Airmen of the 480th Intelligence, Surveillance and Reconnaissance Wing make life or death decisions every day to support warfighters around the world. To alleviate stress from these missions, the Air Force deployed a small group of medical, psychological and spiritual professionals called the Airmen Resiliency Team (ART), which is achieving measurable success.
The 480th ISR Wing is stationed at six locations worldwide, taking information from many different sources and creating fused intelligence products in near-real time to support contingency operations and support kinetic strikes at enemy targets. As Lt. Col. (Dr.) Cameron Thurman, the 480th ISR Wing surgeon, puts it, “ISR doesn’t just make power point briefs anymore.”
“We’ve seen a 1000 percent increase in weapons expended in the last three years,” said Thurman. “These young Airmen, who may be teenagers straight out of high school, are watching ISIS and other bad people do really bad things. They are often making split second decisions that determine who gets struck by U.S. forces and who doesn’t. They see in full color, and near real time, the effects of their decisions.”
ART members are embedded with 480th ISR Wing operators at every level – they attend briefings, trainings, squadron commander’s calls, staff meetings and are on the operational floor. This level of close contact builds trust between Airmen and the ART members, helping to break down some of the stigma against seeking mental health care.
“We understand their fears and stresses, because we experience the same events,” said Thurman. “Airmen, especially those with special clearances, are afraid they will harm their career or lose their security clearance if they seek mental health treatment. The ART is there to allay those concerns, and I think that’s something you do best by being an embedded provider, sharing their lives on a day-to-day basis.”
This model of embedded care is part of the Air Force Medical Service’s Integrated Operational Support program. IOS extends medical support into non-traditional environments, and missions with special performance requirements or operational health issues. IOS programs tackle a wide array of health issues, from mental health, physical therapy, diet and exercise, occupational exposures and hazards, well-visits, sick call and administrative health visits.
Integration of the 480th ISR Wing ART team took place in 2015. The embedded teams have made a huge difference in the physical and mental wellbeing of its Airmen. Long considered a career field with higher risk of suicide, 2016 saw zero suicides for the unit.
“We all work together as a team, medical, psychological and spiritual,” said Thurman. “The ART team is always on the operational floor, interacting with the Airmen. Our goal is to keep them on duty, reduce errors and improve their efficiency, their work environment and their quality of life.”
Getting through to the 480th Airmen is an ongoing process. One young Airman heard an ART psychologist deliver a presentation about how traumatic experiences can open up old wounds they thought had healed. After the talk ended, the Airman sought out the ART member and said “you’re talking about me.” Her mother had died by suicide, and she thought she had moved past the grief. Now, her wounds were reopening and increasing her stress level. The Airman didn’t plan to seek mental health services, but after repeated conversations with ART members, she got the help she needed.
“Early intervention made the difference for that Airman,” said Thurman. “The ART team made sure she didn’t become a statistic, and she is still on the operational floor today.”
The ART team also offers mental and physical health coaching to the Airmen of the 480th ISR Wing. They teach tactical breathing, mind over mood, sleep hygiene, stress management and other techniques to help Airmen cope with their experiences.
“We want to help create a safety net for our Airmen,” said Thurman. “We want them to understand that their feelings of stress and trauma are normal reactions to an abnormal situation. We know these Airmen, and we can tell when something is wrong, and get them plugged into additional care when needed.”
In addition to providing physical, mental and spiritual care to the Airmen of the 480 ISR Wing, the ART team is also engaged in improving their work environment and processes. Thurman’s team observed that operators on the DCGS Distributed Common Ground System (DCGS) were becoming more tired, easily distracted and less effective towards the end of shifts longer than eight hours. They recommended a new crew construct that minimized 12-hour shifts (really 14 hours, including briefings and debriefings) and increased 8-hour shifts.
“The Wing Commander wasn’t a believer when we proposed it at the first location,” said Thurman. “But he let us try it for six months. We saw a six percent reduction in errors and an overall increase in production. We’re now implementing it at all ISR Wing locations.”
Another skill the ART team brings to the Wing is human-systems integration. This requires the ART members to be problem solvers, and look for solutions that engineers or designers might have missed, since they don’t have a medical background.
One example is the layout of work stations. Operators are in close contact with computers and screens every moment they are on duty. What might be a minor annoyance for most office workers becomes magnified in the fast-paced, life or death environment of the DCGS.
“We found that a screen that operators used frequently was poorly placed, causing major neck strain for Airmen,” explained Thurman. “We got in there with saws and hammers, working with the operators to design a workstation that lets them access the most important information with ease. We have immediate, useful interactions at the local level with Airmen that we could never have if we weren’t embedded.”
Another example of optimizing human-system integration is the lighting on the operational floor. Lights have to be kept low, to improve the visibility of the monitors. But how low is too low?
“The floor used to be so dark that people couldn’t stay awake. We had an Airman fall asleep while on duty, and no one noticed until the group commander stepped on him,” said Thurman. “They need to be able to see the screen, so they can tell the difference between a broom in the hands of a regular person and an AK-47 in the hands of an ISIS combatant. But that doesn’t matter if your operators are falling asleep.”
The ART team took on this problem, despite having little experience with light engineering.
“We had an emergency room doctor, a psychiatrist and two civil engineers who knew nothing about lighting trying to solve this problem,” said Thurman. “We did our research, consulted outside experts, got smart fast, and were able to determine the optimal amount of light to keep people awake while ensuring maximum visibility of the screens. The next generation of ISR work stations will be designed using the results of our work.”
In all of this work, being embedded is critical for the ART team. Shared experience, familiarity, and friendship all build trust, and that is what lets the ART team help the Airmen operators of the 480th ISR Wing.
“There are three pillars of the ART model, physical, mental and spiritual care,” said Thurman. “It doesn’t take an MD or a PhD to know that the work our operators do can be traumatizing. We all work together to keep our Airmen on the floor and keep the mission going.”