FALLS CHURCH, Va. -- In the complex and cognitively demanding environment of space operations, a Guardian’s psychological resilience is inextricably linked to joint force mission readiness. Recognizing that modern battlefield supremacy relies heavily on space capabilities, the Air Force Medical Service is evolving its medical readiness models to provide specialized, accessible mental health support to the U.S. Space Force.
U.S. Air Force Lt. Col. Kieran Dhillon, USSF director of psychological health, shared the Department of the Air Force’s strategic efforts to provide targeted mental health care tailored for Guardians.
How is mental health framed as a component of mission readiness for Guardians given their unique mission set?
Mental health readiness is mission readiness for Guardians. Their primary operating skills come from the cognitive domain. It is the most essential aspect of Guardian readiness because of the nature of what they do.
Battlefield operations start with space capabilities; without Guardians the Department of War executes warfare while fighting, flying and sailing blind. With strategic guidance, Guardians execute real-time decisions simultaneously evaluating complex second- and third-order effects. It is like playing chess with extremely high stakes for our national security and preserving our way of life.
With Guardians operating in remote and resource-constrained locations, what must the Department prioritize to ensure consistent, reliable access to mental health care across all assignment types?
The DAF is committed to supporting the mental health needs of Guardians through standing up the Space Force Medical Operations Directorate, which is where my position sits. Our team includes the operational medicine subject matter experts necessary to assess the medical and psychological needs of Guardians. To do this, we have visited a variety of locations and determined gaps based on requirements. We then work with DAF counterparts to bridge the gaps.
Space Force leaders have requested embedded medics to support operational needs, but there are not enough medics to go around. While we continue to advocate for more medics to support remote Space Force locations, we have to implement creative solutions until the available inventory of medics increases. One of these solutions has been the push from leadership to create Guardian Resilience Teams for on-base holistic health support.
Creativity comes from looking at remote mental health resources, collaborating with sister services closer to their sites geographically, and developing plans for meeting the different levels of mental health care Guardians may need. These range from non-clinical care to a higher level of care such as inpatient hospitalization.
From your site visits and field engagement, what feedback has been received from Guardians regarding mental health support they are seeking? What feedback has come from Airmen medical providers or partners providing these resources?
Guardians want a combination of virtual and in-person support - it varies from person to person. Mental health providers do more than provide one-to-one clinical care. Line leaders see the value of unit climate assessments, coaching leaders as they develop through the ranks, identifying ways to optimize performance during high stress and high stakes operations, and more.
DAF mental health assets not only provide clinical care, but more importantly, they provide services designed to enhance operational performance and prevent decrement. I think the majority of Guardians are ready for performance optimization approaches. We just need more availability of mental health assets.
In a force where all Guardians hold high-level security clearances, how can the DAF continue to reduce stigma and ensure seeking mental health care is compatible with career progression and mission demands?
Many young service members grew up in a more accepting culture of mental health care. Decreasing stigma and a more health-conscious younger force have driven a substantial increase in mental health use. This high demand currently outpaces on-base clinical resources, leading to a strategic increase in community-based referrals to maintain Guardian and Airman wellness.
To further reduce the stigma of mental health care, I gather as much data I can get my hands on, and so far, the number of Guardians being referred to mental health due to command concerns is extremely low - under a dozen since USSF’s inception. I am also working with the DoW mental health clinical community to provide more transparency on factors related to mental health care and clearances.
Data from 2012-2023 show that out of almost 8 million adjudicative actions by the Defense Counterintelligence and Security Agency, only 178 were for denials and revocations solely due to mental health concerns - that is .002%. The number one factor leading to favorable findings was seeking and completing treatment for a mental health condition.
My advice is if you think you need specialty mental health care, make the appointment and hear from the expert regarding the level of care you need. If specialty mental health care is warranted, then follow your treatment plan. Once you achieve your goals and complete the care, document that your case is closed with your provider.
What DAF/USSF initiatives are in place, or in future consideration, to build a mental health system that keeps with the evolving Guardian mission?
Currently, the Space Force Medical Operations Directorate is assessing where mental health assets will have the best USSF mission optimizing impact. Specifically, we are considering placement of senior mental health assets at the field command levels - like Air Force major commands - to identify gaps and ensure resources are emplaced to close them. USSF senior leaders are quite forward-thinking in the stand-up of the Guardian Resilience Teams, which include mental health providers.
Collaborating with the Holistic Health Approach leadership has been a phenomenal partnership. With Operation Epic Fury, we have Guardians directly engaged on site and remotely who are impacted in very real ways by the effects of war. In partnering with the HHA leaders, our GRTs trained Guardians to use iCOVER, a rapid recovery intervention for warfighters to manage acute stress reactions during combat. Though the training was developed with direct ground force combat in mind, the GRT did a phenomenal job adapting it to space operations, especially for Guardians in geographically separated locations. This ties in perfectly to how our directorate has been answering questions about why we need to do things differently for Guardians.
USSF’s missions are constantly evolving, and psychological health approaches need to meet the Guardians where, when and how they best need them.