Military Mental Health: Whole Persons

January 20, 2022 | By Jadan Anderson MC ‘22

image description: the silhouettes of three soldiers, laden with rucksacks and bags. There is a bay in the background behind them.

This piece was written at the Veritas Forum 2020, an annual writing program offered by the Augustine Collective. Students from various universities work with writing coaches to write articles about virtue in the sciences or social sciences.

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Two years out from her twenty-year service with the U.S. Air Force, Mom keeps an American flag, neatly folded and elegantly framed in a closet downstairs, and insomnia between the restless tosses and turns of her four-hour sleep cycle. Though Mom is undoubtedly one of the strongest women I know, insomnia is just a single item on the long list of ailments that warrant her full disability compensation. That she has full disability is, to service members recently retired or retiring, great news. The sudden and somewhat steep drop of benefits experienced by veterans as they retire from service often feels more like getting the boot than a grateful send-off.

Determinations of military disability begin with the Whole Person Theory, which ensures that no one can receive a disability rating above one-hundred percent, since no person can be one-hundred percent disabled. The severity and symptoms associated with military-related injuries correlate to a certain percentage rating. For example, post-traumatic stress disorder (PTSD) can grant a service member 10, 30, 50, 70 or 100 percent disability. The more severe the symptoms, such as suicidal ideation, the higher the percentage.

With some branch variation, a disability rating equal to or above fifty percent means the retiree will be paid both disability compensation and their full retirement check every month. With a disability rating below fifty percent, veterans must choose between a combination of disability compensation and partial retirement pay, or their full retirement pay without any compensation for their service-related injuries. They choose what will give them the highest untaxed dollar amount, but ideally they would be given their whole retirement check and compensation for any job-related injuries. So, service members looking to retire try to rack up their disability score, which is determined by past health documentation, from within the window of their military service, and a series of just-to-be-sure doctors’ appointments right before retirement. Even with the final rush to meet or exceed the “magic number”—a disability rating of fifty percent—with conditions such as plantar fasciitis, migraines, and insomnia, mental health issues are, anecdotally, often underclaimed during a member’s service term and therefore not compensated upon retirement.

The U.S. military has an evolving history with veteran compensation and mental health. Its evolution was prompted by vocal and violent dissatisfaction from veterans themselves, beginning with protests after World War I through General Omar Bradley’s establishment of integrated Veteran Affairs (VA) hospitals post-World War II––meaning they paired mental health services with general health and surgical services. After two world wars, Korea, Vietnam, the Gulf War, and conflicts in Iraq and Afghanistan, the ideas of shell shock and battle fatigue became traumatic brain injury (TBI) and PTSD. Studying the effects of warfare on service members has led to the expansion of psychiatry and psychiatric treatments in the military.

Today, as with physical ailments, conditions such as bipolar disorder, inpatient care for anxiety or depression, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, and alcohol or drug addiction disqualify potential recruits. To some extent these restrictions are appropriate preventative measures for the protection of potential enlistees and the people with whom they would work. But not all struggles with mental health are disqualifying, and many airmen will have their mental stability unraveled by the harshness of basic training or, worse, by war. After the conflicts in Iraq and Afghanistan, members of the U.S. military for the first time met and exceeded the civilian rates of depression and suicide, and—following the national trend—the number of affected service men and women has been increasing. From studies conducted on military mental health, those most affected by trauma in the Iraq and Afghanistan wars were those that cited some sort of pre-enlistment mental health treatment.

When I was a freshman in high school, Mom took a position as the Commandant of our base’s Airmen Leadership School (ALS). It was a four-year position, and my mom agreed to it so that I would not have to transfer to yet another school before graduation. ALS is the first tier of professional military education in the U.S. Air Force. All the airmen candidates for E5 promotion—that is, promotion from senior airman to staff sergeant—were required to attend a seven-week course at the school. The course was designed to provide the information and leadership skills necessary for these candidates to become effective supervisors. As Commandant, Mom stayed on-call 24/7 in order to communicate to and about her students through the command chain, the hierarchical structure of sergeants at the school under Mom’s direction. At least once every class period, she received a call reporting that one of her students had suffered a mental health breakdown. It was often mental exhaustion from academic pressure. Suicidal ideation was common, too.

Though mental health issues are exacerbated in service men and women, people remain silent, and mental health waiting rooms in military hospitals stay nearly empty. To seek help within the walls of a military hospital not only runs the risk of losing special clearance or your career, but also living with a (self-)imposed stigma of weakness and deficiency. For fear of losing a job or simply of being viewed as weak—lesser—, mental health issues are left undocumented during a member’s service term and will not count toward their disability rating. The problem here is more than lack of due compensation: it is that the disincentives for reporting struggles with mental health that result in a lack of timely treatment and therapy. These barriers render inefficient the daily efforts of Veteran Affairs Mental Health toward their stated goal to “support recovery and enable veterans who experience mental health problems to live meaningful lives in their communities and achieve their full potential.”

An uncle on Mom’s side, looking to retire within the next year or so, told me he recently learned that people can get places by being kind and attentive. To him, it was a revolutionary thought in an environment that welcomed him with the bark of cold commands and contemptible commanders. His superiors never needed to show particular consideration toward their subordinates to get what they wanted. Ranking ensured that their orders would be completed. This relational dynamic is accepted as the culture. My uncle thought the military’s successful all wore foul attitudes. He credited his rise in rank with hard work and the ability to wear the same kind of attitude. It was easy enough for him, anyway; playing the role, and in some ways, the military itself, was a time-sink distraction from his suppressed trauma through a childhood of being impoverished and African-American in New York City.

An implied and sinister fact of U.S. military culture is that it can become little more than a sad grasp at a mentally tough, physically strong, powerful, military-grade mask. To be sure, the job description of a soldier requires strength and strengthening. Physical weakness is indisputably a liability when the duty to “serve and protect” often means strong-arming another force. Soldiers, in the generous public eye, are meant to be humans that conquer their weaknesses through and for love of their country. They can be made into superhuman symbols of patriotism, protection and strength. My high-school classmates, many with lower grades and/or lower family income, wanted the opportunity and honor of symbolizing these things—for perhaps the first time in the public’s eye. They desired to be seen as noble and strong. They desired to be noble and strong. To give one’s life in defense of that which is loved is a noble cause, one that drew many of those old classmates to enlist.

But struggle implies frailty. Any health struggle, physical or otherwise—and, for that matter, any struggle generally—reminds us that behind all our attempts to grow stronger and more efficient is our prevailing vulnerability, frailty and weakness. Whether or not the association with mental health struggles and weakness is correct or fair, weaknesses in some form exist in every person. But weakness is never the whole person. Neither is strength. Antonyms as they are, both exist in a single person.

I sometimes wonder if the stigma around mental health or any other weakness “deficiency” might be fought more easily in the military if the weight of symbolism were placed on single acts rather than Whole Persons. It is one’s actions that are emblematic of a person’s capacity for strength and weakness, bravery and cowardice, discipline and disorder, intelligence and stupidity—not the person him or herself. It is impossible for a person to be a true symbol of any one thing, anyway. One decries claiming their frailty to become a pure symbol of strength, and so abhors the realization that frailty in many forms is inextricable from their being. Frailty is a threat to the symbol of their strength, not something that co-exists with it. To be a symbol denies the human, denies the oscillating nature between the best and divine in us and the worst and most base. The denial of this duality of our nature sets up for failure the well-meaning people who work hard to symbolize virtues like strength. Perhaps this is part of the warning from the Judeo-Christian God against graven images.

Dad, a member of the U.S. Army Reserves, met my interest in military mental health with a furrowed brow. Over some engine oil, he told me that if I wanted to know about mental health in the military, I should go ask another uncle, whose main duty in the Iraq and Afghanistan conflicts was demining. Demining is the process of removing land mines, especially unexploded land mines, from an area. Unlike others in his platoon that only combed the ground four or five times during their tour, this uncle went out eight times. “Humans are not made for that,” Dad reflected. By “that,” he meant the stress of demining, driven by the knowledge that you will find the mine one of two ways, and one of those options involves detonation. He also meant war mentality generally, not just in war but starting with the brutality of basic training. “We are not made to be yelled at all the time for everything, or to be so scared of waking up a minute past dawn that we sleep in our boots.” And, recounting this final sentiment with a mix of sadness and bitterness, Dad mentioned that the use of soldiers’ truly courageous and patriotic and strength-filled acts for political conquest, not protection of the country, ruined men. Many return home feeling that their nobility was exploited by higher corruption.

That uncle arrived back home with posttraumatic stress disorder and a severe craving for liquor. I was told that though he is past retirement age, Uncle is still active duty. “You have to understand, Jade,” Dad offered for my confusion. “It becomes a brotherhood.” Empathy and understanding can only be found in the military community, where the people around you know exactly what you have seen and are going through. If you leave, you might be alone, so people often stay either as active duty or on reserve. To this I nodded. Then at least the purpose of camaraderie, of banding around and building up their fellow man, was fulfilled.

The first unit in the seven-week ALS course was on the self. Students were led to be more aware of their own work habits, motivations, emotional tendencies, strengths, and weaknesses—in short, a more whole understanding of themselves. One tool Mom used for this was the Four Color Personalities test, distributed by a company called True Colors International. She, like any good teacher, I suppose, used the test on her children before her students. Step-Dad at the time, also enlisted in the Air Force, scoffed, incredulous when I tested as a Blue—the romantic, small gestures, warm, supportive, listening type—instead of a Green—the non-conformist, visionary, problem solving, head-over-heart type. (Actually, Mom just told me that the first time, I tested as a gold-blue mix. Golds are supposed to be dependable, organized and caring.) My results made no sense to Step-Dad: I was a 4.0 student, hard-working, took small jabs well and served even better ones. I assured him I must have tested wrong, or otherwise been a Green-Blue mix, but definitely Green primarily. Truthfully, at fourteen, I was surprised and disappointed at the results. Blues did not seem like a good fit for someone enlisting after high school. In reading, thinking, and asking about mental health in the military recently, Mom rummaged around the house and found the old Four Color Personalities test set she kept. It was in the same closet as her flag. I am still a gold-blue.

Mom spent the last four years of her military service as Commandant. She grew to be a strong proponent of the idea that creating emotionally safe and open environments in the military is essential to forming effective leaders. In her own small ways, she sought to instill in these emerging leaders an integrated approach to military professionalism that critically hinged on human connection. This, and whatever impact it had on the students, was her final contribution to the U.S. Air Force.