Mortuary Affairs Soldiers: Early Intervention and Altering Barriers to Care for Traumatic Stress and PTSD

PUBLIC ABSTRACT

The sustained operations, combat environment includes ongoing exposure to threat to life, risk of injury, and potential exposure to the bodies of our dead, and those of enemy soldiers and civilians including women and children. Exposure to war dead in soldiers is associated with psychiatric distress and illness including post-traumatic stress disorder (PTSD). Our group has done much recognized work in this area. However, little is known about the specific effects of exposure to war dead on those who work with the dead as part of their military job while working in the high stress environment of sustained operational combat. In particular, little is known regarding risk and protective factors of Mortuary Affairs (MA) soldiers operating in the high intensity combat environment of Iraq and Afghanistan, despite the fact that these individuals are under extremely demanding conditions, exposed to known risks of PTSD, and reported by commanders to be suffering decreased operational effectiveness. This study has implications for early intervention, training, education, leadership, and health surveillance of MA soldiers. Findings will identify resilience factors including preparation, training, and education of troops for stressors of deployment and working with the dead, as well as risk factors for performance breakdown, stress, and psychiatric illness.

This proposed project will implement and assess a unique and newly developed early intervention designed to meet the specific needs of MA soldiers for early intervention to speed recovery and return to work and to limit barriers to care through enhanced buddy care and spouse support. We will assess short and longer-term outcome of the intervention on traumatic stress, PTSD, Depression, marital conflict, work function and barriers to health care utilization.

Using evidenced-based and informed principles of cognitive therapy, psychological first aid, and stepped care models of community outreach, CSHG focuses on education and training (a) MA soldiers and (b) their "buddies" and "spouses" to (1) identify soldiers in need of care, (2) provide early support to foster more rapid recovery, and (3) promote health care seeking when needed to overcome individual soldier and practical barriers to care.

Aims: (1) Identify the stressors (including combat exposure, exposure to the dead, and stressful deployment events) of deployment to the Middle East and return in MA soldiers. (2) Demonstrate the feasibility of CSHG early intervention for care, support, and lessening barriers to care for MA soldiers. (3) Assess the effectiveness of CSHG on traumatic stress, PTSD, depression, marital conflict, work function, and barriers to health care utilization.