COSC Program Update
September 2011
Patricia Powell
Program Manager
Combat and Operational Stress Control (COSC)
COSC assists Commanders and Marine leaders in
maintaining their warfighting capabilities.
• COSC implements activities focusing on:
– Force preservation and readiness
– Long-term health and well-being of the Marine and their family
• Leaders are key to COSC
– Leaders influence prevention, mitigation, early identification and
referral for treatment
– Leaders set a command climate to reduce the stigma of seeking
and receiving treatment
– COSC utilizes five Core Leader Functions (SMITR)
– Supported by Regional Training Coordinators
IOM Prevention Model
USMC
Treatment Providers and Resources
USMC
STRESS CONTINUUM
READY
REACTING
INJURED
ILL
USMC
and
TX Providers
and Resources
Where Are You On The Stress Continuum?
READY
REACTING
INJURED
ILL
Good to go
Well trained
Prepared
Fit and
tough
• Cohesive
units, ready
families
• Distress or
impairment
• Mild,
transient
• Anxious or
irritable
• Behavior
change
• More severe
or persistent
distress or
impairment
• Leaves
lasting
evidence
(personality
change)
• Stress
injuries that
don’t heal
without
intervention
• Diagnosable
•
•
•
•
Unit Leader
Responsibility
Individual
Responsibility
PTSD
 Depression
 Anxiety
 Addictive
Disorder

Chaplain &
Medical
Responsibility
J-MHAT 7 Assessment
Army
USMC
Army
USMC
% agree or
strongly agree:
Screen positive
% agree or
strongly agree:
Screen positive
% agree or strongly
agree:
Did not screen positive
% agree or strongly
agree:
Did not screen positive
Mental health services
aren't available
28.2%
7.9 %
11.2 %
7.0%
I don't know where to get
help
17.0 %
5.8 %
4.7%
6.8 %*
It is difficult to get an
appointment
31.3 %
11.9 %
11.8 %
6.6%
There would be difficulty
getting time off work for
treatment
49.3%
24.5 %
19.6 %
18.3 %
It's too difficult to get to the
location where the mental
health specialist is
32.7%
14.2 %
15.7 %
12.5 %
My leaders discourage the
use of mental health
services.
15.1 %
9.6%
4.0%
5.2%*
Factors that affect your
decision to receive
mental health services
Recent findings regarding barriers to
mental health care
Note: * = USMC numbers in bold higher than
comparative US Army sample.
Key Initiatives
• COSC training
– Deployment Cycle Training, known as
Marine Operational Stress Training (MOST)
• OSCAR Team Training
– MARADMIN requires Bn-sized units to train &
maintain OSCAR teams
– Outlines certifications & authorized training
– Provides guidance to complete reporting
• Resources and tools
– Behavioral Health Information Network (BHIN)
– Resource map
Operational Stress Control and Readiness
OSCAR Teams:
– Team Members / Mentors (Selected Marines)
OSCAR training:
– Builds teams to assist
commanders in prevention,
early identification, referral and
support
– Incorporates mental health
providers embedded in the
operating forces, where they
are needed most
– Develops OSCAR teams
across the Marine Air Ground
Task Force
– Extenders (Corpsmen, Medical Officers,
Religious Ministry Team)
– Providers (Mental Health Professionals)
OSCAR Team Members/Mentors:
– Identify small changes in behavior
– Quickly intervene when Marines show signs
of negative stress reactions
– Refer for assistance when appropriate
– Reduce stigma concerning behavioral health
– Over 3000 Marines are OSCAR trained
Mental Health Professionals
– Embedded at the Division/Regimental level
OSCAR Team Structure (Infantry)
XX
DIVISION
OSCAR Mental Health Providers (3, full time)
OSCAR Psych Techs (4, full time)
III
INFANTRY REGIMENTS
OSCAR Mental Health Providers
(2, full time)
OSCAR Psych Techs (2, full time)
II
I
INFANTRY BATTALIONS
OSCAR Mentors
(XO, SgtMaj, and selected Marines)
OSCAR Extenders (Medical Providers,
Chaplain, RP and Corpsmen)
INFANTRY COMPANIES
OSCAR Mentors
(XO, 1stSgt, and selected Marines)
OSCAR Extenders (Corpsmen)
OSCAR Training Structure
MEF MASTER TRAINERS
(56 hour course plus experience training)
100
Certified to train trainers
OSCAR TEAM TRAINERS
(40 hour course)
Certified to train team members
200
ADVANCED TEAM MEMBERS
(32 hour course)
~50
Mentors able to provide
informal briefings and assist
trainers in conducting Team
Training
MENTORS
(6 hour course)
50–75 per Battalion
Mentors able to
provide informal
briefings
OSCAR Training Value for Leaders
SgtMaj Barrett, Sergeant Major of the Marine Corps
3 min
OSCAR Way Ahead
• MARADMIN
• Sustainment
- Certifying Master Trainers in all MEFs & MFR
• Preparing for Generation 2
–
–
–
–
Lessons learned from 18 months of OSCAR Team Training
Conducting focus groups
Integrating emergent priorities
Developing trainer skills
• Developing specialized training
– OSCAR Providers
– OSCAR Executive Course
Supporting Families
• Developing strategies with Marine Corps Family Team
Building (MCFTB) to:
– Raise awareness and provide tools to help identify stress reactions
and refer using a common frame of reference
• Conducted working groups with active duty spouses to
review concepts and tools – Instructor Battalion &1/6
– Foundational COSC training
– Leveraging OSCAR format
• Piloting with I MEF NOV 2011
Deployment Cycle Training Way Ahead
• Currently (2005): Marine Operational Stress Training (MOST)
– Generic COSC information with a medical bias
– Targets Warriors (Marines), Leaders & family members
• Planned
– Interactive, small unit discussion; practical use of concepts
– Lessons learned from OSCAR Training & Third Location
Decompression
– Emerging priorities such as TBI protocols
– Content tailored to each specific point on the deployment cycle
– Unit leadership & OSCAR Team Members lead discussions
– Retain audience focus: Warriors (Marines), Leaders & family members
COSC Way Ahead
•
•
•
•
Finalizing Marine Corps Order
Developing AIRS Checklist
Preparing for Third Location Decompression for PRP & EOD
Updating Deployment Cycle Training (MOST)
FY 2012 Strategy:
• Developing a strategic plan
• Institutionalizing COSC fundamentals
• Supporting the Commandant’s resiliency efforts
• Developing specific tool kits
• Building a scientific base
• Gathering best-evidence
• Developing communication plan
• Collaboration
• Staff development
How You Can Help
 Let the Marines own it
 Support when asked
 Partner with the RTCs
 Institutionalize key concepts
 Promote seeking leadership tools
Points of Contact
Questions?
Ms. Patricia Powell, Program Manager, COSC
patricia.powell@usmc.mil
LtCol Curt Strader, OSCAR Lead, COSC
curtis.strader@usmc.mil