BH GEAR training empowers front-line helpers with mental health skills for the future battlefield

As forces prepare for large scale combat environments (LSCO), military medicine must adapt by building an in-theater system capable of providing prolonged casualty care under direct threat, moving away from reliance on access to specialty providers and rapid evacuation. This new approach needs to address mental health (MH) conditions by equipping front-line personnel with MH skills. This work aimed to evaluate the effectiveness of the BH GEAR training, which teaches MH prevention, identification and management skills to soldiers without prior MH training. Soldiers (n = 545) from seven U.S. Army units participated in the study from October 2022-April 2024, attended the training, and completed pre- and post-training surveys on the same day. The six-hour training provided instruction on conducting MH assessments, signs and symptoms of illnesses, interventions to prevent or manage concerns, and considerations for managing medical evacuations. Analyses examined satisfaction with the training, self-report of skills learned, and changes in scope of practice, knowledge and confidence utilizing the skills. Most participants (89%) rated the training as relevant and useful, and learned how to assess for (93%) and provide interventions for (91%) MH concerns. Post-training, participants experienced significant increases in MH-related scope of work, knowledge, and confidence. This work shows that completion of a one-day training is associated with increased MH skill knowledge and anticipated confidence using these skills with military service members. Integrating this training into military curriculums will increase the availability of support during current and future operations, ultimately sustaining readiness and lessening the impact of mental health challenges.