COSC Program UpdateSeptember 2011

Patricia PowellProgram Manager

COSC Program UpdateSeptember 2011

Patricia PowellProgram Manager

COSC assists Commanders and Marine leaders in maintaining their warfighting capabilities.

• COSC implements activities focusing on:– Force preservation and readiness – Long-term health and well-being of the Marine and their family

• Leaders are key to COSC– Leaders influence prevention, mitigation, early identification and

referral for treatment– Leaders set a command climate to reduce the stigma of seeking

and receiving treatment– COSC utilizes five Core Leader Functions (SMITR) – Supported by Regional Training Coordinators

Combat and Operational Stress Control (COSC)Combat and Operational Stress Control (COSC)

INJUREDINJUREDINJUREDINJURED ILLILLILLILLREADYREADYREADYREADY REACTINGREACTINGREACTINGREACTING

STRESS CONTINUUM

USMC

USMCand

TX Providers and Resources

USMCTreatment Providers and Resources

OSCAR

IOM Prevention ModelIOM Prevention Model

READYREADYREADYREADY REACTINGREACTINGREACTINGREACTING INJUREDINJUREDINJUREDINJURED ILLILLILLILL

Unit LeaderResponsibilityUnit LeaderResponsibility

Chaplain & Medical

Responsibility

Chaplain & Medical

Responsibility

Individual ResponsibilityIndividual Responsibility

• Good to go• Well trained• Prepared• Fit and

tough• Cohesive

units, ready families

• Distress or impairment

• Mild, transient

• Anxious or irritable

• Behavior change

• More severe or persistent distress or impairment

• Leaves lasting evidence (personality change)

• Stress injuries that don’t heal without intervention

• Diagnosable PTSD Depression Anxiety Addictive

Disorder

Where Are You On The Stress Continuum?Where Are You On The Stress Continuum?

Factors that affect your decision to receive

mental health services

Army% agree or

strongly agree: Screen positive

USMC% agree or

strongly agree: Screen positive

Army% agree or strongly

agree: Did not screen positive

USMC% agree or strongly

agree: Did not screen positive

Mental health services aren't available 28.2% 7.9 % 11.2 % 7.0%

I don't know where to get help 17.0 % 5.8 % 4.7% 6.8 %*

It is difficult to get an appointment 31.3 % 11.9 % 11.8 % 6.6%

There would be difficulty getting time off work for treatment

49.3% 24.5 % 19.6 % 18.3 %

It's too difficult to get to the location where the mental health specialist is

32.7% 14.2 % 15.7 % 12.5 %

My leaders discourage the use of mental health services.

15.1 % 9.6% 4.0% 5.2%*

Note: * = USMC numbers in bold higher than comparative US Army sample.

Recent findings regarding barriers to mental health care

J-MHAT 7 AssessmentJ-MHAT 7 Assessment

Key InitiativesKey Initiatives

• COSC training– Deployment Cycle Training, known as

Marine Operational Stress Training (MOST)

• OSCAR Team Training– MARADMIN requires Bn-sized units to train &

maintain OSCAR teams– Outlines certifications & authorized training– Provides guidance to complete reporting

• Resources and tools– Behavioral Health Information Network (BHIN)– Resource map

OSCAR Teams:– Team Members / Mentors (Selected Marines)

– Extenders (Corpsmen, Medical Officers, Religious Ministry Team)

– Providers (Mental Health Professionals)

OSCAR Team Members/Mentors:– Identify small changes in behavior

– Quickly intervene when Marines show signs of negative stress reactions

– Refer for assistance when appropriate

– Reduce stigma concerning behavioral health

– Over 3000 Marines are OSCAR trained

Mental Health Professionals– Embedded at the Division/Regimental level

OSCAR training:

– Builds teams to assist commanders in prevention, early identification, referral and support

– Incorporates mental health providers embedded in the operating forces, where they are needed most

– Develops OSCAR teams across the Marine Air Ground Task Force

Operational Stress Control and ReadinessOperational Stress Control and Readiness

DIVISIONOSCAR Mental Health Providers (3, full time)OSCAR Psych Techs (4, full time)

INFANTRY REGIMENTSOSCAR Mental Health Providers (2, full time) OSCAR Psych Techs (2, full time)

XX

III

II

I

INFANTRY BATTALIONSOSCAR Mentors (XO, SgtMaj, and selected Marines)OSCAR Extenders (Medical Providers, Chaplain, RP and Corpsmen)

INFANTRY COMPANIESOSCAR Mentors(XO, 1stSgt, and selected Marines)OSCAR Extenders (Corpsmen)

OSCAR Team Structure (Infantry)OSCAR Team Structure (Infantry)

MEF MASTER TRAINERS(56 hour course plus experience training)

100

ADVANCED TEAM MEMBERS (32 hour course)

~50

OSCAR TEAM TRAINERS(40 hour course)

200

MENTORS(6 hour course)

50–75 per Battalion

Certified to train trainers

Certified to train team members

Mentors able to provide informal briefings

Mentors able to provide informal briefings and assist trainers in conducting Team Training

OSCAR Training StructureOSCAR Training Structure

OSCAR Training Value for LeadersOSCAR Training Value for Leaders

SgtMaj Barrett, Sergeant Major of the Marine Corps3 min

• MARADMIN

• Sustainment- Certifying Master Trainers in all MEFs & MFR

• Preparing for Generation 2– Lessons learned from 18 months of OSCAR Team Training– Conducting focus groups– Integrating emergent priorities– Developing trainer skills

• Developing specialized training– OSCAR Providers– OSCAR Executive Course

OSCAR Way AheadOSCAR Way Ahead

• Developing strategies with Marine Corps Family Team Building (MCFTB) to:– Raise awareness and provide tools to help identify stress reactions

and refer using a common frame of reference

• Conducted working groups with active duty spouses to review concepts and tools – Instructor Battalion &1/6– Foundational COSC training– Leveraging OSCAR format

• Piloting with I MEF NOV 2011

Supporting FamiliesSupporting Families

• Currently (2005): Marine Operational Stress Training (MOST)– Generic COSC information with a medical bias– Targets Warriors (Marines), Leaders & family members

• Planned– Interactive, small unit discussion; practical use of concepts– Lessons learned from OSCAR Training & Third Location

Decompression– Emerging priorities such as TBI protocols– Content tailored to each specific point on the deployment cycle– Unit leadership & OSCAR Team Members lead discussions– Retain audience focus: Warriors (Marines), Leaders & family members

Deployment Cycle Training Way AheadDeployment Cycle Training Way Ahead

• Finalizing Marine Corps Order• Developing AIRS Checklist• Preparing for Third Location Decompression for PRP & EOD• Updating Deployment Cycle Training (MOST)

FY 2012 Strategy:• Developing a strategic plan• Institutionalizing COSC fundamentals• Supporting the Commandant’s resiliency efforts• Developing specific tool kits• Building a scientific base• Gathering best-evidence• Developing communication plan• Collaboration• Staff development

COSC Way AheadCOSC Way Ahead

Let the Marines own it

Support when asked

Partner with the RTCs

Institutionalize key concepts

Promote seeking leadership tools

How You Can HelpHow You Can Help

Questions?Questions?

Ms. Patricia Powell, Program Manager, COSC

patricia.powell@usmc.mil

LtCol Curt Strader, OSCAR Lead, COSC

curtis.strader@usmc.mil

Points of ContactPoints of Contact