it's hard to promote when you are just trying to get a paycheck. Um But if you're if your values are deeper than that, or or parallel to those in other ways that are more important to you like providing for your family or being able to afford a house for the first time, because you're the first person in your families owned a house or something like very, very specific to your circumstance, just know what those things are. Because those are going to be the things that sort of anchor you to the ground when people are telling you what you have to do 20 years or this is what it means to be a good officer this what it means to be a good person. Like if you don't have a sense of self before hearing those things, you're going to get trapped in this massive yo yo effect of every base you go to and every new Captain or Lieutenant or Colonel that you're meeting, swinging you left and right telling you the kind of person you're supposed to be without having a true sort of locking point to call yourself. If you do that you put yourself in a position where at the very minimum when people give you military advice, which is good, bad and everything in between you can you have a dearth of information to sort of run that data up against versus just flying by the seat of your pants and hoping that every commanding officer has your best intentions in mind.

Very much appreciated. You both been so incredibly open and candid and have shared your experiences and given us the nuance and Deonte, Nick, I just really want to thank you both for being here for discussing your experiences and your careers. You're both amazing professionals. And I'm excited to watch you know you continue your careers. As we wrap up today, I want to encourage our listeners to check out Deonte's podcast DNA of Love with Dr. Williams posted weekly on Spotify. We'll also post that in the resources for this podcast. I'd also like to encourage listeners to check out GLMA health care professionals advancing LGBTQ plus equality at glma.org. So those are near and dear to both Deonte and Nick's hearts. I appreciate you both bringing awareness to both those as well as military psychology in general and your careers specifically in your experiences. So thank you so much for joining me today. I really appreciate it. It was wonderful to get to know you both a little bit better and very much appreciate the time that you took, especially at the time that it was for you Nick early, not early, but approaching noon or so ish in Hawaii and Deonte approaching midnight or so ish in Italy. So thank you very much. You guys have both been wonderful. I appreciate it.

No problem at all. Thank you guys. Thank you so much.

Thank you and I hope you have a great rest of your day Deonte. I hope you actually can get some sleep. Appreciate it.

Oh, you got the salute.

Thank you again for listening. I hope you join us for the next episode where Dr. Afik Faerman will discuss neuro psychology with experts in the field.