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Monday, February 18, 2008

Navy, Marines May Send Psychologists to the Front

During the Russo-Japanese War (1904-1906), the first organized military system for treating combat fatigue occurred when physicians were placed close to the front ("forward treatment"). They were sent to perform evaluations of and administer care to traumatized soldiers.

The lessons of forward treatment, that soldiers receiving immediate care close to the action and their battle buddies were more resilient, is still relevant today. From the Associated Press:

Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.

For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis. The Navy and Marine Corps aim to change that by sending teams of mental health professionals to the front lines after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.

"We've got a lot of knowledge about the way combat trauma affects people, and having somebody there to guide Marines through it in Iraq means we can respond to it more quickly," Pusateri said.

While psychologists and psychiatrists have long treated military service members on bases and in field hospitals, next month's deployment of teams of psychological professionals - one per regiment - to combat zones marks a new approach in identifying and treating mental health before problems arise.

In educational interest, article(s) quoted from extensively.


The teams assigned to the 1st Marine Expeditionary Force - made up of about 11,000 Marines - will include a psychiatric technician, a chaplain and, in some cases, a naval social worker. Psychiatrists or psychologists could deploy to forward operating bases and, in extreme cases, patrol with units.

Three top commanders of the U.S. Marine Corps' fighting forces recently asked to make the pilot program a permanent fixture.

"Now is the time to adjust fire," the generals wrote in a letter to the commandant. "We must shift the current direction of combat/operational stress control efforts to a more holistic, nested enabling strategy that provides a sound, unified approach."

Marine commandant Gen. James T. Conway is reviewing the request and a decision is expected later this year.

The Army adopted a similar approach last year and has been deploying behavioral health specialists to patrol with its troops in Iraq and Afghanistan.

"What is probably new here is that we want to address it close on the front lines, and thereby return people both back to combat and back to society healthy," said Navy Capt. Mike Maddox, the 1st Marine Expeditionary Force surgeon.

The push to make the program permanent comes after a report by the Institute of Medicine found post-traumatic stress disorder to be the most commonly diagnosed mental disorder among veterans. It affected an estimated 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Figures released by the Marine Corps show a fourfold increase in the number of Marines diagnosed with PTSD - from 394 in 2003 to 1,669 to 2006.

"If we identify a stress and if we can treat it close to the unit, it's less likely that person will be sent back, medevaced out of there," said Cmdr. David Oliver, the 1st Marine Expeditionary Force psychiatrist.

Previously, Marines identified with possible combat-related mental health stress or disorders have been pulled from duty in Iraq and shipped to the United States or Germany for assessment and treatment.

Under the expanded program, mental health specialists would be in daily contact with troops at forward bases, working with chaplains to identify potential risks to troops, talking with squad leaders about their troops, and responding to IED explosions and other combat situations that could effect a Marine's mental health.

My only question: What took you so long?

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