Combat stress prevention

Courtesy Photo | Col. Lewis Van Osdel, a psychiatrist with the 883rd Medical Company (Combat Stress Control) takes his advice on the road to Forward Operating Base McKenzie providing case consultations for the mental health staff there.  

12.22.2005

Courtesy Story

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Helping Soldiers cope with the critical events that are sandwiched between arriving and departing a combat zone poses one of the biggest challenges for the staff of the 883rd Medical Company, Combat Stress Control.

The 883rd is divided into two groups, the prevention team and the restoration team, and each plays a pivotal role in the effort to minimize the effects of stress on the battlefield.

"The prevention team is a smaller team. Their mission is to travel to units to make contact and let them know who we are, what we do, and how we can be of service to both the command and the individuals," Maj. Ed Moschella, a psychiatric nurse with the 883rd at Logistical Support Area Anaconda, said. "If they don't know us before an event, it's unlikely they'll call us."

One of the services offered by the traveling team is critical event debriefings when units lose a Soldier or when a Soldier is evacuated for medical treatment. Moschella acknowledged that it can be difficult for "outsiders" to approach a unit dealing with a tragedy.

"There's a whole theme of us being an outsider that creates a barrier to our services. Part of how we try to deal with that is to have the prevention team do a walk-about, meet Soldiers, introduce themselves to the command staff. Our goal is to keep every Soldier in the mission," Moschella said.

After suffering a traumatic event, some Soldiers need more in-depth or follow-up care. Enter Staff Sgt. Philip Burke, the NCOIC of the restoration team. Burke has a master's degree in social work and a doctorate in education. As a clinician and an educator, he works hard to help Soldiers heal the wounds their experiences can create.

"From a clinician's point a view, I see some of the more complex situations," Burke said. "I see Soldiers on a regular basis for counseling every week or two weeks."

Burke said there are three major points of a deployment at which Soldiers are likely to seek counseling.

"There's three periods when we see people. Some that are adjusting, just in the first 60 days of their deployment," Burke said. "Then, people in the middle phase, at about the six-month marker, it's kind of the same thing as a marathon. There's kind of a natural sense of, "oh boy, there's another whole six months to go." Burke added, "I'm really happy about how many Soldiers come in to us in their last 60 days of deployment, not because they're worn out after 11 months on the job, but because they already identified some anxiety about provoking a situation at home that they need to begin thinking about.

They're already beginning to adjust to home, thinking about what they need to do, and they're planning for it."

Burke said he tries to staff the clinic to make the administrative portion of a Soldier's first visit as efficient as possible.

"I don't like anyone to come in here, fill out some of our intake paperwork and have to wait to see someone. I like to be available to the Soldiers as quickly as possible," Burke said.

The staff performs an assessment on the results of the surveys Soldiers complete on their initial visit.

"They fill out some paperwork, just some demographic information. We need to know what's going on," Burke said.

Part of the assessment is asking Soldiers what their needs are.

"We ask about what their thoughts are. How distressed are they? Are they having thoughts of hurting someone, or if they have thoughts of hurting themselves," Burke said. "Some have financial issues, some have relationship issues. Most of us need a lot of experience with the hellos and goodbyes of life."

A residential program is available for Soldiers who need a step back from the source of their stress.

"Some Soldiers need to stay with us for a couple of days. Often we're changing their medication and evaluating that; getting them into a neutral site where there aren't any work demands and see if we can recharge their batteries," Burke said. "They come in from forward operating bases, having very long and demanding missions, maybe seeing the worst aspects of this conflict. They may not have the capacity to recharge their batteries. We can do that. Often it begins with just a good night's sleep."

A benefit of the residential program is that it creates an environment where the medical staff can help gauge and control a Soldier's physical health. Patients who haven't been eating or sleeping well can recuperate from the physical effects of the critical events they've endured. Once the body has begun healing, they can go to work on the psychological effects of the event that can create a foundation for post-traumatic stress disorder.

"It's a place to talk about the things that you've seen, to understand you've been through a lot, and a place to help yourself out for the long haul so you don't develop the kind of foundation that may lead to some future conditions," Burke said. "A lot of people have this reservoir of difficult events in their life that they just haven't got rid of, and it starts to intrude on their daily life."

It's common for two Soldiers to go through the same event and not be affected the same way. Although the staff of the 883rd spends some time thinking about why an event affects one Soldier deeply while another is not affected, their main concern is for the Soldier who needs assistance working through the stress that remains.

"Our job here is to deal with the Soldier when it really sticks with them. We support resilience for any number of issues that happen during deployment, from the most horrific to the most ordinary," Burke said. "When people are left alone to deal with a critical event in their lives, they become a casualty. With talking, debriefing, then people can recover from that difficult event to be functional again."

He added that it's not unusual to have a reaction to life in a combat zone.

"We're here in a difficult situation having a normal reaction to abnormal stress," Burke said. "These things don't happen to us when we're not deployed. We don't have to worry about improvised explosive devices or being shot at in Black Hawks when we're not deployed."

• Date Taken: 12.22.2005
• Date Posted: 12.22.2005 09:05
• Story ID: 4172