Air Force Updates Mental Health Policies and Lowers Barriers

SCOTT AIR FORCE BASE, Illinois —

On January 28, 2022, Air Mobility Command Commander Gen. Mike Minihan tweeted: “Warrior’s heart. No stigma.” with a screenshot of his calendar revealing an upcoming mental health appointment, thus starting a movement within AMC to remove stigma, reduce barriers and increase access and options to support the mind, the airmen’s body and craftsmanship.

It also inspired the establishment of AMC’s Warrior Mental Health Task Force, which focused its efforts on establishing pathways to care, strengthening command teams, and reviewing and, if necessary, advocating for policy updates of mental health based on current standards.

In a major step forward in reducing barriers, the Air Force’s mental health exemption policy in both the Air Force Medical Standards Directory (MSD) and the Aerospace Medicine Exemption Guide has been updated to allow Airmen to receive 60 days of treatment for mental health issues early. a return to duty waiver is required to fly. This change benefits Air Force Airmen seeking treatment for stress, post-traumatic stress and other mental health-related illnesses.

Maj. Jane Marlow, a C-130J pilot and leader of the Warrior Mental Health Task Force, was motivated by personal experience.

“Like many of my colleagues, I delayed seeking care until I was on a non-flying assignment because I knew that as a pilot, the moment I picked up the phone to schedule that appointment, I would be grounded for a indefinite period,” said Marlow. “The trauma care I went through was life-changing. I knew I was undoubtedly a safer pilot, a better leader and a stronger wingmate because of the care I received, but I still had to go through months without flying because of my diagnosis.”

Thanks to Marlow, his cohort and medical experts, that has now changed.

Prior to the updated MSD, Special Duty Airmen faced a significant amount of time in non-flying status while undergoing periods of mandatory evaluation, treatment, and stabilization before they could submit a waiver to return to duty. Such long periods could have detrimental impacts on careers, such as delaying upgrades, formal training, and eligibility for development programs and opportunities.

Now, for mental health diagnoses, there are no longer mandatory stabilization periods. Additionally, flight surgeons can file a waiver for an airman seeking mental health treatment to return to flying status without a waiting period.

“If you’re going to look at a driver with PTSD, you’re looking at one right now,” Minihan told his commanding teams during the 2024 Spring Rally of Phoenix. “This policy affects me, and if I it affects, it affects someone in your unit: they have it, they haven’t asked for help, and they suffer in silence. It’s incredibly powerful work by this team to lower barriers to mental health care for our Warrior Airmen.”

The Warrior Mental Health task force included more than 50 crew members, 12 aviation psychologists, a pilot physician, Joint Force flight surgeons and a NASA medical specialist. Two of the key contributors were Lt. Col. Sandra “Salty” Salzman, a C-130J pilot, and Lt. Col. Carrie Lucas, chief of the AMC’s Behavioral Health Branch. They were warned that it could take 5-10 years to achieve the policy changes they sought, but through passionate leadership and presenting strong evidence, they inspired change within a year.

“As a pilot physician, I have the unique opportunity to advocate for policy-making leadership as a subject matter expert.” Salzman said, “In this capacity, I presented new considerations based on medical research in mental health and operational truths. Based on these new considerations, [the working group] Parts of mental health policy were suggested to be modified, taking into account our evolving understanding of human responses to stress and the development of resilience through early treatment.”

“From a mental health perspective, this precedent-setting policy change is exactly what we need and is in line with General Minihan’s mandate to reduce stigma and allow Airmen to seek help when needed.” Lucas said.