NICoE Symposium Focuses on In-Theater Service Member Psychological Care

By Robyn Mincher, DCoE Strategic Communications

“The conversation today is of people [coming] together around a common purpose. We’re doing what only a few years ago many thought not possible—helping [service members] achieve restoration and recovery.”

 - Rear Adm. Karen Flaherty, Navy Deputy Surgeon General

The conversation at a National Intrepid Center of Excellence (NICoE) symposium titled “Accelerating Advancements in the Prevention and Treatment of Combat and Operational Stress and Related Comorbidities,” brought together premiere experts in military psychological health to discuss how to advance the in-theater care of service members and the significance of educating line leadership June 3, 2011, in Bethesda, Md.

Dr. Miguel Roberts, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), clinical guidelines chief of the psychological health directorate, presented “DCoE Psychological Health In-theater Protocol Discussion,” addressing policy and clinical practice guidelines for psychological first aid. Roberts also highlighted symptoms line leaders need to look for using the IDOCARE model of care: insomnia, depression, operational readiness, lack of concentration, anger, removed behavior and event avoidance.

“Given the complexity [of service member psychological health], we find that there is a vital need for training line leaders to identify service members who should be monitored and screened using IDOCARE,” Roberts said.

Sleep was the focus during Dr. Fred Turek’s, Northwestern University, presentation on “Current In-theater Approaches: Sleep Hygiene.” Experts discussed the common tendency for service members to drink high-energy, caffeinated beverages to keep awake while often having anxiety-induced insomnia.

“After a traumatic event, sleep is often disrupted which may contribute to or accelerate the development and progression of changes in behavior,” said Turek. “Disruptive sleep is a consequence of the event, but then it has a negative effect on psychological health.”

Navy Capt. Robert Koffman and Air Force Maj. Joshua Morganstein presented on critical incidents on the battlefield, and how leaders need to look for behavioral changes after a traumatic event, such as a convoy attack or death of a service member.

Other topics of the symposium included pain management, in-theater psychiatry and suicide prevention.

As the symposium came to a close, experts agreed on the importance of sharing expert knowledge on psychological health with line leaders to take action.

"This symposium brought together some of the best in military and civilian medicine to address these pressing concerns and the importance of line leaders in maintaining the psychological health of our service members,” said Navy Capt. Paul Hammer, DCoE director. “It’s important that conversations of these types continue to expand and foster change."