Air Guard considers cutting enlisted mental health specialists
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The Air National Guard is considering cutting its corps of enlisted mental health specialists, but a final decision is still in the works, a spokesperson told Air Force Times.
“Care for our airmen and their mental health is very important to the Air National Guard,” ANG spokesperson Lt. Col. Amber Schatz said in an email Monday.
She declined to answer questions about why the Guard is considering the move and when it may happen.
Around 1,000 enlisted airmen work in the mental health services field, known by the code “4C0,” across the active duty Air Force and its reserve components, according to the Air Force Association’s 2022 almanac. Schatz did not answer how many are part of the Air National Guard.
Mental health technicians are specialized medics who can help triage patients who seek treatment from their medical group for behavioral health issues like anxiety, depression and addiction.
Downsizing that corps of specialists could save money and free up airmen for higher priority Air Force jobs. But one enlisted airman who spoke to Air Force Times argues that eliminating the field would remove an important resource for individual airmen and units overall.
“If somebody’s having an issue, they can come to us first, and we can … direct them to where they need to go,” the airman said. “A lot of people don’t know how to locate a medical professional, and … there’s a lot of misconceptions.”
Techs can offer preliminary diagnoses before a patient sees a licensed health provider and determine whether a person may hurt themselves or others.
The airman recalled an instance when they assisted someone who arrived at the emergency room with suicidal thoughts. They created a list of steps to help the patient deescalate their feelings, including someone to call in a crisis, particularly in cases when a clinician isn’t available.
Their units also offer classes on stress management and coping skills, and can help prepare people for what to expect on deployments.
“Command consultation is a big part of our job, where they say, ‘Hey, we’ve been noticing … [an] uptick in drinking’ and things like that. And we can assess, ‘OK, what do you guys need, or what might you guys benefit from?’” the airman added.
The Guard believes it’s not possible or worthwhile to train its mental health technicians to the same standard as their active duty counterparts, making them unable to deploy without a waiver, the airman said. Another reason: Guardsmen don’t have the same alcohol and drug counseling certification as active duty airmen because of differences in the facilities where they work, they added.
The airman believes the considerations boil down to a lack of money and the will to fix those problems.
In technical school, the airmen learn to identify various emotional disorders and treatments before starting on-the-job training at a medical clinic. That’s where students begin to medically clear airmen for deployment, measure vital signs and understand the unique stressors of the local mission.
Distance learning could bridge that training gap without requiring part-time guardsmen to report to a military medical facility, the airman told Air Force Times. Technicians could also earn new certifications through their state instead.
Guard clinics don’t fall under the same accreditation guidelines as active duty clinics, meaning they can’t treat airmen in the same ways as active duty units, the airman added. That could be fixed by changing policies around the standards that Guard clinics must follow, they argued.
“It isn’t that we’re in the wild, wild west, and we’re just doing our own thing,” they said. “It’s that we don’t have to adhere to a lot of the policies because they don’t apply to us.”
On a personal level, the airman who spoke to Air Force Times worries the Guard’s decision will hurt people’s chances of promotion if they have to start over in another job. But those complaints have fallen on deaf ears, they said.
One option for replacing mental health technicians could be to hire more civilian directors of psychological health, the airman said. But the airman believes that having uniformed behavioral health specialists makes it easier to connect with service members who may be hesitant to open up.
At Creech Air Force Base, Nevada, the techs are part of support teams with top-secret clearances so they can meet with drone operators in secure work areas. That has helped boost access to care while alleviating airmen’s concerns about discussing their highly classified jobs.
“When you have people that can speak to that experience of being deployed … we can [prevent] adverse outcomes by giving good preparation and skill-building,” the airman said. “That’s one of the biggest roles I think we can play.”
The potential move also contradicts the recommendations of a recent Pentagon report on suicide prevention, which suggested that using those technicians more effectively could lessen the impact of a nationwide shortage of mental health care in the United States.
Seventy airmen died by suicide in 2021, according to the Pentagon’s most recent data. That jumped to 90 suspected suicides in 2022 as of Dec. 31.
The Suicide Prevention and Response Independent Review Committee recommended hiring more active duty technicians and training them in therapeutic techniques designed to change poor health habits.
It also suggested that behavioral health technicians be present when the military notifies a service member \they are under investigation, if the person is at particularly high risk of suicide.
Likewise, the report raised concerns that mental health technicians lack enough administrative support to focus on their clinical roles. Building up those offices could help the specialists spend more time with patients, the committee said.
The airman who spoke with Air Force Times hopes the Guard opts to bolster mental health technicians rather than cut their work short.
“We’re seeing people for their annual follow-ups if they’re on medication, [or] if they’re being seen by a counselor … in the civilian world,” the airman said. “Our goal is to do a lot more outreach to let everybody know we’re here.”