Aircrew and Mental Health Services

[Danger41]

Happy Memorial Day

As I saw all the social media posts about fallen military members, I was struck by the number of suicides mentioned. It’s such a sad thing and always surprising that people don’t seek help. 
 

It reminded me of a time a few years back when I was talking to a bro going through some bad times and I suggested he seek out some mental health services and replied that he didn’t want to do that because he would be DNIF’d and “flying is the only thing that makes me happy.” He ended up fine and got through it with a combination of booze and flying a ton.

What’s the opinion of this esteemed body about aviators using mental health services? I hate to admit it, but I don’t think I would seek help from the various services offered for the fear of being DNIF.

[SurelySerious]

I think both the AF and FAA like to talk a good game about access to mental health for pilots, but I don’t trust them to not take flying status away.

[raimius]

If you go early enough that the issue is still minor, maybe.

For significant issues, I don't think there is a ton of trust from the aircrew side.

 

...there are plenty of alternative options, fortunately.

[StrikeOut312]

This is an important enough conversation that I’ll stop lurking and make my second post ever.

Talking to your bros is a good step. Just open up and share, even if it’s just a bit.

The chaplains are a great avenue for professional help. 100% confidential. Talk to them about anything.

Bottom line: take care of yourself. Find someone you can talk to.

[D_Vezencuando]

Thanks for this timely thread. During Mental Health First Aid Instructor training, I learned that -at a minimum- the following are available: (1) Chaplain - as StrikeOut mentioned, completely confidential, (2) Military OneSource Providers - 12 free confidential sessions, (3) Bro network, (4) Out-of-pocket provider and, of course, (5) Base Clinic - DNIF being a distinct possibility. It's not a counseling service, per se, but on-base an Mental Health First Aid class is an opportunity to meet folks who care about these types of issues or are experiencing them themselves. It's also a civilian clothes, first name basis class that can lead to more informal support. That and Leadership should consider it an alternate duty location. For those who want long-term help but are worried about DNIF, look up DoD Accession Disqualifying and Air Force DNIF-ing conditions - all Public Doman. I'm not a provider, but am of the opinion that "if the issue is serious" it's probably going to manifest itself in flying or elsewhere in Air Force life. That is, if you're honest with your bro's and the ORM sheet... Take care and Fly Safe!     

[pawnman]

20 minutes ago, D_Vezencuando said:

Thanks for this timely thread. During Mental Health First Aid Instructor training, I learned that -at a minimum- the following are available: (1) Chaplain - as StrikeOut mentioned, completely confidential, (2) Military OneSource Providers - 12 free confidential sessions, (3) Bro network, (4) Out-of-pocket provider and, of course, (5) Base Clinic - DNIF being a distinct possibility. It's not a counseling service, per se, but on-base an Mental Health First Aid class is an opportunity to meet folks who care about these types of issues or are experiencing them themselves. It's also a civilian clothes, first name basis class that can lead to more informal support. That and Leadership should consider it an alternate duty location. For those who want long-term help but are worried about DNIF, look up DoD Accession Disqualifying and Air Force DNIF-ing conditions - all Public Doman. I'm not a provider, but am of the opinion that "if the issue is serious" it's probably going to manifest itself in flying or elsewhere in Air Force life. That is, if you're honest with your bro's and the ORM sheet... Take care and Fly Safe!     

Agree with 95% of this.  But my issue with military Mental Health providers is that I don't really trust them.  Just like I don't really trust the flight doc when I fill out my PHA questionnaire and get to the drinking question.  I can look up the disqualifying conditions, but I don't trust some yahoo at Mental Health to tell the difference between stress because of my 15-year-old learning to drive and generalized anxiety disorder.

[Magellan]

Depending on the situation (And not trying to advertise) but Noom is a fairly good option for people looking to get their life back in order.  I.E. trying to regain a sense of control over their life.  They throw a bunch of psychology at the wall and I am sure some people will find that 15-25% of it could stick for them.  And it is cheaper than seeing a clinical psychologist or licensed therapist.  Plus it is just on your phone so the only people that know are you and your credit card company.

I would argue it is a much better approach then self-medicating with delicious fried food and booze.  Even if not nearly as fun in the short term...

Edited June 1, 2021 by Magellan

[bfargin]

It's not a "fix" per say but really having a friend or two who you can tell anything to and trust the confidentiality is crucial. Even if you have to seek out a person or two that you completely trust and have them as a sounding board and confidante. I have a couple of best friends who I can do that with but I also established (weird at first but now it really works) a contact that I'm not great friends with, but completely trust his judgement and character. He is, for lack of a better term, my "accountability" partner. We don't always hang out and he's a bit eccentric at times, but I trust him and discuss stuff with him that I might not want to talk about with my friends or a wife. Admittedly it was a little awkward when i first approached him with the idea, but it works and I usually chat with him at least a couple of times a year even if nothing is happening (just to stay engaged). The chaplain is a great idea though and for the most part I'd guess won't care if you talk about flying, relationships, depression, work stress, or anything ... and its confidential.

 

Edited June 1, 2021 by bfargin

[Tonka]

I went to MH a few years before I retired, knowing 2 things - it was my last assignment and I was going to retire, so I knew I had little to lose if I said the wrong thing to the wrong people... (I think you all knows these “words” and they are serious enough that you/we should put them at a priority above flying, but I know full well the internal dilemma) ... I had been encouraged after talking with (and taking) another pilot at another base who went through a divorce and who smartly gave someone else his guns (temporarily of course!) and went to mental health... and I don’t think he ever got dnif-ed.

so after they ask the big question about 20 times in a mostly straight forward manner, then you are just going to talk about your life and daily routine.  I had a game plan, but please don’t feel like you have too, just remember if you are dancing around the big question, they are really there to help ascertain where on the “scale” you are... and yes they’ll error to the side of safety as they should...they tried to push some meds that I knew were a no-go for the FAA (they are easy to figure out, most likely you’ll have to show 6 months of use with them, with limited side effects and reduction of symptoms for FAA approval)... so if FAA is your plan you can get those months out of the way while you are on AD, NOTE: there is little guarantee that you’ll make it through the FAA waiver, but I would rather know that on AD/early then wait to fly for the airlines for 10 years and then take that gamble at 50.

I’m really glad I went, at least it is documented if something goes south later, I felt it was pretty low threat and I was never dnif-ed (even though it was non-flying, it was a flying billet and the FSO didn’t know the difference). If nothing else, I realized that life really does suck some times and feeling that way can be a normal response or it can be a imbalance and it is not that “you” are bad, there is just somethings you need to balance in your life, and sometimes it can be chemical and there is help there if it is needed.  It definitely does get better.

so risky yes, but much less than you think... just talking with someone about something I had bottled up for a decade plus was pretty liberating and worth the risk... throw a spouse and kids in the equation and it becomes a no brainer, they need you even if you can’t make the airline pay check.  I eventually chose to not do the airlines (this being a minor part of the decision)... glad I did, gave me time to get “me” in order... looking back I can’t believe I waited so long, and can’t believe I put flying above my life and my family for sooooo long, but that’s unfortunately part of what you are going through. I do remember many nights struggling/worrying about the what-ifs.  You can get better, there are people who want to help you get better, and there is way more to life then Mach 1.5 or a airline gig, WAY more! You just have to realize that first.

Edited June 1, 2021 by Tonka
Poor choice of words

[cleared_hot]

I’m not the “cleared hot” of yore on this forum, just a lurker who asked about this 4 years ago.  Check my post history.  That said, this info is similarly dated, so I will edit or delete this post if someone shares newer data.

There at least one, if not two other factors besides staying medically qualified that you need to consider.  First is your security clearance, second is PRP (personnel reliability program, if you are subject to it).  Neither of these are as important as your long term well-being, but failing to disclose or at least remain consistent early and often can also cause problems for you.

With regard to security clearance, if you seek out help that changes any of your answers to the SF86 or the other localized questionnaires for various jobs, let your security manager know.

If you’re on PRP, the MFLC is obligated to notify your certifying official if you see them for things that aren’t marital or family-related.  This is not a huge secret, the MFLC will disclose it up front, and give you the option to continue or to walk.  Best just to talk to your certifying official first and request to be temporarily brought down.  No need to get into specifics, just better that they hear it first from you and not an outside agency.

Finally, the chaplain has no such stipulations, which makes them a great option initially.

[HossHarris]

If you’ve never sat down and chatted with a chaplain one on one, give it a try.  If you’re not a religious person, most are very good at taking off the “religion hat” and putting on the “counseling hat.”  Most are very receptive and flexible if you tell them you aren’t coming to them for Religious needs, you’re coming to them for their confidentiality.  Highly recommend. 

[Lockjaw]

Great thread idea. I was inspired to reply after a long time lurking.

From personal experience, no, I did not have confidence in the military system. We lost an aircraft and crew and it seemed like the base was unprepared for that contingency, especially when it came to the mental health of other aircrew. 

For the TL;DR version: the bro network and an outside mental health provider (who was prior Army infantry) helped me quite a bit. So did flying; it was one of the things that was a reminder of the good times I had with those guys and kept me mentally grounded. A bunch of peers also found help through outside organizations and even the VA Mental Health personnel.

Being prior emergency services, I am a huge believer in early intervention following a traumatic event, along the CISM model, which combines mental health professionals and trained peers. It still surprises me that after two decades of war, there isn't a DOD wide effort to replicate that safety net which I positively experienced on several occasions in my civilian career.

[skibum]

From my latest re-investigation brief, it now says you do not have to report mental health counseling related to "marriage, family, grief, sexual assault, or PTSD". Can't remember what it used to say, but I'm pretty sure that's new.

[Guest LumberjackAxe]

If you go to your flight doc and say, “Hey I’ve been depressed for much longer than normal and don’t feel quite right,” they will send you to Behavioral Health, not Mental Health. Behavioral Health is behind a medical iron curtain (unless you indicate you’re a threat to yourself/others or confess a crime) and the only public record that anyone can see is that you saw Behavioral Health for something. The flight docs won’t see what you discussed with the psychologist, nor will anyone in your chain of command even know you went there, nor does it affect any flying or security status because it’s just behavioral health. In my personal opinion, I think anyone who has been subjected to the infamously “heroic” ops tempo since 9/11 would benefit from at least one visit with that office. It’s really just phase maintenance for your mind and they’ll give you some course corrections for what you’re doing in your day to day life and doesn’t cost anything, professionally or otherwise.