Command Interview: Dr. Julie LaRow, AF Resilience

Published Feb. 21, 2023
By AIRMAN Staff
Airman Magazine

Dr. Julie LaRow, Ph.D., is the Acting Director and Integrated Resilience Policy Division Chief at United States Department of the Air Force.

The Department of the Air Force Resilience office is dedicated to helping forces and families find the resources and support they need to succeed and thrive in all aspects of military life. Resiliency, mental and physical health, spirituality, positive relationships are the qualities for which all Airmen and their families strive.

Airman magazine:
Let's describe the purpose and purview of the Air Force Resiliency Office, because I think, at least outside of the Air Force, it may not be common knowledge.

Dr. Julie LaRow:
The mission of the Air Force Resilience Office is to help support or to ensure support for individuals that experience different experiences across the continuum of harm. Our overall mission is to decrease ISDV (interpersonal and self-directed violence) and to increase support services.

The overall mission for the agency is to reduce interpersonal and self-directed harm and then to increase performance through support activities and enhancing well-being.

Our resilience office focuses on primary prevention, that is, the prevention of a wide variety of interpersonal and self-directed forms of violence. We focus on the earliest stages to prevent incidences from occurring. Then we also focus on the advocacy response aspect of sexual assault and sexual harassment.

Those are the two different aspects of our work across the continuum of harm.

Our Airmen are our greatest asset; we cannot do any of the things that we do without our Airmen and Guardians together. The support they provide each other and the team effort to work and address the worldwide mission of the Air Force is vital and cannot be accomplished without the support from everyone.

Airman magazine:
Can you describe what that primary prevention entails and also the continuum of harm?

Dr. Julie LaRow:
We really try to take an approach that understands the holistic experience for folks. That's a strength-based framework that helps us understand where we are and how we can help each other from different domains. We look at the mental domain, the physical domain, the social domain and the spiritual domain.

We really try to understand how all of this comes together, [the] different ways that we interact with each other, and how we can connect and find ways of areas of need where we can help address stress in any of those areas. Then we find mechanisms for support.

It helps guide us to understand which different areas of support someone might need and how to help that person get to that resource.

Airman magazine:
And sometimes multiple areas of support, correct?

Dr. Julie LaRow:
Exactly.

U.S. Air Force Capt. Ryan Miccio, 603rd Air Operations Center Future Operations Division Multidomain strategic center planner, shares past experiences dealing with mental illness during the Storytellers event at Ramstein Air Base, Germany, Sept. 26, 2022. The Storytellers event focused on personal stories and highlighted various resources to support members who might be struggling with mental health. (U.S. Air Force photo by Airman 1st Class Edgar Grimaldo)

Airman magazine:
Do these issues with mental health often have physical symptoms associated with them?

Dr. Julie LaRow:
Yes, and they can really interact with each other. We really try not to look at it as simply as those domains. It can really incorporate other things, but it’s a mechanism to really understand how we can self-assess and assess each other, to see what challenges might exist and to see how they interact with each other.

Airman magazine:
I know this is kind of early in the game to ask this question, but what’s the goal? Why is this important to the Air Force? Is it about being able to retain people who may have gone through something?

Dr. Julie LaRow:
It’s multiple things. It’s about retention, but it’s also about readiness. It’s about taking care of our members of the Air Force in general and as a community. We think this is important because it helps us learn how to identify and manage stress.

It doesn’t assume that we’re going to eliminate all stress, but we’re going to learn how to manage it, how we can help each other and help ourselves understand what it feels like—how we know that we might be going through something, identify that need and then know where to go.

We want Airmen to trust the system and the resources that we have and trust that those things will be helpful, and they will be able to have improvements in any of those areas of well-being.

Airman magazine:
Is there also a training component for officers and enlisted supervisors on how to recognize and interact with Airmen that are having issues? People are not always open about what they’re going through, right?

Dr. Julie LaRow:
Yes. This is about training folks at every level. We want to train folks in leadership roles–in formal and informal leadership roles–how to identify signs and symptoms, how to know how to interact, how to create an environment that’s ready to react and is ready to respond and care for each other and support each other.

And this is true for peers, right? We want to help folks know how to help each other at every level. We also do this for family members, too. We help families find different resources and identify when their partners or their family members have an area of need and know where to get help.

Airman magazine:
I think a lot of the families, at times, are just completely mystified. They noticed a change, yeah, but they’ve got no way to put a label on it. And even the people who are suffering oftentimes don’t have a label. They know something is happening; they just don’t know what’s happening.

How does your office guide people to resources that could help them realize [that] maybe this behavior is linked to that?

Dr. Julie LaRow:
I think that's an interesting topic–trying to figure out what the causes are and what the label is. Really, what we're teaching are tools to identify changes, right? To know when something just doesn't seem right, and there might be additional resources or help that might be needed. So, we do that.

Then, how to identify where to go for help and for questions. So, whether that's the military and family readiness centers, whether that's mental health, whether that's one of our community support coordinators that can help guide.

Airman magazine:
Can you describe the CAF (Comprehensive Airman Fitness) models and what they were established to accomplish and how are they utilized today?

Dr. Julie LaRow:
The CAF model is that domain to help us understand different experiences and view ourselves in a holistic way from physical components, spiritual mental health, emotional health, social support [and] our social domains.

It's to really be able to view a holistic approach to the person and the person in their environment. The goal is to help provide a framework to identify needs and resources, and support.

We use that framework to inform a lot of different things that we do, a lot of different prevention activities that we've created and that we support across the DAF.

Airman magazine:
What does your office do to try and guide Airmen to more positive social media experience? How do you them avoid or disconnect from some of the more toxic things in the virtual world?

Dr. Julie LaRow:
You're talking a lot about stimulus and then the different things that are out there that folks may get involved with, both inside and outside of work. That sounds like what you're talking about.

What we do at the DAF is set a framework for different priorities that are going to address how to kind of build that community, and in this way, that supports the CAF model and connectedness.

We'll have tools for leaders to help build that culture within their units, tools for Airmen to get an understanding of how they could gain help and support, and tools for family members in the same way. We really focus on building connections–building connections with peers, with family members, within units as well.

And that's a really good way to address some of that, those stressors that you're talking about. Building a sense of connectedness within units sets the stage for when someone does need help, they'll have a trusted unit member’s knowledge to access the services that they may need.

wingman days — Chief Master Sgt. of the Air Force Kaleth O. Wright poses for a photo with an Airman during the Wingman Day Herk Nation Mission Expo at Little Rock Air Force Base, Arkansas, Oct. 4, 2019. The festival style event was designed to connect every junior Airman to their vital role in our Combat Airlift Mission; featuring static and interactive displays of equipment and facilities. (U.S. Air Force photo by 1st Lt. Jessica Cicchetto)

Airman magazine:
Are there specific examples out there of programs that your office supports to achieve that connectedness?

Dr. Julie LaRow:
What that system does is it enables and empowers installations to be able to look at the data that they have that identifies the needs, the risks and the protective factors. Those are positive things that are happening in their units and at their installations.

And they take that information, and that guides them to develop different prevention activities. Across the DAF, installations will build and identify different prevention activities that embody the core components that we talked and address the needs that they see on the installation.

Some of the things that we are also working on are things like Wingman Connect.

This is a project that's in the research stage and is showing promising impacts of building connections among peers that can help decrease depression and suicidal ideations. We'll take these practices and measure them and evaluate them for effectiveness.

Airman magazine:
What is the environment for Wingman Connect? Is that a social media network, or is it face-to-face? Or a combination?

Dr. Julie LaRow:
That would mostly be a face-to-face building of communities within groups--peer support. Teaching folks how to reach out to each other, [and] learn the skills to build and grow connectedness within their unit and their group.

Airman magazine:
Is emotional intelligence training a component of that approach?

Dr. Julie LaRow:
It's really important.

Emotional intelligence teaches us how to engage with others in a way that helps build understanding and compassion for different experiences. It helps break down some of that wall by understanding each other's worldview and experiences.

It also provides us tools with how to do that for ourselves, how to do self-assessment on how we're feeling, experiencing and understanding what might be going on around us.

It does two things: to really be able to encourage and grow that connectedness that we were talking about within units and within peer groups, and then create that environment of trust.

Emotional intelligence can help us feel more ready to be able to ask for help when needed or offer help to someone else when you identify that they might need support.

It's really a core component in building that connectedness across the DAF.

Airman magazine:
I wondered about this during the pandemic because it became so obvious; who cares for the caretakers?

Dr. Julie LaRow:
Great question. That came up for us, too, with so many first responders having to work so hard and in an environment that was often scary.

Building connections and being able to support each other goes with supporting caretakers as well.

Family members are caretakers, as are support providers across the DAF, all of that, you know, these are applied to all those different communities.

Airman magazine:
Even in our career field, we have people who are responsible for documenting not just combat but things like accidents and suicides. Stress really builds up from repeatedly being in those environments.

Dr. Julie LaRow:
It activates our fear response mechanism, right? And then it becomes the standard way of experiencing the world – a world that's in hyperdrive.

Airman magazine:
Immersion therapy paid off dividends for me – being able to relive those experiences but in a safe place.

Dr. Julie LaRow:
You're starting to learn how to retrain your brain and your body to bring yourself back down again from these experiences. Right. Get back into a mode where you can turn off that flight-fear response that you may be experiencing.

Airman magazine:
I interviewed an Air Force combat controller who had a very succinct metaphor to describe the rationale for Special Operators to embrace seeking mental health support. He said, “You wouldn't go out on a mission without cleaning your weapon first, so why aren't we cleaning the most expensive, most valued weapon we've got, our Airmen, after each deployment?” Is the connectedness you seek a part of a changing culture within the force to seek mental health support?

Dr. Julie LaRow:
It's a great question. I think it's important for a lot of many different reasons. We know it works. There's evidence behind the support for connections being a prevention activity, a prevention mechanism for the different things that are that many people experience.

It's helpful for reducing stigma because the more we build connections, we help people understand that it's normal to have these experiences and that it's okay to seek help. That's going to help reduce the stigma and shift the way we understand and the way we view a variety of different mental health challenges.

It's also helpful to build trust across the units, too. If we learn this early, we can continue to grow those skills over time. These are future leaders of the Air Force. We're going to be able to see the benefits of that connectedness and emotional growth compounded over time shift the culture in general.

One of the things we see around building trust is that it is a living thing, right? Situations can arise that might impact trust. We need to learn and know and understand that it's okay to keep rebuilding it, learn from those experiences and be able to keep working towards that connected, trusting culture over time.

Airman magazine:
Let's talk about some of the hard stuff. According to DoD data, more military personnel have taken their own lives than have died in combat over the past two decades. That's bleak. How is your department specifically helping Airmen recognize and deal with suicidal ideation or severe depression?

Dr. Julie LaRow:
You're right. We are continuing to see a rise, just like in the greater U.S. population. While seeing a rise, we have also seen some promising impacts from a number of different interventions like Wingman Connect and time-based prevention. That is a tool that we use to try to put time between an individual and means to act on those impulses; give folks time to intervene, seek other help, or have someone else intervene.

We take a multi-level approach, focusing on it from a command climate, leadership strategies, family interventions, time-based prevention and building connections. We take this approach because the issue is complex. There isn't one thing that's going to solve the problem. It's going to be multiple approaches, and the other thing that we're doing is evaluating all of those practices.

We need to know what works and what isn't working. Over time, we'll be able to see what is having an impact so we can continue those practices, enhance those practices, and then what might not be working so that we can reevaluate the direction we need to take. So, we're taking many different approaches to prevention.

It's going to take some time to see the impact of all the different things that we're doing.

Airman magazine:
What are the mechanics of the time-based approach? What are the things that people can do to lengthen that gap between ideation and being accessible to a method of carrying it out?

Dr. Julie LaRow:
The concept is to make it difficult to access means, and what we know is the most common lethal mean is firearms. If you own your gun, it's about how to store that gun whether that's in a locked location, having it stored with someone else or someone else having supervision of that weapon.

Airman magazine:
Creating drag on taking action?

Dr. Julie LaRow:
You're adding space to be able to think about it and to think about other options. This is true for medications as well. That's another means that we can put time and space in between ideation and access. So safe storage of those, having it locked or storing it with someone you trust, provides some time and space in between the thought and then the action.

Airman magazine:
Let’s talk, within the framework of sexual assault and harassment, about the continuum of harm. What does that term mean?

Dr. Julie LaRow:
It's the way we understand different interactions and progression and other causes of harm.

If we look at harassment and bullying, acts like that are potentially precipitating events. How we can intervene and how we need to address prevention activities and our responses and understand how those might interact or link with other elements of harm.

And that continues to family violence, sexual violence and then also self-directed harm.

Airman magazine:
Are there any specific programs that you can reference as far as educating families, spouses and children?

Dr. Julie LaRow:
We would focus on adult family members, and we have a specific tool that's popular, and a lot of folks have access to it. That's our suicide prevention family tool kit. It's a training program that they can access on the web and get a certificate at the end.

It helps identify risk factors, how to approach a family member who might be in need, how to understand and identify need, where to go and how to respond.

Airman magazine:
So, the opposite side of that coin, nobody comes out of it and seeks help and has one appointment and they're all better. So maybe talk about the continuum of care process.

Dr. Julie LaRow:
The way we look at how to help folks that have experienced that might be victims or survivors of many of these things or in need of mental health services. There isn't just one type of service that works best for everyone. The continuum of care really looks at that. You can enter into seeking help at many different levels – seeking a service at a Military Family Readiness Center, seeking support from a peer, seeking support from a supervisor or seeking support from family – those are all different aspects of care. It also includes advocacy efforts and mental health response.

In medical treatment, there's a wide variety of different types of services.

Is that an individual or a family can seek out to get the support that they need. And the idea, too, is that you could and should be able to access any level of that service and be able to then navigate to the right level. You may find that you seek out a service on one level, but you really need something else.

We really try to support this cohesive continuum of care that seeks to connect folks to the appropriate service at the right time.

One of the things that we're that we've piloted this year is the co-location pilot. It's where we're co-locating advocacy services.

Response efforts for folks that have been a victim of sexual abuse, harassment, bullying, cyber-bullying [and] cyber-harassment, are located in one place and they can seek support across any of those different levels of harm.

Patricia Montes Barron, Deputy Assistant Secretary of Defense for Military Community and Family Policy, center, and Erika R. Slaton, director, Military Community Support Programs, far right, visit a Joint Base San Antonio-Fort Sam Houston School Age Program July 12, 2022. During their two-day immersive tour with JBSA Force Support Squadrons, they visited multiple locations to learn about resiliency building efforts across the country’s largest joint base.

Airman magazine:
How many of those kinds of facilities exist?

Dr. Julie LaRow:
Right now, we have seven sites that we're piloting across the Air Force at different locations – different size installations.

We tried to pick places that had a wide variety, so we could really understand the differences and the benefits and experiences of co-locating in these different environments. Then we also have some control locations, places where we kept business as usual, where the services are not necessarily in the same center.

They would still refer to each other and be able to ensure people get to the right place, but they aren't physically in the same location. And that way, we can see whether there's a benefit or not to being able to have all the service providers in the same locations.

Airman magazine:
Is there a differentiation in how we try and get people from diverse backgrounds and cultures to certain services? Is that something that enters into the equation?

Dr. Julie LaRow:
I don't think we've really looked at how culture impacts referral, but what we what we do is try to ensure the cultural competency of our providers and that we have an array of services depending on the type of need that you have.

We have chaplains that also provide many supportive services, and that might be the identified type of service that the individual wants versus other levels of service. There is some differentiation, and some variation for the type of service someone might need.

Chaplain Pierre St. Louis, 4th Fighter Wing, and Airman 1st Class Alyssa Ellis, 4th FW religious affairs airman, speak with Airmen assigned to the 4th Fighter Generation Squadron at Seymour Johnson Air Force Base, North Carolina, Nov. 3, 2022. Religious service teams engage with units across the base to promote healthy engagements, provide services and promote positive morale within squadrons. (U.S. Air Force photo by Airman 1st Class Sabrina Fuller)

Airman magazine:
Can you talk about the mind-body connection and how that affects an Airman’s overall health?

Dr. Julie LaRow:
I think that's really part of the CAF model, right, in that framework to really help folks learn the interconnectedness of all of those things.

Then inform them of the resources to be able to kind of enhance that aspect. Who do they need to seek out, like in medical, to get consultation on some of those things.

But that would be really part of that that CAF model and then supported at the installation level when they identify that that might be a need within their units.

Airman magazine:
It's really kind of amazing how you can get an immediate positive feedback loop going between the mind and body just by taking a nature walk.

Dr. Julie LaRow:
It's a great example of figuring out what your “thing” is, like, what's the thing to help you relax, and get connected with yourself. And for some folks, that is nature, right?

For some folks, that is physical activity, and for some folks, that might be listening to music or art; there's a wide variety of different things that help us improve our well-being.

And they may not be the same for everyone. And figuring that out is key.

Airman magazine:
On another bleak topic, the number of reported sexual assaults has been steadily increasing.

Dr. Julie LaRow:
Yes.

Airman magazine:
Is this issue of increased reporting because of improved victim support and advocacy within the force, or is it actually getting worse, or is it a combination of the two, and how can we tell?

Dr. Julie LaRow:
Yes, it's hard to know. But what we do know is our prevention activities aren't doing enough yet, and we know that we need time for those to become effective. One of the things that happened this past year was the Independent Review Commission for Sexual Assault and Harassment that came out with 82 recommendations on how to improve services across many domains: accountability, victim care and support, culture and climate and prevention.

What we've been doing over the past year is building out our responses and changes across those recommendations. One of those is the prevention workforce. We are building up that prevention workforce so that we'll be able to implement more prevention activities and identify and target those prevention activities. We're improving and increasing our evaluation mechanisms for those prevention activities so we know what works and if we're making an impact. We need time to see those things come to fruition to see changes in accountability and in victim care and support.

I talked about the co-location pilot. That's one of the things that we're working on to see improving trust and reporting, to see if folks are reporting and trusting our support providers and our system. We also are rolling out efforts to improve referrals across the services that are connected care approach.

There are many different things that we're working on this year to address all of those recommendations and ultimately improve the services that we have and the prevention activities that we're beginning to implement across the DAF. We'll see, as we move through this process, outcomes from those and be able to understand if they're making an impact.

Airman magazine:
Could you go into the differences between unrestricted and restricted reporting of sexual assault and harassment?

Dr. Julie LaRow:
The goal is to encourage reporting, but we also want to encourage folks to seek help. That's the most important thing to seek the care you need. Sometimes that is through reporting. We have two mechanisms to do that: One is unrestricted, which means involvement of the Air Force Office of Special Investigations or an investigation into the report, and then restricted meaning there will not be an investigation into the report.

The restricted option is there to provide an avenue for folks to be able to report what happened, access services, get advocacy services and not have to go through the process of the investigation if they don't want to.

They do have a choice at any point to do what we call a ban on restricting it; they got to place what they were ready for that.

There have been some changes to the restricted reporting options to be able to ensure folks can utilize that more often.

In the past, if a report had come out through another mechanism, they may not have [had] the option to be able to utilize restricted reporting. We've been able to change that with support from the Department of Defense and allow folks the opportunity for a restricted report to do more.

Airman magazine:
Is that data coming into your office and being analyzed there?

Dr. Julie LaRow:
It will be, yes. We're just starting to lay out the foundation now to be able to do all these things. But yes, that the evaluation of those activities is in our office.

Everything must be evidence-based and data-informed. This helps us know it's going to be effective and then ensures effectiveness over time. It's very important, that data, and we're working constantly to improve our data mechanisms and how we can analyze and be able to understand the data.

Airman magazine:
The Invisible Wounds Initiative group wrapped up a few months ago. Is that still an ongoing effort under another name?

Dr. Julie LaRow:
It's still a thing. The Invisible Wounds Initiative researched and gained a better understanding of different forms of invisible wounds that impact our Airmen and Guardians. Then it came up with a number of recommendations for policy and programing. That is what we have begun implementing, and it's becoming a standard part [of] the DAF framework – being able to understand and identify invisible wounds, then how to seek and access the support that individuals might need based on those experiences. It also helps leaders recognize and understand more about what invisible wounds are, what are the symptoms and what are the different supports services.

Airman magazine:
Okay. So, the IW Initiative set up a task force of sorts, and while that has run its course, the priority of Invisible Wounds support is always there.

Dr. Julie LaRow:
Yes. It’s all part of now that continuum of care and the agency approach to how we understand the needs of our Airmen and Guardians and help them access the services they need and reduce the stigma for seeking support. That was a piece to the Invisible Wounds Initiative, reducing the stigma for seeking help for folks that are experiencing invisible wounds.

That is part of what we do. We are constantly working to reduce the stigma for accessing the wide variety of services we have and increase access [to] the care that is available across the DAF.

Service members stand together during a candlelight vigil at Spangdahlem Air Base, Germany, Sept. 30, 2022. October is recognized as National Domestic Violence Awareness Month, while September is Suicide Prevention and Awareness Month. (U.S. Air Force photo by Airman 1st Class Imani West)

Airman magazine:
What changes are coming for the SAPR (Sexual Assault Prevention and Response) program?

Dr. Julie LaRow:
The Independent Review Commission had many changes to the SAPR program. Our SAPR structure is improving and professionalizing the workforce, and co-location, pulling together services to improve access for our clients. And there are many across this independent review commission approach.

This is a 10-year process, so there will be many changes that will build upon each other to be able to care [for] and support folks that are needing our services.

Airman magazine:
So, when you say professionalizing, what does that mean exactly?

Dr. Julie LaRow:
It has to do with the credentialing process. It has to do with requirements like education and experience. We did a manpower assessment to look at our staffing levels and to look at the educational requirements, and it's making recommendations for improvements where needed across the support workforce.

One of the changes is that the IRC, the Independent Review Commission, requires we sunset the volunteer victim advocate program. The purpose of that was to be able to ensure that we had the optimal full-time for civilian or military full-time advocates.

We’re rolling out hiring additional victim advocates, civilian victim advocates, to meet the need until the end of 2024 and sun-setting the volunteer advocate program. The volunteer advocate program can still continue in places that are remote and isolated because we recognize the need for additional support in that area. But the case management, part of what volunteer victim advocates did, will fall to those full-time victim advocates.

U.S. Air Force Tech. Sgt. Amanda Martinez, 86th Airlift Wing integrated resilience office noncommissioned officer in charge, teaches the Resilience Training Assistant course at Ramstein Air Base, Germany, Dec. 13, 2022. The intent of the RTA course is to give Airmen the ability to overcome big and small adversities using psychology based Air Force resiliency skills, and help others after attending the course. (U.S. Air Force photo by Airman 1st Class Regan Spinner)

Airman magazine:
What is Airmen's Time, and how is it being implemented?

Dr. Julie LaRow:
Airmen's time is establishing a culture of taking time and space to spend with your Airmen, valuing and prioritizing that space for Airmen and supervisors and leaders to come together. It is left open for leaders to determine what they need and the topics they want to utilize for that Airmen's Time.

We can provide tools to help support what they choose and what they've identified that they need within their units.

Airman magazine:
What would be your elevator pitch on the benefits of holistic support for Airmen to the effectiveness of the force?

Dr. Julie LaRow:
It improves readiness. The more prepared we are to deal with and manage the daily stressors and other stressors that we experience, the more ready we are to fulfill the missions that we came into the service to provide.

Airman magazine:
So, what are some of the barriers that still exist that have to be overcome?

Dr. Julie LaRow:
We're really in an amazing moment in time where we have all of these recommendations that are coming to fruition from the Independent Review Commission, the Racial Disparity Review Report and the IPV report – the interpersonal violence report – that was done two years ago.

It's going to take us some time to see that impact, but when you look at all of these changes and where we can be in two, three, five years, I think things will look fundamentally different. We're going to have some great information to help us guide what's effective and what and where we're going.

You know, when we look at all the different recommendations and the things we're doing, they're backed by evidence. They are backed by other research. We've seen other suggestions both inside the military and outside the military. There's a lot of goodness in what we're seeing and the momentum that we have right now.

I'm very excited to see where we're going to be in a couple of years, next year and a couple of years as we build up this workforce and we make all of these fundamental changes.

Airman magazine:
What are some of the places where the co-location trials are being conducted, and why were they selected?

Dr. Julie LaRow:
A couple of different places are JBLE [Joint Base Lewis-McChord], Vandenberg [Space Force Base] and JBSA [Joint Base San Antonio]. Those are a couple of different examples that were chosen for readiness rate, who had the facility and the capacity to bring folks together and the willingness to do so. We really wanted to find places that were excited in support of this idea of bringing centers together.

Both CONUS and outside CONUS, some larger installations and some smaller installations. We tried to pick a wide variety of different locations to really be able to understand how the differences might pan out.

Airman magazine:
I would think with the divergent missions that JBSA must be an interesting proving ground.

Dr. Julie LaRow:
Exactly. That was one of the things to make sure we know the impact on Airmen at different levels across their careers.

Airman magazine:
How would you direct somebody – a commander – who inquires about what their command can do to start moving in this direction?

Dr. Julie LaRow:
Talk with their violence prevention integrators and their community support coordinator. Those are two folks that they already have on the ground. Those are the folks that have been responsible for really understanding what's happening at their installations, the protective factors and the risk factors.

Those people will have a good understanding of what can be done now on their installation because they understand the demographics, the challenges, [and] the strengths of the installation and be able to move out and know where to move out.

Airman magazine:
Do most places have those people in place already?

Dr. Julie LaRow:
They do.

Airman magazine:
I guess with everything going on at an installation and [with the] mission, one might forget they've got assets that are right there.

Dr. Julie LaRow:
That's a good point. We would encourage reaching out to their violence prevention integrators [VPIs] and their community support coordinator [CSC]. They work for the commanders – they work for the installation or the wing commanders at their base – to help them, guide them through what's available, what the needs are. And then if something isn't available, how to get it.

Airman magazine:
And those people can come directly to you to get additional guidance?

Dr. Julie LaRow:
Yes. We have an operational arm at the Air Force Personnel Center/Integrated Resilience Division [AFPC/DPFZ], and they are the operational arm that really helps provide that operational guidance, and they are working with the VPIs and the CSCs constantly.

Airman magazine:
Who can access all those resources and where?

Dr. Julie LaRow:
That is accessible on our website. Commanders have access to that toolkit, and commanders can use that to better understand what invisible wounds are, how to talk with their units, how to talk with members about invisible wounds, how to access services, what types of services are out there, and understanding signs and symptoms. It’s a wide variety of ways to help support commanders better understand the invisible wounds, the Invisible Wounds program and what's available to them.

Airman magazine:
What about programs for people dealing with PTSD or TBIs? Physically manifested issues that they have with brain injuries. What kind of resources do you have for those people?

Dr. Julie LaRow:
We direct them to mental health clinics. That is those types of mental health interventions are what we would consider a secondary and tertiary levels of intervention. And so that would be an outside agency, but we would definitely help guide them to those programs.

Airman magazine:
We talked about the social stigma for seeking help, but then there's also the professional stigma. Whether it's real or not, it is certainly a concern for Airmen. And how do you – how does your office try and combat that, so Airmen pass that worrying about how is this going to affect my career?

Dr. Julie LaRow:
It goes back to trusting the system, right? Trusting there won't be a negative impact on your career. We do that through educating commanders, right? Through educating providers on how to protect folks. But it also goes through evaluating policies.

We do go through a process of evaluating policies for stigma or anything that may negatively impact, even inadvertently, someone's career. The Invisible Wounds Initiative did some of that.

We've done that with the suicide prevention program, too. Evaluating policies to ensure that there isn't a policy out there that would negatively impact an individual so they won't be seen seeking help. We do it at multiple levels, both looking at the institutional stuff, but also how you train commanders.