Stigma Reduction in the Marine CorpsStigma Reduction in the Marine Corps

Thomas A. Gaskin, PhDUSMC Operational Stress Control and Readiness

(OSCAR) Program Manager

DCOE Stigma Reduction Webinar28 Oct 2010

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Problem and SolutionsProblem and Solutions

Problem:

Stigma:

- Keeps Marines and families from getting the help they deserve.

- Impacts mission readiness, force preservation, and long-term health.

Solutions:

- Educate leaders and Marines on causes and effects of stress

- Normalize deployment-related stress (common, involuntary)

- Reduce institutional sources of stigma (policies, directives)

- Leverage USMC culture at all levels for change

- Publicize good news stories (successes, stats)

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Stress ContinuumStress Continuum

READYREADY REACTINGREACTING INJUREDINJURED ILLILL

• 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

Leader ResponsibilityLeader Responsibility

Chaplain and Medical Responsibility

Chaplain and Medical ResponsibilityIndividual ResponsibilityIndividual Responsibility

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Sources of Stress Injury Sources of Stress Injury

• A beliefs injury

• Due to conflict between moral/ethical beliefs and current experiences

• A fatigue injury

• Due to the accumulation of stress over time

• A grief injury• Due to loss of

people who are cared about

WEARWEARAND TEARAND TEAR

WEARWEARAND TEARAND TEAR LOSSLOSSLOSSLOSSLIFE LIFE

THREATTHREATLIFE LIFE

THREATTHREAT

Intense or ProlongedIntense or ProlongedCombat or Operational Combat or Operational

StressStress

Intense or ProlongedIntense or ProlongedCombat or Operational Combat or Operational

StressStress

INNER INNER CONFLICTCONFLICT

INNER INNER CONFLICTCONFLICT

• A trauma injury

• Due to events provoking terror, helplessness, horror, shock

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Mechanisms of Stress InjuryMechanisms of Stress InjuryMechanisms of Stress InjuryMechanisms of Stress Injury

PsychologicalTrouble making sense of fragmented memoriesSevere self-blame or guiltGrief over lost friends and acquaintancesFeeling out of control

Social/SpiritualCan’t forgive self or othersLoss of trustLoss of purposeLoss of social support

BiologicalMemory problems: Damage to memory centerOverreaction: Lowered threshold for fear responseHypervigilance: Neurotransmitters on overdrive Depression/anxiety: Neurotransmitters get used up Personality change: Diminished control of emotion and impulses

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Barriers to Seeking HelpBarriers to Seeking Help

• Stress injuries are invisible, unlike physical injuries

• Stress injuries can be subtle in their early stages

• Stress injuries may not be evident until return home

• Warfighters hide their stress injuries

– Don’t want to appear weak

– Ashamed to admit problems

– Worried it will affect their career

– Want to return to combat theater with their unit

– Hope it will just go away and not affect performance

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Deployment Cycle TrainingDeployment Cycle Training

• Pre-deployment– Leader Preparation– Warrior Preparation– Family Preparation

• Before Redeployment– Leader Transition– Warrior Transition– Family Transition

• Post-deployment (60-120 days)

– Leader Transition II– Warrior Transition II– Family Transition II

COSC Awareness Briefs

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Five Core Leader FunctionsFive Core Leader FunctionsFive Core Leader FunctionsFive Core Leader Functions

READYREADYREADYREADY REACTINGREACTINGREACTINGREACTING INJUREDINJUREDINJUREDINJURED ILLILLILLILL

Unit LeaderResponsibilityUnit LeaderResponsibility

Chaplain & MedicalResponsibility

Chaplain & MedicalResponsibility

Individual ResponsibilityIndividual Responsibility

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OSCAROSCAR

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How OSCAR WorksHow OSCAR WorksHow OSCAR WorksHow OSCAR Works

OSCAR-trained Marine leaders and peers

(Collateral)

OSCAR-trained medical providers, chaplains, corpsmen, and RPs

(Collateral)

OSCAR-trained mental health providers and psych techs assigned to operational units

(Full-time)

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OSCAR SatisfactionOSCAR SatisfactionOSCAR SatisfactionOSCAR Satisfaction

Do you have the tools you need to help identify and manage combat operational stress in your Marines?

100%

0%

52%

48%

Pre-OSCAR-Training Post-OSCAR-Training

YesNo

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STRESS CONTINUUMBehavioral Health Information Network (BHIN)

Behavioral Health Information Network (BHIN)

• Information portal for Marines, families, educators and caregivers

• Free educational tools and products:– Brochures– Pamphlets– Quick Series– Wallet Cards– Posters– DVD/CD

– Online:

– http://bhin.usmc-mccs.org

Questions?Comments?Questions?Comments?

POC: Dr. Tom Gaskin, PhDPhone: 703-432-9563

Email: cosc@usmc.milWebsite: www.manpower.usmc.mil/cosc