The Importance of Mental Health in Uniform Published May 11, 2020 By Cadet Samantha Beck Wild Blue Yonder / Maxwell AFB, AL -- As humans, our mental health is important. As a military member it is even more so. “Life in the military can be stressful for anyone from an Airman to a general officer.”1 The Centers for Disease Control and Prevention (CDC) defines mental health as “our emotional, psychological, and social well-being.”2 It plays a major role in many aspects of a person’s life, including “how we handle stress, relate to others, and make healthy choices.”3 Many times, mental health and mental illness are used interchangeably; however, they are not the same thing. “Mental illnesses are conditions that affect a person’s thinking, feeling, mood or behavior.”4 Examples of mental illnesses are depression, anxiety, bipolar disorder, or schizophrenia. With mental illness being among the most common health conditions in the United States, more than 50 percent of Americans will be diagnosed over their lifetime. Additionally, 1 in 5 Americans will experience some form of a mental illness each year.5 Our military members are no exception to this statistic. The August 2019 edition of the Medical Surveillance Monthly Report included the Department of Defense’s 2018 “Health of the Force” study, which “found that mental health appointments among active-duty troops accounted for roughly 16% of all military medical appointments, or 1.8 million outpatient visits.”6 It is important to note that “a person can experience poor mental health and not be diagnosed with a mental illness. Likewise, a person diagnosed with a mental illness can experience periods of physical, mental, and social well-being.”7 While these are mental health appointments, there is no indication of how many patients walked away with a mental illness diagnosis. The appointments, however, are just as important, because as stated previously, mental health affects various aspects of performance. The Air Force has already made it evident that mental health is important. In fact, “the Air Force’s Comprehensive Airman Fitness program includes mental wellness as one of the four pillars of wellness.”8 Photo Details / Download Hi-Res (US Air National Guard photo by SSgt Alexander Frank, 142nd Fighter Wing Public Affairs) Figure 1. Weathering COVID-19: mental resilience. Danielle Frank, a military spouse, uses video-conferencing technology to stay in contact with family during COVID-19 quarantine, Gresham, Oregon, 27 March 2020. Staying connected while practicing social distancing is crucial to the mental well-being of Airmen and their families. The question remains, if mental health is being stressed in the Air Force, why did we just have one of the highest suspected suicide rates last year? Back in January, an article from Stars and Stripes stated: The Air Force had 137 suspected suicides last year, the highest number since the service began tracking suicide in 2008, officials said Friday. The 2019 figure includes active duty, reserve, guard and Air Force civilians and compares to 103 suicides across the service in 2018 — a 33% increase.9 This could just be because of the nature of the job, or it could be an indication there is something that has gone severely wrong. The military in general is a high-stress environment, with the significant possibility of service members seeing combat. Not knowing how to cope with these environments can lead to poor mental health and eventually mental illnesses. Trauma, history of abuse, genetics, use of alcohol or recreational drugs, feeling lonely, and isolation are all causes of mental illnesses. This means that many military personnel are at risk, as one or more of these applies to them. As stressors build, so does the likelihood of someone developing poor mental health. If someone is being overworked and then must go home and care for a sick relative or is experiencing financial issues and is not getting good rest at night, they may experience poor mental health.10 Oftentimes, military members will not get help out of fear of it impacting their career negatively.11 The fact of the matter is, the medical professionals cannot disclose any of the medical information to the commanding officers. There is a list of nine circumstances where information disclosure is required by Department of Defense Instruction 6490.08.12 Back in 2014, then–Lt Col Wendy Travis, the chief of mental health policy and program evaluation with the Air Force Medical Operations Agency, Lackland Air Force Base, stated, “The earlier you seek assistance for problems, the easier the problems are to treat and the less impact those problems have on you and those you love.”13 Travis also made the statement that “most of the people who come to the mental health clinic do not fall under these categories, especially if they come early - when the problems first get to be difficult.”14 These statements are backed up with evidence. In 2006, a study was published that showed “97 percent of Airmen who sought mental health care voluntarily—before problems are noticed by commanders or other community members—did not experience any negative career impact.”15 That study was conducted more than a decade ago, and whether it holds true today is uncertain. However, individuals, military or not, should always seek help when their mental health is at risk, and we all need to look out for one another. Cadet Samantha Beck Cadet Beck a sophomore from AFROTC Detachment 915, attending West Virginia University (WVU). She is currently enrolled in their honors program, studying mechanical engineering and is a summer hire for the US Army Corps of Engineers. She is involved in the Silver Wings chapter at WVU and plans to graduate and commission in May 2022 as an engineer in the US Air Force. Notes 1 Nicolas Z. Erwin, “Breaking Down the Image: Mental Health,” Air Force Medical Service, 21 May 2018, https://www.airforcemedicine.af.mil/. 2 Center for Disease Control and Prevention, “Learn About Mental Health,” 26 January 2018, https://www.cdc.gov/. 3 Ibid. 4 Ibid. 5 Ibid. 6 Patricia Kime, “Mental Health Disorders in Troops Far Below National Average,” Military.com, 4 September 2019, https://www.military.com/. 7 Center for Disease Control and Prevention, “Learn About Mental Health.” 8 Larine Barr, “Air Force Mental Health Programs Encourage Seeking Help,” U.S. Air Force, 28 May 2014, https://www.af.mil/. 9 Jennifer H. Svan, “Air Force Saw Record Suicide Rate in 2019,” Stars and Stripes, 31 January 2020, https://www.stripes.com/news/air-force/air-force-saw-record-suicide-rate-in-2019-1.617143. 10 Center for Disease Control and Prevention, “Learn About Mental Health.” 11 Barr, “Air Force Mental Health Programs.” 12 Psychological Health Center of Excellence, “Disclosure of Protected Health Information,” https://www.pdhealth.mil/. 13 Barr, “Air Force Mental Health Programs.” 14 Ibid. 15 Ibid.