Brace for impact: A roadmap for the future of mental health in large-scale combat operations
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Updated: Oct 30, 2026

System for Focal, Closed-System Central Nervous System Injury
Published on: November 29, 2024
1Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland.
Abstract:
Large-scale combat operations (LSCO) are expected to present critical challenges to military units in terms of austere conditions, the potential for misinformation, specific LSCO-related threats, and the limitations of access to traditional medical care. As part of a special issue of Military Psychology dedicated to the topic of mental health in LSCO, 25 articles address these challenges. Articles cover key threats such as mass casualty events, drone warfare, and threats to the community. Articles also identify how traditional military mental health support may need to be adapted to take prolonged field care into account, with a focus on mental health support becoming the responsibility of individuals, informal peers, trained peers, and leaders. Furthermore, the articles address special topics such as the impact of LSCO on medical personnel burnout, attitudes toward novel solutions such as mindfulness, and training models for integrating mental skills into simulations and field-based exercises. Collectively, these articles inform the development of a schematic model of LSCO Mental Health. In addition, future research topics provide direction for assessing, preventing, and intervening with mental health health and cognitive strain in the LSCO context. By bringing this array of articles together, the field can prepare more effectively to meet the psychological demands of the LSCO battlespace.
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