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Attack the Stigma!: How Leaders can support Mental Health Maintenance

by Mandi Rollinson

What is mental health?

Despite the stigma existing in contemporary culture around the term “mental health,” mental health is not a condition in and of itself. It is a fact of being human. 

The WHO defines mental health as: “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to [their] community.”  If you’re thinking, “Well, what does that mean?”, then you aren’t alone. 

In a 2015 survey of mental health experts asking, “What are the core concepts of mental health?”, the majority could not agree on a singular definition. Interest in the topic isn’t new, either, with the discussion of the definition of mental health in the US going back at least as far back as the Civil War era.

Due to confusion (and stigma), many leaders may shy away from discussing mental health. However, a difficult subject does not mean it is unimportant. In fact, the existence of confusion indicates that it’s something we as leaders must focus on to guide our own soldiers for the sake of readiness. People, not items, are the most important weapons system in the Army. Both leaders and systems are set into place to maintain tactical training, physical wellness, and maintenance of equipment. Thus, it is a logical step to factor in mental wellness into this overarching system of maintenance. Leaders who do not consider mental wellness as part of readiness are not doing what they can to take care of their soldiers and units. To not act is to propagate stigma about receiving treatment for health. Leaders who fail to role model overcoming stigma for seeking any kind of healthcare must be prepared to pay a high cost, sometimes an incalculable cost of a soldier dying from suicide. Suicidal ideation is preventable and treatable, but individuals experiencing mental health illness or injury require professional medical care to begin healing. Support from leaders can be a keystone for soldiers accessing that care. 

What does care look like?

Care for one’s mental health includes a number of options, you could say, a spectrum of self care. On one side of the spectrum, there are elements of preventative care, while on the other there are reactive elements. Preventative care could be social relationships but could also look like routine counseling from a licensed therapist. Reactive care is the care that may come to mind, such as intervention of someone expressing self-harm. Intervention of this type might include taking that person to the local ER or walking them into the BH clinic. And you know what? Attack the stigma! That’s ok. It’s okay not to be okay. What’s not okay is ignoring signs of needing care.

The US Army already recognizes that health’ and ‘fitness’ no longer equate to only physical strength, as seen in FM 7-22 “Holistic Health and Fitness.” A soldier only needs to review the table of contents to see the inclusive cultural shift to truly reflect holistic health that the Army has already declared from senior levels. Chapter 3 identifies the five “domains” of health: “Physical Readiness; Nutritional Readiness; Mental Readiness (including character, behavior, resilience, cognitive skill, and social activity); Spiritual; and Sleep Readiness.” FM 7-22, Chapter 3-1, even acknowledges the intertwined relationship of mental and physical work, proving that mental health and physical health are all connected. Therefore, this framework for Army culture already exists in doctrine, but it’s up to leaders to implement it. 

How does this factor into a person’s routine? And why should that influence my leadership?

Leaders must ensure that their soldiers have the time and resources to take care of their health to ensure they can fulfill their duties and responsibilities as soldiers. Being fit as a soldier also includes readiness in the form of mental fitness. For soldiers who seek out routine medical care to aid in, bolster, or otherwise support their mental health needs, this could look both informal and formal. Some examples of informal care that Soldiers may seek out include: routinely seeing soldiers going to lunch or weekend plans together; talking to their mentor; or using family as a support structure. Some examples of more formal care include: performance coaching or social support meals or activities; routine medical appointments at a Behavioral Health clinic; or use of Military and Family Life Consultant (MFLC) counselors. The benefits of actively supporting and role modeling mental health far outweigh the costs.

Understanding the options available to yourself or Soldiers is a vital first step. Next is understanding the influence that seeking this routine medical care will have on a Soldier’s routine. The influence of taking time to prioritize one’s mental health needs is just that – it literally takes time. That is time that it may be tempting to look at, in the short term, “isn’t going to the Army.”  But that’s the key to consider about mental health care: it’s not about the short term. Life is an endurance sport. If a soldier is seeking informal or formal care, then it’s about the long-term, not the short term.

Going to counseling is work, plus transit time to the appointment location, and maybe, depending on the person, taking time afterward to process the memories and feelings that came up in counseling. Also, remember that seeking medical care is something that must happen during the duty day. After all, the BH clinic (or other means of support) likely operates on the same hours your unit does, and there is only so much time in a duty day. 

Thinking of this in terms of re-enlistment goals may be one helpful way to think of the long term.  We should all hope to see our soldiers achieve their maximum potential in life; if we are not providing them with the support they need to achieve these goals then we are effectively shutting the door on their continued service to our nation. While these measures are “costs” in terms of time, leaders can positively influence this process.

Use the maintenance model that already exists

Long-term maintenance for readiness is already a process that the Army has in place. The difference is we do not currently have it in place for healthcare like we do for something like our equipment – “Motorpool Monday.” This process of conducting maintenance costs the Army at least 10% of a Soldier’s work week (assuming morning work hours over a 5-day work week), but may last longer if Soldiers are conducting preventative maintenance on weapons, radios, or other specialized equipment. With these additions, this could quickly increase time to a full duty-day of maintenance, equating to nearly 20% of a Soldier’s work week. But despite this time required, individual leaders and Army culture investing in this model reap the rewards. 

The Army accepts this model and emphasizes that time spent on prevention is a worthy use of a Soldier’s time. We culturally understand that conducting routine, preventative maintenance decreases the likelihood of equipment breaking down, but it does not eliminate that possibility completely. Further, when a piece of equipment breaks down, we culturally acknowledge that abandoning it and saying, “well, it was weak” is simply not an option. If we’re declaring a cultural identity of People First, then our actions must follow the promise of that declaration. We can apply this model of Motorpool Monday – preventative maintenance in the present reducing the need or degree of devastating maintenance in the future – to mental health care in the Army. 

Leadership solutions

What can leaders do about this situation?  Some suggestions:

1.     Talk about mental health to reduce stigma about mental fitness. Use routine counseling to integrate this into a pre-existing battle rhythm. Also, discuss mental fitness across the organization or check in with soldiers during PT.  You might consider sharing some of your own personal struggles. That said, I must make it clear that my goal here is not to shame you into sharing any struggles you may be going through or have experienced, but instead to share human experiences as part and parcel of being a soldier with your soldiers.

2.     Practice both active and reflective listening skills – ask your soldiers (junior, peer, and superior) how they are and listen to what they have to say. Then, as a leader, you’ll be able to help them be the best version of themselves, whether that means a chat over lunch or practicing the A.C.E. steps of Ask, Care, and Escorting them to medical care.

3.     Role model prioritizing your own peer support and mentoring, and also encourage your soldiers to do the same. This could be lunch at the DFAC with a buddy, or a soldier leaving work early so they can engage in a mentoring session. It doesn’t need to be a BH appointment to be a ‘legitimate’ way to care for mental health. 

4.     Practice empathy if you have a soldier who has routine medical appointments. Don’t get pulled down into the pejorative mindset that this somehow means they are a slacker. Work to build trust with your soldiers so that, should scheduling conflicts arise between training or work and the only open time for BH, you can aid your soldier in navigating that scheduling conflict. As necessary, work in shifting your mindset to understand that they are trying to actively take care of themselves. This creates the challenge for leaders to build trust, seek understanding, and practice empathy.

5.     If need be, adjust your expectations of a soldier’s workload if they are seeking routine medical care. Remember, a reduced number of hours that they are working does not mean they are “broken,” or worse, that they cannot partake in the mission at any level. “Lost” time in the present is investing in the Soldier in the long run (and likely for when the mission necessitates it). Remember: the quantity of time at work is not equal to the amount of work accomplished. Therefore, being a leader who supports a few hours for a healthy outcome means that you are not only role modeling putting People First, but you are doing exactly the type of risk-benefit analysis that the Army expects People First leaders to make.

Takeaways for company-grade leaders

Being human is hard sometimes, whether that manifests in physical health (example: PT profiles), mental health (example: seeking BH counseling), or some combination. Cultural stigma – both in American society and military culture – is a real barrier for some people to access life-saving healthcare. Experiencing a mental or illness or injury, up to the point of suicidal ideation, is also on the spectrum of realities that humans may experience. To reconcile that, leaders need to actively expose the inaccuracy of stigma to support all manner of healthcare needs. This requires a dovetailed support system of hard work from leaders and those experiencing those injuries.

Life can be hard sometimes. For some folks, they are in a ‘maintenance phase’ of their mental health care. For others, they are in the ‘reactive treatment phase’, others still may be experiencing a combination. Leaders who take action in some of the ways discussed here can help address the stigma of receiving healthcare and also improve unit readiness. In short, the cost will be worth the benefits you receive – happy, healthy, and ready soldiers.

Mandi Rollinson is an instructor at the United States Military Academy in the Department of History. She finds that being genuine in her relationships, living authentically, learning mindfulness, practicing empathy, and routinely going to counseling at behavioral health are necessary ways for her to maintain mental fitness in her life.

These views are the authors own and not those of the Department of Defense, the United States Military Academy, or the Department of the Army. 

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