By Richard Meldrum and Melissa McKeveny
Mental health in the military is an increasingly pressing and prevalent issue. According to the National Council for Mental Wellbeing, 30 percent of active duty and reserve personnel who served in Iraq or Afghanistan – 730,000 warfighters – have a mental condition that requires treatment. Yet less than 50 percent of veterans returning from overseas deployment receive any professional help. 22 veterans die by suicide daily, and a 2014 JAMA Psychiatry study concluded that one in four warfighters struggle with symptoms of a mental health issue.
Traditionally, achieving and preserving the physical readiness of active duty and reserve personnel has been the main focus. Yet in recent years, a wide range of initiatives across all branches of the armed forces have kickstarted a more holistic approach to warfighter health and resilience that incorporates family dynamics, emotional wellbeing, cognitive performance, and more.
Still, it is common for sports scientists to shy away from the psychological and emotional components of performance. The reason: they are harder to measure than physical attributes. But what gets measured, gets attention. Which is why, as a human performance industry, we must use all the tools at our disposal to help monitor, assess, and support warfighters’ mental and emotional health.
In this article, we’ll explain how daily monitoring and data collection can be used to help quantify, build awareness, normalize, and improve the mental health of the warfighter.
Identifying and Presenting Indicators of Mental Health Issues
Many units are currently using technology to capture warfighters’ self-evaluations of sleep quality, energy levels, soreness, and more. They are also recording daily assessments for Rate of Perceived Exertion (RPE) and other factors relating to physical load, as well as more objective measurements like duration and intensity of training, activity type, and so on.
Such self-reporting can be extended to include regular surveys on mood, emotional state, and other indicators of cognitive and mental wellbeing. The process to identify which information is most pertinent to psycho-emotional health should start with a unit’s performance team asking, “What are the correlating risk factors for mental issues?”
Once they have come up with a list of these – which could include feelings of anger, anxiety, and depression – the next check box is deciding how to measure them. Then a cross-department group can determine which technology can be utilized to gather the required data, and decide how information will be presented and to whom.
The latter should be focused on two groups. First, the chain of command needs to decide what kind of data should be shown to the warfighters themselves. Empowering individuals to make better and more proactive decisions that positively impact their psychological and physical health starts by making them aware of what’s going on in real-time.
Second, cognitive and emotional data needs to be made available to authorized staff who oversee the wellbeing of warfighters in various ways so they can keep tabs on the mental state of the personnel in their charge and respond quickly to any red flags that might be raised by certain data points or trends. This list could include psychologists, chaplains, coaches, commanding officers, counselors, and more.
Normalizing a Focus on Emotional Wellbeing
Another benefit of collecting, collating, and presenting psychological data on a daily basis is that it starts to destigmatize mental health.
Warfighters are constantly competing against each other in training and during selection processes. As a result, they are often uncomfortable with disclosing anything they believe could be viewed by their peers or instructors as weakness or vulnerability.
By making it clear that the chain of command is putting an emphasis on psychological wellbeing, providing resources that can help warfighters work through any issues they might be having, and offering convenient access to cognitive data, units can start to normalize talking about and taking action on mental health.
The POTFF (Preservation of the Force and Family) program has made great strides in this area. It is also helping special forces units better understand the importance that support networks play in preserving the emotional wellbeing of personnel.
POTFF was initiated in response to rising rates of domestic violence, divorce, suicide, depression, and self-harm among operators and has been successful in drawing attention to the issues that underlie such problems. Technology-based monitoring can be implemented to extend the impact of POTFF and related initiatives.
When data is managed across the full lifecycle of warfighters and combines physical, mental, emotional, and even spiritual elements, it makes it easier for distinct domains to speak a common language regarding the care for personnel – particularly those who are suffering from a chronic mental health condition.
In addition to capturing data daily, historical analysis can help practitioners identify trends and highlight factors that can predispose someone to a higher risk of suicide, clinical depression, domestic violence, and other issues.
For example, the JAMA Psychiatry study mentioned earlier noted that a traumatic life experience before an individual enlists in the armed forces makes them more likely to suffer from a mental health disorder. Other research has identified a correlation between ongoing feelings of anger and emotional problems after returning from a tour of duty, while a paper published in Depression & Anxiety noted a connection between how cohesive a warfighter believes their unit to be and their likelihood of developing post-deployment mental health issues.iv
Using a system like the Smartabase Tactical Performance Platform can provide both an up-to-date snapshot of where each warfighter is from a mindset perspective and incorporate older information to provide greater context and feedback to the individual and those responsible for their performance and wellbeing. In this way, personnel can make better decisions that benefit them and their families.
Connecting Subjective and Objective Data to Create Context
Data collection and visualization help identify blind spots. Most warfighters know what they’re good at but many are surprised to learn that they don’t recover adequately or are emotionally volatile.
Presenting data from daily surveys in a simple, intuitive, and usable way can illuminate issues an individual might have previously failed to recognize so they can take charge of their mental health. Such subjective information can also be combined with objective data concerning sleep duration and quality, HRV, and other quantitative measurements that can be tied back to emotional regulation and cognitive performance.
To this point, the authors of a review titled Sleep in the Military stated, “Sleep disturbances are a common reaction to stress and are reliably and prospectively linked with a host of adverse mental and physical health outcomes, including increased risk of depression, suicide, posttraumatic stress disorder (PTSD), accidents and injuries, cardiometabolic disorders, and mortality.”v
Overlaying survey data about how well-rested an operator feels each morning and what their emotional state is (e.g., calm, worried, or anxious) with sleep scores and other metrics can help identify an issue and allow the warfighter to double down on their sleep hygiene, which will in turn positively influence their mental health.
The Department of Defense has identified the Human Weapon System as the most valuable resource the military has. The level of investment in each warfighter is significant and, in the case of operators, can run into millions of dollars. Protecting this investment should start with every branch of the military finding ways to safeguard the mental health of its personnel and their families. Technology might not be a cure-all on this front, but it can be an effective part of a holistic, human-centric approach.