Do the Military’s Frontline Psychiatry/Combat Operational Stress Control Programs Benefit Veterans? Part Two: Systematic Review of the Evidence

Russell, Mark C.; Figley, Charles R.

doi:10.1007/s12207-016-9279-x

Cited by 11 publications

(5 citation statements)

References 91 publications

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“… 61 Similarly, a recent exhaustive three-part review by Russell and Figley (2017) discussed the role of deployed mental health providers, as a primary administrative function, returning as many patients to duty as possible to prevent mission degradation; the Command approving only the most severe patients for psychiatric evacuation. 64 , 67 , 68 The authors go on to question the clinical effectiveness and value of frontline psychiatry with regard to the long-term health of ADSMs experiencing mental health conditions in theater. 64 , 67 , 68 The remaining publications focused on actionable strategies for improving the delivery of mental health services in theater, such as utilizing a mental health liaison to be able to speak command language and understand the culture of mission-first mentality, maintaining manpower resources, and communicating mental health needs of acute patients effectively.…”

Section: Resultsmentioning

confidence: 99%

“… 64 , 67 , 68 The authors go on to question the clinical effectiveness and value of frontline psychiatry with regard to the long-term health of ADSMs experiencing mental health conditions in theater. 64 , 67 , 68 The remaining publications focused on actionable strategies for improving the delivery of mental health services in theater, such as utilizing a mental health liaison to be able to speak command language and understand the culture of mission-first mentality, maintaining manpower resources, and communicating mental health needs of acute patients effectively. 63 Several authors advocated for embedded mental health staff, 66 specific practice models and inpatient consultations, 27 potential benefits of deploying psychiatric mental health nurse practitioners, 27 the concept of stabilizing mental health patients for 3-7 days before transport, 7 and standardized operational CPG definitions to decrease variance in diagnostic criteria.…”

Section: Resultsmentioning

confidence: 99%

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Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review

et al. 2021

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Background Although combat stress and psychiatric casualties of war have consistently contributed to the need for deployed patient transport to higher echelons of care, little is known regarding specific evidence-based strategies for providing psychological support and optimal transport interventions for warriors. Study Objective The purpose of this scoping review is to map existing literature related to considerations for deployed mental health patient transport. The review’s primary aims are to identify the existing scientific research evidence, determine research and training gaps, and recommend critical areas for future military research. Methods We used Arksey and O’Malley’s six-stage scoping review methodological framework (identify the research question, identify relevant studies, select studies, chart data, report results, and consultation). Using a systematic search strategy, we evaluated peer-reviewed literature from five databases (PubMed, CINAHL, PsycINFO, Web of Science, and Embase) and gray literature from the Defense Technical Information Center. All publications were independently screened for eligibility by two researchers during three review rounds (title, abstract, and full text). Results We identified 1,384 publications, 61 of which met our inclusion criteria. Most publications and technical reports were level IV evidence and below, primarily retrospective cohort studies and epidemiologic surveillance reports. Few rigorously designed studies were identified. Eight research themes and a variety of research and critical training gaps were derived from the reviewed literature. Themes included (1) characterizing mental health patients aeromedically evacuated from theater; (2) in-flight sedation medications; (3) need for aeromedical evacuation (AE) in-theater education, training, and guidelines for staff; (4) epidemiological surveillance of AE from theater; (5) mental health management in deployed settings; (6) suicide-related event management; (7) transport issues for mental health patients; and (8) psychological stressors of AE. Research is needed to establish clinical practice guidelines for mental health condition management in theater and throughout the continuum of en route care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review

et al. 2021

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“…Within the USA military battlefield setting, there are widely accepted methods of ASR management largely based on guidance formed from data collected among a small sample of soldiers within the Israel Defense Forces (IDF) in 1982, during the Lebanon War. 8 Treatment programmes based on variations of these principles are referred to as front-line psychiatry, 9 combat operational stress control, 10 PIE (proximity, immediacy, expectancy), PIES (proximity, immediacy, expectancy, simplicity) 11 and BICEPS (brevity, immediacy, centrality, expectancy, proximity). 12 The study by Solomon and Benbenishty examined PIE among the IDF, specifically, the ‘proximity’ of care to the site where trauma occurred, how quickly the soldier was treated (‘immediacy’) and whether the goals of care (‘expectations’) were clear to the soldier.…”

mentioning

confidence: 99%

“…In 2017, Russell and Figley published a systematic review 9 examining all data available on mental health outcomes between service members experiencing psychiatric causalities who received front-line care and those who were evacuated. This review showed that, among USA military service members who experienced psychiatric casualties in theatre, there was insufficient evidence to support that current treatment approaches reduced the long-term development of PTSD and other mental health outcomes.…”

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confidence: 99%

Examining the development of PTSD symptoms in individuals who witness acute stress reaction on the battlefield

2021

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“…Traditionally, front-line interventions have been provided by behavioral health personnel (Potter, Baker, Sanders, & Peterson, 2009; Russell & Figley, 2017). In the case of an ASR experienced during a combat-related event, however, the need for an intervention is immediate, and the only personnel available to provide psychological intervention may be other team members who have not received training in managing ASRs.…”

mentioning

confidence: 99%

Rapid response to acute stress reaction: Pilot test of iCOVER training for military units.

Adler¹,

Start²,

Milham

et al. 2020

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective:The purpose of this study was to pilot the iCOVER curriculum-a training product designed to teach service members how to recognize and respond to acute stress reactions (ASRs) using a simple, 6-step procedure, iCOVER. Three goals guided the pilot: (a) assess training acceptability, (b) assess impact of training on knowledge and performance of the iCOVER procedure, and (c) explore the effects of in-person and computer-simulated practical exercises. Method: Six military squads (N ϭ 66) were randomly assigned to 3 conditions: iCOVER Standard (iCOVER instruction with an in-person practical exercise), iCOVER Tech (iCOVER instruction with a computer-simulated practical exercise), or Control (no iCOVER instruction). Squads in the iCOVER conditions received iCOVER instruction, completed a knowledge test and practical exercise to which they were assigned (i.e., Standard or Tech), demonstrated their iCOVER skills in live-action scenarios, and reported their perceptions of the training. Results: iCOVER training was acceptable to most participants and associated with improved knowledge about iCOVER (M pre ϭ 3.33 vs. M post ϭ 5.15; t[42] ϭ Ϫ7.61, p Ͻ .001, d ϭ 1.41); iCOVER Standard resulted in more iCOVER behaviors during a live-action scenario compared with the other conditions, F(2, 35) ϭ 13.36, p Ͻ .001, 2 ϭ 0.43. Compared with iCOVER Tech, iCOVER Standard had greater acceptability and resulted in better performance of iCOVER. Conclusions: This is the first U.S. demonstration of a training program designed to address ASRs during high-risk operations and offers a potential way ahead for preparing military teams to manage ASRs.

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Do the Military’s Frontline Psychiatry/Combat Operational Stress Control Programs Benefit Veterans? Part Two: Systematic Review of the Evidence

Cited by 11 publications

References 91 publications

Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review

Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review

Examining the development of PTSD symptoms in individuals who witness acute stress reaction on the battlefield

Rapid response to acute stress reaction: Pilot test of iCOVER training for military units.

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