Taking care of Airmen: How Air Force mental health services helped an Academy leader

Chief Master Sgt. Maxwell Grindstaff poses for a photograph in his Harmon Hall office here July 16. He replaces soon-to-be-retired Chief Master Sgt. Stephen Ludwig as the Academy’s command chief. (U.S. Air Force/Carol Lawrence)

Chief Master Sgt. Maxwell Grindstaff poses for a photograph in his Harmon Hall office here July 16. He replaces soon-to-be-retired Chief Master Sgt. Stephen Ludwig as the Academy’s command chief. (U.S. Air Force/Carol Lawrence)

Chief Master Sgt. Max Grindstaff (right), the-then NATO Air Training Command and 438th Air Expeditionary Wing command chief, marches with a contingent of wing leaders on the Bagram Air Base flightline April 29, 2011. The group marched toward a C-17 waiting to begin the dignified transfer of nine Americans who lost their lives in an inside attack there April 27, 2011. Nearly 2,000 service members met on the flightline  to pay respect to the victims. Grindstaff now serves as command chief at the U.S. Air Force Academy. (Courtesy photo)

Chief Master Sgt. Max Grindstaff (right), the-then NATO Air Training Command and 438th Air Expeditionary Wing command chief, marches with a contingent of wing leaders on the Bagram Air Base flightline April 29, 2011. The group marched toward a C-17 waiting to begin the dignified transfer of nine Americans who lost their lives in an inside attack there April 27, 2011. Nearly 2,000 service members met on the flightline to pay respect to the victims. Grindstaff now serves as command chief at the U.S. Air Force Academy. (Courtesy photo)

U.S. AIR FORCE ACADEMY, Colo. -- Chief Master Sgt. Max Grindstaff, the Academy's command chief, said taking advantage of Air Force mental health support services helps him cope today with the deaths of nine Americans he served with in Kabul, Afghanistan.

"I sought counseling because I needed it," the chief said. "If I feel like I still need it, I'm going back. I owe it to my fellow Airmen. I owe it to my family."

Grindstaff served as the NATO Air Training Command and 438th Air Expeditionary Wing command chief at the Kabul International Airport from May 2010 to May 2011.

He speaks fondly of his nine coworkers, two who were Academy grads.

"We all got there at different times in our tours and many were due to depart within a few months of me," he said. "We all talked about how it would be to leave together. I was as close to them as I was to any Airman. Some of them I lived next door to in the dorm."

Grindstaff was nearing the end of his deployment and "everything was going smoothly," he said, until April 27, 2011, when an Afghan pilot killed all nine with a firearm. The chief's eyes filled with emotion when describing this inside attack and the loss the victims' families must still feel.
 
That morning, Grindstaff was in an office a few doors down from a first-floor operations center in the Afghan Air Force Headquarters building. On his way into this office, he passed the group as they headed into operations center.

"It was 10:11 a.m.." he said. "I remember looking at my watch." 

The group included Lt. Col. Frank Bryant of Knoxville, Tenn., an Academy graduate and F-16 Fighting Falcon pilot.

"Lt. Col. Bryant was an air operations guy," Grindstaff said. "He had the most beautiful deep southern voice. He was a complete southern gentleman."

The chief went to his office, about 100 yards from the operations center. Soon, "things got chaotic," he said. 

"We got a text from someone inside the (command center)," Grindstaff said. "We hunkered down for a bit and established security on the building. Gunfire was reported  and I ran outside. I ran back to the operations center and a medic stopped me. He said 'Chief, there's nine dead in there.' I asked him, 'Nine Afghans, nine contractors, nine what?' He said, 'Nine Airmen."'

Later that day, the chief identified the victims' bodies and moved their gear into his room. 

"You could tell from their positions some died defending each other," he said. "It was terrible. I had the personal effects of all these guys in my room. Their bloodied gear was a somber reminder of the tragedy."

Also killed were Maj. Philip Ambard, a Venezuelan immigrant and a former Academy Language Department assistant; Majors Jeffrey Ausborn of Randolph AFB, Texas; David Brodeur of Joint Base Elmendorf-Richardson, Alaska; Raymond Estelle II and Charles Ransom of Joint BaseLangley-Eustis, Va.; Capt. Nathan Nylander of Davis-Monthan AFB, Ariz.; Master Sgt. Tara Brown of Joint Base Andrews-Naval Air Facility Washington, Md.; and retired Army Lt. Col. James McLaughlin, a contractor from Santa Rosa, Calif.

Five Afghan soldiers were injured. According to Associated Press reports, at least one was shot in the wrist and the others suffered broken bones and cuts.

Though he knew the tragedy would affect him, Grindstaff pushed the thought aside in the immediate aftermath of the attack. 

"I remember thinking, 'You've got to take care of your people,'" he said. "You keep telling yourself, 'You've got to take care of your friends. We've got to get them home to their families.' You just focus on the situation and the things you've got to do."

Still, for all the initial commotion, the chief knew he would eventually have to take care of himself. He met with an Army Combat Stress Team chaplain three days after the attack.

"I was still in shock in a lot of ways but knew I had to see someone," Grindstaff said. "I didn't want to bring this home. After meeting with the chaplain, I knew I'd be better off if I was seen again after I got home and was able to put some distance between myself and the date of the attack."

Grindstaff said everyone kept a close eye on each other after the shooting.

"We tried to care for each other as best we could," he said. "I'm telling everyone to get help, to get seen, and the Airmen are checking on me saying, 'Chief, you too.' After this happened, they all said, 'Don't let this follow you. Get seen.' What Airmen do naturally is take care of other Airmen before they take care of themselves, so getting help for ourselves can often be the last thing on our mind."

Later, Grindstaff thought of Bryant.

"I heard his voice in my head saying, 'Get seen Max. Don't let this keep you down. You've tried to take care of everyone else, but now you do it. Get help,"' he said.

When the chief returned to his home station, Hill AFB, Utah, a few weeks after the attack, he took an Air Force post-deployment survey and within days, received a call from a mental health clinician assigned to the 75th Medical Group there.

"I answered that survey honestly, so I knew I would get a call. It was expected," he said. "So I went to mental health. I got help. I did not want to have to deal with the effects of this tragedy in 10 years. I did not want to have this yoke around my neck for the rest of my life. I did not want to increase the sphere of evil influence this attack could have on my life." 

The chief visited a mental health clinician every two weeks for six months.

"It was very easy," he said. "When I first walked in, the staff asked if I wanted to use the (distinguished visitor entrance) because I was a chief. I said 'Heck no!' What kind of hypocrite would I be if I used a DV entrance? I'm not ashamed to admit I needed help."

The chief said he wasn't worried about being stigmatized for seeking help.

"There was a stigma back in the '80s when I came in, but 20 years of being on the battlefield has driven Airmen to be more pragmatic," he said. "Leaders are much more comfortable with getting the help they need and encouraging their Airmen to get help. It's an issue of integrity. If Airmen see their leaders getting help, they're more likely to get it themselves."

While some argue this stigma still exists, a mental health clinician here argues strongly against that stereotype.

"Historically, there has been an inappropriate and undeserved stigma associated with mental health care - an impact on one's career, an indication of weakness, perception that only 'crazy people' go to mental health," said Dr. (Maj.) Chad Ackison, a clinical psychologist assigned to the 10th Medical Operations Squadron. "In reality, mental health is just that - health focused on wellbeing and improving the patient's quality of life. Although a diagnosis may be used by a clinician to identify symptoms that may inform treatment, ultimately we look at how these symptoms negatively impact someone's life and assist Airmen create a plan to hopefully improve their wellness."

The goal of the Air Force's mental health services is to improve an Airman's wellbeing, Ackison said.

"Many no longer think in terms of mind-body dualism, meaning the mind is separate from the body, but rather embrace a holistic approach to health and wellbeing that assumes there's a connection between physical, emotional, behavior and the environment," he said. "This notion is referred to as the Bio-psychosocial Model and some clinicians would even add bio-psychosocial-spiritual model. By addressing all aspects of the person, we hope to make small changes in each of these areas to collectively improve overall wellbeing."

Airmen needing mental health support are not alone, Grindstaff said.

"With every champion we have who has been helped, we know there are 10 Airmen privately battling problems," he said. "If you stepped into a room of 50 Airmen, I guarantee you at least half have seen trauma. So they are not the minority. The great preponderance of Airmen experience significant trauma in combat and our mental health clinicians are so very well equipped to help. You are absolutely not alone."

There's still work to be done, but mental health support services here and across the Air Force continue to improve, Grindstaff said.

"We're almost there, but we can never rest on our laurels," he said. "You don't need a command chief to say they've gotten help for you to get help. Our services are more than credible in themselves."

The 10th Medical Group Mental Health Clinic offers comprehensive mental health services to include individual and couples counseling, psychological testing, educational classes, substance abuse education and treatment through the Alcohol and Drug Abuse Prevention and Treatment Program, and family services through Family Advocacy.

"The mental health clinic also oversees the Behavioral Health Optimization Program in Family Health, where behavioral health services are also offered," Ackison said.
"Services in the BHOP model focus on specific issues such as mild mood issues, partner relational issues, sleep, stress and etc., and can usually be resolved within four sessions."

Ackison said Airmen can expect a comfortable counseling environment but suggested they keep track of their medical documentation.

"In many cases, it benefits the patient to have medical or mental health issues documented for continuity of care between providers, ensuring they receive the highest quality of care," he said. "Documentation establishes a record that any issue that has developed has been treated, making mission-essential questions concerning worldwide qualification, clearance, cross training and etc., often more easily answered by the medical community."

Ackison said only limited information can be shared with an Airman's command unless a release of information is signed by the patient.

"Rare is the case in which a provider would need to speak with command; those cases are limited to safety issues, mission essential questions concerning deployment and weapons status and etc," he said. "The majority of the issues mental health sees are quite amenable to treatment so it's truly in the Airman's best interest to seek help for an issue prior it escalates into something much bigger."

Grindstaff recommends Academy supervisors familiarize themselves with Academy mental health services.

"If you're genuinely committed to your people, seek out our mental health clinicians and services so you can help your Airmen and their families," he said. "Visit the organizations. If you lead Airmen, find out where to take them, arrange a visit, organize a commander's call attended by a clinician and tell your family how to get help. Seeing these clinicians face to face is so much better than an email or phone call."

Grindstaff credits the mental health counseling he received with helping him come to terms with the death of his friends and coworkers. He's now able to share his story and think of these Airmen without being overcome with debilitating sadness, he said.

"I feel better every time I tell my story about getting help," Grindstaff said. "It makes me feel good. If I share this story with anyone and it encourages them to get help, it will be worth it."

To reach an Academy mental health clinician, call 333-5177 or call the Defense Centers of Excellence for Psychological Health and TBI Outreach Center at 866-966-1020 or. A Vet4Warriors peer support representative for service members, civilians and their family members can be reached at 855-838-8255. 

For confidential assistance, call Military OneSource at 800-342-9647.