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Field study of troops serving in Afghanistan

Field study of troops serving in Afghanistan

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Published by USA TODAY
Joint Mental Health Advisory Team 7 report on Operation Enduring Freedom 2010, Afghanistan.
Joint Mental Health Advisory Team 7 report on Operation Enduring Freedom 2010, Afghanistan.

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Published by: USA TODAY on May 09, 2011
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Joint
Mental Health
Advisory
Team 7 (J-MHAT 7) 
Operation
Enduring
Freedom
2010 
Afghanistan
22 February 2011 Office
of
The
Surgeon
General United States Army
Medical
Command 
and 
Office
of
the Command Surgeon 
HQ,
USCENTCOM and 
Office
of
the Command Surgeon 
US
Forces
Afghanistan (USFOR-A) 
The results and opinions presented in this report are those
of
the Joint Mental Health AdvisoryTeam 7 members and do not necessarily represent official policy or position
of
the Department
of
Defense.
1
 
1.
EXECUTIVE SUMMARy .................................................................................................... 4 
1.1
Introduction ................................................................................................................. 4 1.2
Key
Findings: Army .................................................................................................... 4 
1.3Key
Findings: Marines ............................................................................................... 6 
1.4
Key
Findings
from
Behavioral
Health
Personnel ......................................................... 7
2.
BACKGROUND ................................................................................................................. 9 
2.1
Mission
and
Background ............................................................................................ 9 2.2 Sampling Strategy ...................................................................................................... 9 2.3 Comparison Groups ...................................................................................................
10 
2.4 Analytical Strategy
and
Verification
of Results
...........................................................
11 
2.5
Focus
Groups ............................................................................................................
11 
3.
CONCEPTUAL OVERViEW .............................................................................................
13 
3.1
Service Member Combat
&
Well-Being
Model
...........................................................
13 
4.
SOLDIER
REPORT:
SAMPLE CHARACTERISTICS .......................................................
15 
5.
SOLDIER
REPORT:
WELL-BEING
INDICES
....................................................................
17 
5.1
Morale .......................................................................................................................
17 
5.2
Behavioral Health: Acute Stress, Depression
and
Anxiety .........................................
18 
5.3 Suicide Ideation .........................................................................................................
19 
5.4 Concussion (mTBI) ....................................................................................................
20 
5.5
Pain
Medications .......................................................................................................
22 
5.6
Medications for Sleep
and
Mental
Health Problems ...................................................
22 
5.7 Factors Impacting Sleep Disturbance
and
Work Performance ...................................
23 
6.
SOLDIER
REPORT: RISK
FACTORS...............................................................................
25 
6.1
Combat Experiences .................................................................................................
25 
6.2 Relationship Problems ...............................................................................................
26 
6.3 OPTEMPO Factors: Months
Deployed
......................................................................
28 
6.4 OPTEMPO Factors: Multiple Deployments ................................................................
28 
6.5 Deployment Concerns ...............................................................................................
30 
7.
SOLDIER
REPORT:
RESILIENCE
FACTORS
..................................................................
31 
7.1
Unit Factors ...............................................................................................................
31 
7.2
Stigma .......................................................................................................................
32 
7.3
Barriers
to
Care .........................................................................................................
33 
7.4
Training .....................................................................................................................
34 
8.
SOLDIER
FOCUS
GROUP
SUMMARY
............................................................................
36 
8.1
Methods.....................................................................................................................
37 
8.2
Results ......................................................................................................................
38 
8.3
Themes Emerging
from
Focus
Groups .....................................................................
.40 
9.
SOLDIER
REPORT:
DISCUSSION
AND
RECOMMENDATIONS ....................................
50 
9.1
Overview of Findings .................................................................................................
50 
9.2 Evaluating Support
and
Sustainment
Units
................................................................
54 
10.
MARINE
REPORT:
SAMPLE CHARACTERISTICS .....................................................
55 
11.
MARINE REPORT:
BEHAVIORAL
HEALTH
................................................................
57 11.1
Morale .......................................................................................................................
57 
11.2
Behavioral Health: Acute Stress, Depression
and
Anxiety .........................................
58 
11.3
Suicidal Ideation ........................................................................................................
59 
11.4 Interpersonal Adjustment
and
Work Functioning ........................................................
60 
11.5
Concussion (mTBI) ....................................................................................................
61 
11.6
Pain
Medications .......................................................................................................
62 
11.7
Medications for Sleep
andMental
Health Problems ...................................................
63 
11.8 Sleep Problems .........................................................................................................
63
12.
MARINE REPORT: RISK FACTORS
............................................................................
64 
2 
 
12.1
Combat Experiences .................................................................................................
64 
12.2 Relationship Problems ...............................................................................................65 12.3 OPTEMPO Factors: Months Deployed ......................................................................66 12.4 OPTEMPO Factors: Multiple Deployments ................................................................
67 
12.5 Deployment Concerns ...............................................................................................69
13.
MARINE REPORT: RESILIENCE FACTORS ...............................................................
71 
13.1
Unit Factors ...............................................................................................................
71 
13.2 Stigma .......................................................................................................................
72 
13.3 Barriers to Care .........................................................................................................
72 
13.4 Training .....................................................................................................................
73
13.5 Positive Impact of Deployment ..................................................................................
74 
14.
MARINE REPORT: DiSCUSSiON ................................................................................
76 
14.1
Overview of Findings .................................................................................................
76 
14.2 Factors Related to Resilience ..................................................................................
77 
15.
BEHAVIORAL HEALTHCARE SYSTEM ASSESSMENT ..............................................
81 
15.1
ATO Behavioral Health
(BH)
Overview .................
".""",."
........................................
81 
15.2 Behavioral Health (BH) Staffing
and
Distribution........................................................
81 
15.3 Behavioral Health Survey Results ..............................................................................
84 
16.
Theater Suicide Review ................................................................................................
92 
16.1
Demographics......... ................................................................................................
92 17.
JOINT DISCUSSION AND RECOMMENDATIONS .......................................................
93 
17.1
Nature of Recommendations versus Considerations .................................................
93 
17.2 Increasing Behavioral Health Coordination and Training ...........................................93 17.3 Concussive Event Management ................................................................................
94 
17.4 Tele-Mental Health ....................................................................................................
96 
17.5 Sleep Discipline .........................................................................................................
97 
17.6 Support Evaluation of Other Populations ...................................................................97
18.
STATUS
OF
MHAT
VI
RECOMMENDATIONS .............................................................98 APPENDIX
A:
REFERENCES ..................................................................................................
99 
APPENDIX
B:
NAVY/MARINE DOCTRINE
AND
IMPLEMENTATION IMPLICATIONS .........
102 
APPENDIX
C:
mTBI CLINIC OVERViEW ...............................................................................105 APPENDIX
D:
BEHAVIORAL HEALTH SURVEY RESULTS ..................................................107 APPENDIX
E:
BEHAVIORAL HEALTH FOCUS GROUPS .....................................................
11
0 
3 

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Interesting mental health field study of troops serving in Afghanistan.

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