CAPT Scott Johnston, MSC, USN
Director, Naval Center for Combat & Operational Stress Control
Mental Health in the Military
Treatment
Wellness
Total Force Fitness (TFF)
An initiative from the Chairman of the Joint Chiefs of Staff
MIND
•Psychological
•Behavioral
•Spiritual
•Social
BODY
•Physical
•Medical and
Dental
•Nutritional
•Environmental
www.nccosc.navy.mil
TFF Addresses Multiple Needs
Achieving multi-dimensional wholeness and balance to
meet the challenges of changing environments
• Engaging senior leaders
• Providing key terms and definitions for DoD
• Providing framework for cataloging programs and integrating
resilience-focused policy and doctrine
• Starting point for developing standardized metrics
www.nccosc.navy.mil
DCoE Resource and Efforts
RAND studies
• On web: Resilience and Suicide Prevention
• New studies: Stigma Reduction, Sleep Issues, Family Resilience
White papers reviews
• Integrate three areas: scientific evidence, current programming,
stakeholder inputs
• DCoE Integrative Health and Wellness website
• Topics: Mind-body skills, peer support, worksite health
promotion/wellness programs, leveraging technology, well-being,
reintegration programs
www.nccosc.navy.mil
Comprehensive Soldier Fitness
Overview
Five Dimensions
Five Pillars
$140 Million mandatory
program for all Soldiers
Physical
Global Assessment Tool (GAT)
Five dimensions
Five pillars
Social
Comprehensive Resilience
Modules
CSF is not a treatment program
Emotional
Master Resilience Trainers
Spiritual
Institutional Military
Resilience Training
Family
Enhanced Performance
Train specific mental and
physical resilience techniques
through a program of
continuous self - development.
Designed to improve physical
& psychological health and
resilience
Air Force Resilience Initiatives
IMPLEMENTED
ONGOING
AROUND THE CORNER
(Jul 12 & forward)
Deployment Transition Center
(DTC)
Senior Review Group
Joint use of DTC (Navy)
Leadership Toolkit on Portal
Resilience Mobile Training
Teams (RMTT)
Master Resilience Trainers (MRT)
training
Support and Resilience
Inventory (SRI) on Portal and
at A&FRCs
Developing learning goals for
AF Learning
Resilience integrated into
accessions and PME training
Wingman Day resources on
Portal
Leadership Pathways
Metrics:
- MRT
- Resilience impact: Airmen,
civilians, and families
Resilience incorporated in
family programs
Community Support
Coordinator positions (71)
for wings
Lessons Learned Report to CSAF
www.nccosc.navy.mil
Deployment Transition Center Implementation
Ramstein AB, Germany
• Decompression and Re-integration
Training
• Strength-based approach to assist
Airmen regularly exposed to
significant risk of death in direct
combat
• Research on effectiveness
• Showed significantly reduced symptoms
of Post Traumatic Stress, problematic
alcohol use/abuse, and serious conflict
with family/others
• Headcount—total 3,444
• AF/A1 and USAFE/CC working way
ahead on DTC of the future
As of: 29 Feb 12
Marine Total Fitness
Social
Mind
Body
Spirit
Marines and families that
engage in socially healthy
behaviors
Marines and families that
engage in psychologically
healthy behaviors
Mission-capable units
whose Marines are
physically able to perform
current and future missions
Marines and families living
out their spirituality in a way
that enables them to
successfully meet their
duties
E-Marine
Integrate Behavioral
Health
Physical Fitness Policy
Review & Overhaul
Spiritual Fitness Guide
Single Marine Program
Representative
Operational Stress Control
and Readiness Program
(OSCAR)
Enhanced nutrition,
fatigue mgt, combat
conditioning instruction
Chaplain Referral Tool
Pilot Operation Adrenaline
Rush (O.A.R.)
MCFIT- web-based tool to
inform and equip Marines
IRT “Marine Total Fitness
Sports Medicine and
Injury Prevention
Standardized CREDO
Programming
Pre/Post-Deployment Unit
Cohesion
Behavioral Health
Information Network
Physical Fitness Website
Chaplain Billet Structure
Review
MCFTB Curriculum
Refresh
DSTRESS Line
Post PT Nutritional
Enhancements
Revision CREST-chaplain
training.
www.nccosc.navy.mil
Navy Operational Stress Control (OSC)
Functional Areas
Programs
Unit Resilience
Policy- Develop/update Doctrine &
CONOPS and Fleet guidance
Returning Warrior Workshops
(RWWs)
OSC Awareness GMT
Training- Deliver annually and all
career milestones (pre- and postdeployment; and complemented by
regular Unit-level training.
FOCUS (Families Over Coming
Under Stress)
Navy OSC Leaders Course
Strategic CommunicationsFocuses on informing leadership,
changing behavior, and developing
partnerships
Caregiver OSC (CgOSC)
Command Stress
Assessment/DEOCS
Assessment and Analysis Measure
program effectiveness
Psychological Health Outreach
Programs (Mobile Care Teams,
OSCAR Embedded Provider)
Organizational Resilience
Assessment Pilot
www.nccosc.navy.mil
The Operational Stress Continuum
Ready
Reacting
Good to Go
Distress or Impaired
Well-Trained
Mild and
Temporarily Anxious,
Irritable or Sad
Fit and Focused
Cohesive Units
Ready Families
Unit Leader
Responsibility
Physical or
Behavioral Changes
Injured
Ill
More Severe or
Persistent Stress or
Impairment
Stress Injuries
That Don’t Heal Without
Help
May Leave Lasting
Memories, Reactions
and Impressions
Symptoms Persist
Get Worse or Initially
Get Better
Then Return Worse
Individual, Shipmate, Family
Responsibility
Caregiver
Responsibility
Five Core Leader Functions
Strengthen
Treat
Leadership that is Firm, Fair, a Source of
Courage, Communicates Plans and Listens
Rest and Restoration
(24-72 Hours)
Expose to Tough, Realistic Training
“Buddy Help”
Foster Unit Cohesion
Chaplain
Mitigate
Remove Unnecessary Stressors
Medical
Reintegrate
Ensure Adequate Sleep and Rest
Keep with Unit if at all Possible
Conduct After-Action Review (AAR) in Small
Groups
Expect Return to Full Duty
Identify
Know Crew Stress Load
Recognize Reactions, Injuries and Illness
Don’t Allow Retribution or Harassment
Communicate with Treating Professionals
(Both Ways)
Proposed Navy Resilience Program
Four pillars of the program
1. Assessment tools
2. Resilience training modules
3. Train-the-trainer training
4. Institutional resilience training
Resilience program will include:
1. Evidence-supported tools and methods that
support skill development
2. Research-supported program evaluation and
outcome measures
www.nccosc.navy.mil
Initiatives in Wellness and Optimal Performance
www.nccosc.navy.mil
Coherence Training Study
• Evaluate and compare effectiveness of stress regulation skills
• Coherence Training (emWave) Vs. PMR
• N = 106 IDC students
• Classes assigned to Coherence Training or PMR
• Assessments at baseline, 3 mo, 6 mo, 1 year
• Stress, anxiety, sleep, PTSD, unit support, performance & attrition
www.nccosc.navy.mil
Stress Resilience Training System
• Evaluate the effectiveness of stress regulation skills
• SRTS Vs. PMR (both iPad based systems)
• N = 200 service members in training environments
• Random assignment: SRTS, PMR or waitlist control
• All participants receive an iPad for 2 months
• Assessments at baseline, 2 and 4months
• Stress, resilience, coping, anxiety, sleep, PTSD, unit support,
performance & attrition
www.nccosc.navy.mil
Questions and Comments