Far Forward Behavioral Health Service Delivery in Future Combat Environments: A Qualitative Needs Assessment

Area of Science:

• Military Psychology
• Operational Psychiatry
• Combat Stress Management

Background:

• Future multi-domain operational (MDO) combat environments present unique challenges for soldier support.
• Existing behavioral health (BH) treatment models require adaptation for austere battlefield conditions with limited immediate care access.
• Special Forces medics and operators deployed in small groups to austere conditions face significant stressors.

Purpose of the Study:

• To characterize stressors and behavioral health (BH) issues encountered by soldiers in austere, small-group deployments.
• To describe effective mitigation strategies and identify needed resources for BH support in MDO environments.
• To inform the development of a novel BH service delivery model tailored for future MDO combat.

Main Methods:

• Qualitative study employing six focus groups with 23 active duty soldiers, including medics.
• Semi-structured interviews explored stressors, their impact on mission, and mitigation strategies.
• Thematic analysis of transcribed data using NVivo software (version 12) by two independent researchers.

Main Results:

• Behavioral health concerns, ineffective leadership, and poor team dynamics were primary stressors.
• Key mitigation strategies included leadership, morale, resilience training, and team cohesion.
• Soldiers identified a need for accessible BH providers and realistic BH skills training for non-providers and leaders.

Conclusions:

• Current BH treatment models are insufficient for future MDO environments.
• Understanding deployment-specific stressors and effective interventions is crucial for adapting BH services.
• This study provides essential qualitative insights from combat veterans to guide the development of relevant BH support systems.