Integrative Health & Wellness (IHW)

What is Integrative Health?

Integrative health is the application of holistic and integrated approaches for enhancing mind–body wellness. Wellness incorporates more social, spiritual and environmental factors and informs discussions in alternative, complementary and integrative medicine. The military population is increasingly using complementary and alternative medicine therapies to enhance traditional medicine therapies they are receiving to treat their psychological health issues.

Why is Integrative Health Important to the Military?

Since the beginning of Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn, more than two million U.S. troops have been deployed in support of these missions. The operational tempo associated with these conflicts—extended and multiple deployments, exposure to nontraditional combat (e.g., use of improvised explosive devices) and shortened time at home between deployments—is unprecedented in the history of this all-volunteer force. In addition to the unique combat missions of OEF, OIF and OND, the U.S. military serves in a variety of peacekeeping and humanitarian roles around the world.

With the varied operational demands of these missions, it is crucial that the military develop, maintain and promote the health and wellness of the total force (service members, their families, civilians and support staff) to sustain force readiness and preservation.

To that end, approaches to health and wellness must reflect a high level of diversity to address the varying needs of the total force. One of DCoE’s primary goals is to promote resilience, recovery and reintegration for service members dealing with psychological health issues and traumatic brain injuries. Integrative health is just such an approach, aiding resilience and recovery.

How is DCoE Implementing Integrative Health?

Creating an integrated framework that can classify health and wellness programs will help the Defense Department more effectively facilitate customization and adoption of effective programs. Further in-depth research, evaluation and discussion with subject matter experts are necessary to ensure that the best mechanisms for tracking health and wellness programs are selected and utilized.

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury are on the forefront of research into integrative health techniques, working to provide resources and guidance on how best to promote the wellness, resilience and performance of the total force. Below is a listing of some of its latest research initiatives.

• Well-being and Its Measurement
  (May 2012) Well-being is linked to several aspects of health, including the psychological, spiritual, social and physical — all components of force readiness. A simple measure of well-being may be a practical indicator of readiness. This paper will first provide a brief overview of the definition and measurement of well-being with an emphasis on its relevance to military readiness. It will then describe a circumscribed collection of population-based measures of well-being which may be useful to assess family and service member readiness. A set of descriptors including clinical, psychometric and practical factors are utilized to assess each measure. Correlations between these measures of well-being and epidemiological factors are discussed. Limits to existing measures are addressed and future directions are offered for consideration.
• Measures of Autonomic Nervous System Regulation
  (April 2011) The autonomic nervous system (ANS) in the human body continuously controls vital functions such as temperature, metabolism, digestion, excretion and cardiac and respiratory activity. The ANS can adjust or modify some functions of the body in response to a perceived threat. "Measures of Autonomic Nervous System Regulation" provides an overview of ANS activity and explores the physiological measurements of stress. The authors provide a summary of more than 50 tools identified for measuring ANS activity in order to facilitate resilience.
• Worksite Health Promotion: Wellness in the Workplace
  (April 2011) Demands from work often affect home life and can contribute to stress-related behaviors for Defense Department employees. These stressors can have a negative impact on physical and mental fitness. On January 4, 2010, the Defense Department announced a department-wide initiative to improve employee wellness. This white paper reviews the available literature on workplace health promotion and provides guidance for developing sustainable worksite health promotion programs. Key points in the paper include (1) leading principles in workplace health promotion that can facilitate change in unhealthy behaviors; (2) barriers to workplace health promotion implementation and development of metrics for program evaluation and (3) actionable options for application of workplace health promotion in the Defense Department.
• Leveraging Technology for Psychological Health and Traumatic Brain Injury
  (February 2011) The Leveraging Technology for Psychological Health and Traumatic Brain Injury white paper was developed by the National Center for Telehealth and Technology (T2), a DCoE center. The paper documents the extent of psychological health issues and TBI in the U.S. military and cites the advantages of a number of technologies in addressing those issues. It details the pervasive penetration of personal technologies in everyday life and describes some of the technologies that T2 and its collaborators are exploring to help service members and families facing psychological health issues and TBI. Finally, it speculates briefly about the future of technology in military psychological health care and considers the next steps for T2 and its associates.
• Mind-Body Skills for Regulating the Autonomic Nervous System
  (June 2011) In this review, the DCoE Resilience and Prevention (R&P) directorate focuses on promising integrative practices (also referred to as mind-body practices) for regulating stress via the autonomic nervous system. The practices are focused specifically on integrative mind-body techniques designed to help regulate and manage stress, emotions and arousal (i.e., strategies for lowering anxiety when it is too high or for increasing arousal when it is too low). Routine pharmaceutical and psychological interventions are often a last resort for helping people manage stress and their emotions. Consideration of the spectrum of mind-body approaches to help mediate and manage stress before it becomes too intense to self-manage provides a preventative approach to strengthening resilience and prevention of psychological health difficulties.
• Identification of Best Practices in Peer Support: White Paper
  (January 2011) As part of its ongoing mission, DCoE explored how to most effectively apply the model of peer support in the military environment. Peer-to-peer programs facilitate opportunities for individuals to talk with trained peer supporters who can offer educational and social support and provide avenues for additional help if needed.
• Review of Well-Being in the Context of Suicide Prevention and Resilience
  (April 2011) Well-being has been identified as a critical aspect of military readiness by both Defense Department leaders and health care experts, including the DoD Suicide Prevention Task Force. This paper, which was presented at the 2011 NATO Research and Technology Organization (RTO) conference "Mental Health and Well-being Across the Military Spectrum" in Bergen, Norway, includes a summary of definitions, dimensions and measures of well-being. It also provides practical tools and recommendations for enhancing well-being and resilience in military groups while reducing the risk for negative outcomes such as suicide.