An unseen battle rages to preserve the military’s capability for combat in today’s tense global environment. Our nation’s military mental health professionals are at the forefront of this fight — indispensable assets shouldering immense emotional burdens as they fortify the resilience and well-being of those who guard our freedom.
Former Secretary of Defense James Mattis aptly said, “The most important six inches on the battlefield is between your ears.” That is the mission space of these professionals.
The Department of the Air Force has developed considerable resources, programs and communication campaigns to encourage service members to proactively pursue mental health services without fear of retribution. From pre-deployment preparedness to post-traumatic stress treatment, the department’s conversation has centered on increasing access to services and reducing stigma around seeking mental health care.
Amid this laudable push to support the military community, leaders have overlooked a critical perspective: that of their mental health professionals.
The department falls short of effectively staffing, empowering and caring for the mental health workforce that bears the emotional weight of preserving the force. This oversight has left a dedicated career field tragically neglected as demand for services has overwhelmed its capabilities.
The data paints a stark picture. The Air Force Medical Agency Mental Health Branch, where I worked until 2023, found that new mental health patient appointments for active duty personnel across the Department of the Air Force had doubled between 2012 and 2022, while referrals to off-base network providers tripled. This rise in demand is due to leadership’s growing tendency to refer any concern an airman or guardian might have to mental health clinics.
The internal review highlighted Air Force mental health clinic utilization data, which showed that approximately 80% of patients seen in mental health clinics have not been diagnosed with a mental health disorder. Rather, they come in to deal with everyday stresses amid the rigors of life.
The tendency to medicalize normal stress and send everyone to the mental health clinic undermines the providers’ ability to care for those with clinical mental health needs, distracting them from their intended mission and fueling burnout.
Despite a surge in demand for care, staffing and resources for the mental health workforce have remained stagnant over the past decade. In response, Air Force mental health professionals are hunkered down in their clinics to keep up with demand, abandoning their roles as command consultants, compromising trust with leadership, and spawning a vast array of homegrown mental health solutions.
Consequently, there is growing concern about burnout and attrition rates among mental health practitioners. These social workers, psychologists, psychiatric nurse practitioners, psychiatrists and mental health technicians do not feel connected to or supported by the organization they volunteered to serve. They are working at an unsustainable pace dictated by access to care versus completion of care, the metric of medically ready service members. The very specialists who are adept at mitigating psychological stressors find themselves overwhelmed by an environment they cannot control. So they are taking control — by leaving.
The well-being of our military’s mental health community is not merely a human capital issue; it is a threat to our national security, jeopardizing the overall readiness and effectiveness of the joint force. These professionals operate as critical subsystems powering the combat capabilities of our armed forces. Just as a dysfunctional hydraulic line can ground an aircraft, neglecting this workforce risks crippling the lethality of our military.
Mental health professionals have reached an inflection point requiring advocacy and action. Mental Health Awareness Month in May presents an opportunity for department leadership to examine all the components of that support system.
Rather than a resourcing overhaul, the solution lies in aligning mental health expectations with readiness. The recently introduced “Department of the Air Force Mental Health Overview” begins to set these crucial expectations.
But organizational barriers require a strategic review to properly align policy and resources to meet the needs of today’s military. The department should try to end the competing priorities between the Air Force and Defense Health Agency, as well as the lack of clear and consistent guidance, our constant state of change, and the tug-of-war between clinical demands and readiness.
Success in great power competition is contingent on the health and well-being of our military mental health professionals. Their well-being directly impacts the quality of care being provided, affecting the force’s overall readiness posture.
It is time to recognize their sacrifices, address burnout and create a cohesive ecosystem that ensures a resilient mental health community is available to support the warfighter.
Lt. Col. Elisha Parkhill Pippin is an active duty licensed clinical social worker in the U.S. Air Force and a student at the U.S. Army War College in Carlisle Barracks, Pennsylvania. The views expressed in this article are the author’s own and do not represent the views of the U.S. Air Force or DOD.
