US Army psychiatrist Captain Fredrick Hanson institutionalized forward treatment of combat stress during World War II.

The operational environment of today's military exposes Service members and units to many unforeseen demands. The need to perform under these difficult situations can cause stress reactions. Although stress can have the beneficial effect of sharpening the senses, impelling acts of heroism, and drawing a unit's members closer together, when a Service member's ability to deal with stress is exceeded, the consequences may be operationally significant. Independent of whether these consequences are behavioral or physical manifestations, the net result is a loss of manpower and constrained unit resources. The commander's management of stress during these military operations is critical to ensuring mission accomplishment, military readiness and health protection.

Current Situation: To satisfy this training need and to further the dialogue, in October 2000, the Under Secretary of Defense (Personnel and Readiness) established the DoD working group on Human Performance and Military Resiliency. This working group includes representation from the four military Services and the Military Veterans Health Coordinating Board. The underlying objective of this working group is to develop recommendations for enhancing human performance in concert with reducing psychological casualties, before, during and after deployments.

Events for Stress Management: LEADERS AND OPERATIONAL STRESS CONFERENCE - This conference was co-sponsored by the JCS, the FHP&R and OSD (HA). The "Leaders and Operational Stress" Conference was held June 2000 at Ft. McNair. The objectives of the conference were: to initiate a continuing dialogue between the operational, medical and religious communities; to ensure that Service policies implementing the DoD are operationally functional; and to identify assets and training for Command. There were keynote speakers from all the services, Service panels and a Hotwash session. The content was targeted towards the warfighting community. There were over 250 attendees from all five Services, including over 25 active duty and retired officers of flag rank.

• Department of Defense Directive 6490.5. Combat Stress Control Policy. DoDD 6490.5.

Publications:

• Linking Combat and Physical Health: The Legacy of World War II in Men's Lives
• Combat Stress Control Detachment: A Commander's Tool
• A Review of the Scientific Literature As it Pertains to Gulf War Illnesses, RAND report. Vol 4. Stress
• Psychological and Psychosocial Consequences of Combat and Deployment, RAND report. Vol 8.
• Office of the Inspector General, DoD, Report No. 96-079, Feb. 1996, Management of Combat Stress Control in the Department of Defense.
• Institute of Medicine National Research Council, Strategies to Protect the Health of Deployed U.S. Forces.