The number of Airmen seeking mental health care has increased over the last five years -- and this is a trend Air Force leaders encourage, according to a lead psychiatrist with the office of the Air Force Surgeon General.
A mental health encounters report issued by the Air Force Medical Operations Agency noted that the number of mental health appointments scheduled by Airmen rose from 18,858 in 2008 to 33,274 in 2013.
"Since 2008, we've seen a gradual rise in the number of mental health visits for active duty, both in the Military Treatment Facilities and in purchased care -- and we consider this positive news," said Col. (Dr.) John Forbes, the director of psychological health, Air Force Medical Support Agency in Falls Church, Virginia. "There are likely many reasons for this increase such as more availability of providers, better access, reduced perception of stigma, acceptability of evidence-based treatments, and need."
Forbes said the stresses of deployment and ops tempo could be driving the need for care, but those types of problems represent the minority of issues leading people to seek mental health care in the Air Force. He said rates of Post-Traumatic Stress and depression have both remained at less than about 1 percent of the active duty population.
About 23 percent of Airmen are seen in any given year in mental health or primary care for some type of mental health related reason, including issues that are not significantly impairing such as mild stress, a sleep problem, or anxiety, Forbes said.
While the number of mental health visits has gradually increased, Air Force leadership continues to work at removing barriers to care and the perception of stigma. According to Lt. Col. Wendy Travis, the chief of mental health policy and program evaluation with AFMOA, Lackland Air Force Base, one of the biggest obstacles for military members is the belief that seeking help could negatively affect their careers.
"Recent data from the Air Force Community Assessment Survey suggests that one in 10 active duty members reported untreated mental health problems and that 90 percent of these personnel had no intention of seeking mental health services," Travis said.
Reluctance is due in part to misconceptions about what mental health treatment involves, the effectiveness of mental health services, and the concerns about potential impact of help-seeking on one's military career and relationships, said Travis.
"But the fact of the matter is that many mental health problems are very easily treated with effective evidence-based treatments," Travis said. "And although mental health staff may be required to inform command about duty or deployment limitations, these notifications are similar to other medical notifications and do not disclose details of the mental health visit."
Correspondingly, a study published in 2006 showed that 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.
"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," she said.
The Air Force's commitment to fostering a culture of support is found in Department of Defense Instruction 6490.08, Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members. The instruction outlines circumstances when commanders must be notified about an Airman who seeks help. Notification only occurs if the person is hospitalized with a mental health condition, is having active suicidal or homicidal thoughts, child or partner maltreatment is reported, or the person is unable to perform his or her job.
"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," Travis said.
In June, AFMOA will begin to roll out the first-ever Air Force Mental Health Help Seeking Campaign, which actively encourages people who are struggling to seek help early. The campaign's slogan, "Knowing when to get help takes courage," endeavors to dispel the idea that weak people seek help and promotes the idea that seeking help is a sign of strength, self-awareness, and courage, Travis explained.
"This campaign confronts the negative perceptions about help seeking head on, and promotes a new way of thinking about getting help," Travis said.
In conjunction with the campaign, many resources are available to Airmen looking for help with life's challenges. Services and programs include the Airmen and Family Readiness Center's Military Family Life Consultants, the installation chaplain, Mental Health Clinic, the Medical Clinic's Behavioral Health in Primary Care, and the Family Advocacy Program. Master Resilience Trainers also are available to bolster Airmen's resilience and post-deployment screenings deliver support to those who screen positive for medical or mental health problems.
Because mental fitness is paramount to coping with stressors and challenges, the Air Force's Comprehensive Airman Fitness program includes mental wellness as one of the four pillars of wellness, along with physical, social and spiritual elements. Travis said the program equips Airmen with the tools and skills to assess and adjust to their environment by maintaining a healthy balance of cognitive skill, physical endurance, emotional stamina, and spiritual well-being.
"Everyone has times in their life when they have difficulty coping," Travis said. "Knowing when it is time to talk to someone, or get additional help, is one of the key tenants of mental fitness."
For more information about mental health support programs, call the Defense Centers of Excellence for Psychological Health and TBI Outreach Center at 866-966-1020. For confidential assistance, call Military OneSource at 800-342-9647. Call Vet4Warriors peer support for service members, civilians, and family members at 855-838-8255.