USAF Should Rethink Its Approach to Mental Health and Suicide

As the senior leaders of the U.S. Air Force Expeditionary Center, we see the incredible work Airmen do every day to provide expeditionary warfare capability to America’s armed forces. However, this vantage point also allows us to see areas for improvement and even radical change in service culture. 

One area of concern is mental strength and resiliency across the Air Force. We see a need for a cultural overhaul that will return to tried-and-true methods designed to build strength and confidence into our Airmen.   

Year by year, Air Force mental health clinic use has dramatically increased, while the preponderance of those seeking help do not carry diagnosable conditions. Undoubtedly, Air Force programs have saved multiple lives and put many Airmen back on a healthy path. But for all the resources we have applied, Air Force suicide rates have not improved.

Our approach has been anchored in a slew of programs and activities wrapped in the buzzword of resilience, ultimately corrupting the term by applying it as a catch-all for quick-fix solutions to a long-term problem. It is time to rethink our narrative, and ultimately our approach, to addressing mental health and suicide. 

Let us be clear: leaders at all levels have done everything they have been asked to do. Therefore, we have not done anything wrong, but we may not be effectively doing the all the right things.

The Chief of Staff of the Air Force’s Spectrum of Resilience lays out recommendations for addressing mental health, from self-care on the left to clinical health options on the right. We argue that our efforts have leaned towards the right: building support entities, offering clinical or medical help. The prevailing narrative is that we have a mental health crisis and need more mental health providers and resources to combat this problem. This powerful narrative has corralled our thinking into believing the only solutions reside in programs and treatments. 

Our belief is that the Air Force cannot hire enough mental health providers, counselors, and chaplains to lead us out of this crisis.

Ultimately, mental illness and suicides are symptoms. They are manifestations of something much deeper and complex. Have we asked ourselves what might be causing this? What day-to-day conditions might we be able to influence? Have we been patching up symptoms when we should be strengthening our Airmen’s bodies, minds, and spirits for the adversity they will face in life and on the battlefield?

Far too often we are willing to develop another program before doing the hard things that get us left of center on the Chief’s spectrum. Are we willing to do the things necessary that fortify mental health rather than treat mental illness?

We offer a complementary narrative to shift our gaze left on the spectrum, one that looks “upstream” to identify ways to forge physical, mental, spiritual, and social strength in our Airmen, raising their tolerance for stress, boosting their confidence, and reducing the strain on mental health resources. 

Quite simply, this narrative challenges our Airmen to be strong. Its aim is to harden and temper them, and goes beyond resilience to hardiness. It is a narrative that uses winning language to instill a warrior mindset rather than a conditioned mentality of learned helplessness.

Our complimentary narrative may sound controversial to some, but the Air Force needs a cultural overhaul that includes incorporating all but forgotten methods and traditions designed to intentionally strengthen the force.

We have witnessed leaders lament that we do not have any control over the “upstream” since many of the mental health challenges our Airmen face come to us through accessions. We disagree. We can better own our culture, we can better strengthen our culture, and we can better challenge our Airmen to live up to it. Our Airmen are inherently grittier than the current narrative suggests.

We believe they want to be challenged. They seek a “productive struggle.” This is why many of them joined the profession of arms. Let us think boldly about what we accept as being out of our control. Let us think critically about what we tolerate as conditions within our organizations. The conditions set the environment in which our Airmen work and live, and we as leaders own a vast majority of these conditions. 

Therefore, we can shape how our Airmen see themselves and interact with the world around them. How might we use our influence as leaders to strengthen the culture of our organizations, and thereby strengthen our Airmen? 

We believe strong Airmen are built with a strong culture. 

Has Air Force culture changed for the better in some areas and deteriorated in others over time? Have the areas of deterioration contributed to the manifestations of mental illness and suicide rates we unfortunately see today? We believe the answer to both questions is “yes.”    

We need a cultural and mindset overhaul within the Air Force to prepare our Airmen for the adversities they may face in war. Strong unit culture must be consciously cultivated and intentionally engineered, not just with words, but with actions. 

What we may be asked to do as a force in the coming years will be incredibly hard; therefore, we must do hard things. There are a multitude of no-cost or low-cost initiatives and activities that can institute confidence and strengthen mental durability in our Airmen while reinstituting a sense of belonging in the profession of arms. 

Many of you will recognize some of these activities as inherent to our Air Force in the past. They are not programs. They are tools in the hands of able leaders and clearly fall within the command team’s scope of responsibility. 

Simple efforts may include unit roll calls, unit fitness training, reveille and retreat formations, weekly heritage room calls with heritage briefings, equipment inspections led by NCOs, face-to-face awards boards and below-the-zone promotion panels, and opportunities to strengthen spiritual fitness for those inclined.

More ambitious efforts might involve combined unit fitness two to three days per week, weekly Sergeants’ Time, monthly GI parties followed by unit barbeques, unit ruck marches, formation runs, or mandatory life-skills classes for first-term Airmen.

Still more bold efforts might reinstitute double dorm occupancy, develop robust onboarding programs with graduated incentives, or have NCOs once again sit CQ (charge of quarters) in the dorms to oversee the well-being and accountability of their Airmen.

These are but a few examples. We encourage leaders and senior noncommissioned officers at all echelons to use their knowledge and creativity to engineer actions to build strong Airmen and strong unit culture.

Again, such actions are not intended as programs. They are a means to build strength not only in our Airmen, but in our institution. Expected demonstrations of strong unit culture manifest in the form of good order and discipline, dress and personal appearance, customs and courtesies, physical/mental/spiritual/social fitness, positive attitudes, and a tangible sense of purpose, pride, and connectedness. 

We will know we are succeeding when our Airmen feel as if they have the best job in the Air Force and they are part of the best unit in the Air Force. This should be our goal as their leaders.

Make no mistake, our adversaries do not want us to make this change. They hope we maintain the status quo. Let that sink in.

We need a shift in mindset. We need a complementary narrative, one focused on forging strength, that pulls our discussions, our thinking, and most importantly, our actions left of the problems we face as a force. We believe many of the solutions lie in a back-to-basics approach that builds strength and confidence into our Airmen and forges true warrior hearts. How we talk about our profession, and the culture we deliberately build, shapes how our Airmen perform their duties and how they find their way.

This is an institutional imperative. Preparedness for our next fight depends on it.

The authors, Maj. Gen. John Klein and Chief Master Sgt. Courtney Freeman, cowrote a recent memo on this subject for U.S. Expeditionary Center leaders.