JOINT BASE SAN ANTONIO-LACKLAND, Texas  –   Military aviators face unique challenges when it comes to mental health care, often avoiding treatment due to fears of jeopardizing their flight status. Dr. William Hoffman, a neurologist and aeromedical researcher with the 59th Medical Wing, has been studying this issue extensively and is working to change the landscape of aviation mental health.

Addressing Health Care Avoidance in Military Aviation

Studies have shown that most pilots avoid seeking medical attention out of fear it could impact their ability to fly. Hoffman conducted research revealing that 72 percent of U.S. military pilots admitted to withholding medical concerns due to career worries.

“We found that pilots aren’t just avoiding mental health care—they’re avoiding health care in general,” Hoffman said. “This includes everything from back pain to high blood pressure, and that’s a risk to both the individual and the mission.”

Hoffman emphasized that the reluctance to seek care stems from longstanding concerns over medical evaluations and potential grounding. “Pilots fear that if they report a medical issue, they may be sidelined indefinitely,” he said. “That leads to self-diagnosing and avoiding doctors altogether, which only worsens the problem.”

The Role of Peer Support in Breaking Down Barriers

Recognizing the need for a solution within the Air Force, the 59th MDW collaborated with operational units to implement the Military Aviator Peer Support (MAPS) program. Modeled after commercial aviation peer support systems, MAPS provides aviators with a confidential, non-medical support network.

“A major component of what we’re trying to do is normalize these conversations,” Hoffman said. “If an aviator can talk to a trained peer first, they may be more likely to seek help early rather than wait until it becomes a bigger issue.”

This approach, already implemented at Ramstein Air Base’s 86th Operations Group, trains aircrew members to serve as peer supporters. The program, supported by the 59th MDW’s research, helps aviators navigate stressors and access resources while maintaining their operational readiness.

One of the biggest successes of MAPS has been changing how aviators perceive seeking help. “Peer support has allowed pilots to talk to someone who understands their lifestyle and stressors,” Hoffman said. “That makes a world of difference.”

Data-Driven Change and Policy Advocacy

Beyond peer support, Hoffman is advocating for systemic change. As the Department of Defense’s representative on the Federal Aviation Administration’s Aviation Rulemaking Committee on Mental Health, he is working to refine policies that balance safety with accessible health care for pilots.

“The goal isn’t to bypass safety measures,” Hoffman said. “It’s about ensuring that pilots aren’t penalized for seeking care they genuinely need. The data shows that early intervention keeps aviators flying longer and healthier.”

His research has influenced discussions at the highest levels of military medical leadership. “We’re presenting findings that show how health care avoidance leads to more serious medical issues later,” he said. “By addressing concerns early, we not only help pilots but also improve overall mission readiness.”

Looking Ahead: A Cultural Shift in Military Aviation

With ongoing research and advocacy, the future of mental health care in aviation is shifting. Hoffman is set to co-lead a workshop on mental health and peer support at the Aerospace Medical Association Scientific Meeting in June 2025, further solidifying the Air Force’s commitment to improving access to care.

“We’re seeing a shift in culture,” Hoffman said. “More leaders are open to discussing mental health, and more aviators are willing to engage with peer support. That’s how we make lasting change.”

As the Air Force prioritizes resilience and readiness, initiatives like MAPS—backed by the expertise of the 59th MDW—are paving the way for a healthier, more sustainable force. By integrating research, policy advocacy, and peer-driven support, the military is setting a new standard for aviation mental health care.