By Capt. Rita G. Simmons, Ph.D., MSC, commanding officer, Naval Health Research Center
Readiness Through Research and Development, at the Naval Health Research Center (NHRC), that’s not just our motto, it’s what we do. Every day, our scientists are doing incredible work, studying how physical and psychological stressors impact our warfighters. After more than a decade of war, we know that the stressors of military service on top of the day-to-day stressors we all face can take a toll on our active duty population and their families.
The research we conduct to gain a better understanding of psychological illnesses and injuries is an urgent and vital part of our mission. But, research alone is not enough. Scientists at NHRC take the knowledge acquired from their research and develop it into practical applications designed to help lessen the impact of psychological stressors on our warfighters with the goals of improving their mental health and supporting operational readiness.
When it comes to research and development aimed at improving psychological health, we are leading the way in identifying gaps in mental health research, developing methods for early identification of psychological illnesses and injuries, and designing more effective prevention and intervention strategies.
Mental Health Research
NHRC spearheads the Millennium Cohort Study, the largest longitudinal study in military history with more than 200,000 participants. Using data from the study, NHRC researchers have been able to better understand the factors that impact the psychological health of our service members. From learning more about risk factors for suicide, depression, and post-traumatic stress disorder (PTSD) to deepening our knowledge of protective factors that promote resilience, our research findings are helping military leaders and clinicians develop better ways to safeguard the psychological health of our warfighters.
The Recruit Assessment Program (RAP) was initiated by NHRC in 2001 to assess baseline, pre-service psychological health data to better understand the health outcomes of military service. Using this information, researchers will be able to study the impact of service and deployment-related stressors on the psychological health of service members, by accounting for childhood psychosocial experiences and baseline psychological health.
In addition to our larger, long-term studies, our agile team of scientists works on numerous projects that contribute to the growing body of research regarding many psychological health concerns. These include:
- Studying environmental factors associated with substance abuse to identify risk and protective factors related to alcohol misuse.
- Identifying the risk and resilience factors that contribute to mental health problems among Navy hospital corpsmen due to the unique stressors of their occupation.
- Researching ways to identify brain-based biomarkers of PTSD using source-level electroencephalogram (EEG) analysis.
Research contributes to a better understanding of the problems our service members, clinicians, and leaders face when it comes to maintaining, improving, and restoring the mental health of our operational forces. Armed with the knowledge gained by research, the NHRC team develops practical applications—translational research—that will positively impact the psychological readiness of our armed forces.
Identification of Psychological Illness and Injury
Being able to identify a mental illness or injury before it becomes debilitating, either on an individual or force level, helps ensure that our military is mission ready. A service member with a full-blown psychological illness or injury may require extensive treatment and no longer be medically ready for duty. This not only impacts the individual, it also affects unit readiness. Prevention through early detection is key to good mental health and readiness.
One way our researchers at NHRC are working on the early detection of behavioral health problems, including suicidal ideation, is through the U.S. Naval Unit Behavioral Health Needs Assessment Survey (NUBHNAS). The assessment addresses behavioral health topics including PTSD, suicidal thoughts, sexual assault, anxiety, depression, sleep disturbances, and mental health stigma.
The goal of NUBHNAS is to improve the individual readiness of service members by conducting an anonymous behavioral health assessment and providing individual feedback as well as a unit leadership debrief. The debrief, comprised of non-identifiable information, provides a snapshot of the current status of the unit’s behavioral health. Using the information provided by NUBHNAS, leaders have the potential to improve force readiness and reduce PTSD and suicide rates through early detection and corrective action.
Other areas of research at NHRC aimed at early detection of mental health problems include:
- The Primary Care Screening Methods (PRISM) study to develop a more reliable screening tool for use by primary care providers to identify patients at high risk of suicidal behavior.
- Development of a computer-based suicide risk assessment tool that can help clinicians and leaders identify service members at risk by calculating a suicide risk score through an analysis of individual risk and protective factors.
By developing the tools to detect mental and behavioral health concerns before they become incapacitating illnesses and injuries, NHRC’s research is supporting clinicians and unit leaders in their efforts to preserve individual readiness and maintain a mentally fit and psychologically ready fighting force.
Effective Intervention Strategies
The final piece of the research puzzle is taking our findings from the many studies we do at NHRC and transforming it into something actionable. All the knowledge in the world doesn’t hold much value if it isn’t useful. The team at NHRC excels at taking research and translating it into real-world, actionable strategies.
Promoting psychological health through building resilience, reducing stigma, managing stress, and facilitating positive behavior change is an important aspect of our work and we have developed several evidence-based products that do just that.
- The Post-Deployment User’s Guide is a self-help workbook for service members returning from combat to help them manage their transition, reduce stress, and optimize positive factors.
- Educational materials for leaders to help them proactively support reducing stigma associated with seeking help for mental health issues.
- Life After Service is a workbook designed to support transitioning service members as they reenter civilian life with a focus on behavioral health concerns— social ties, anger, pain, and sleep.
- Substance abuse prevention campaign materials designed to reduce high risk drinking and improve readiness.
- A graphic novel, The Docs, developed to prepare Navy corpsmen for the stresses of combat deployment and to teach them psychological first aid.
In addition to our products, researchers at NHRC are also currently developing interventions to improve the mental health outcomes of target populations. These include:
- A new treatment for comorbid PTSD and depression that combines evidence-based treatment for both diagnoses (cognitive processing therapy and behavioral activation) and compares the effectiveness of the combined treatment to cognitive processing therapy alone.
- An intervention for Marine Corps recruits with musculoskeletal injuries that improve their psychological health during their recovery phase to reduce recovery times and improve graduation rates.
- Implementation of a customized program for the Navy’s Explosive Ordnance Disposal (EOD) operators that helps them achieve and maintain peak physical and psychological performance.
At NHRC, when we say readiness through research and development, that is exactly what we mean. We work to ensure that our warfighters are psychologically ready, whether on the battlefront or the home front, by using our research as the catalyst for the development of practical applications.