A new study from the RAND Corporation has found that the Marine Corps' stress control and readiness program — while popular with commanders — is popular with commanders, but has no positive impact on Marines' mental health or related symptoms. However, Marine officials, however, say they plan to continue using an improved version of the program into the post-Afghanistan era.
The 151-page RAND report, published last month by the Rand Corporation, is based on surveys of more than 1,300 Marines who deployed to Afghanistan or Iraq between March 2010 and December 2011. The study compares the outcomes for Marines who received training from the Marines' Corps-wide Operational Stress Control and Readiness Program — or OSCAR — against a control group of Marines who did not receive the training.
While the study did find Marines in OSCAR-trained battalions to be more likely to report seeking help from fellow Marine unit members and corpsmen to deal with personal stress, they were not more likely to seek help from outside medical providers. Moreover, the study found, the prevalence of stress-related conditions or mental health outcomes — such as major depression, post-traumatic stress disorder, and alcohol and substance use — were unaffected by OSCAR participation.
"This evaluation did not find evidence of OSCAR's effectiveness that would support the continuation of OSCAR in its current form," a report summary concludes. The study's authors recommend significant changes to the Corps' approach to dealing with combat stress and training, including pushing the training down through the ranks as far as the squad leader level and identifying patterns of support-seeking and help-seeking in more detail.
OSCAR became a mandated service-wide tool for the Marine Corps in 2012, having been used in a more limited capacity since 1999. Designed to operate at the battalion and company levels, it partners unit leaders, chaplains and medical staff in OSCAR "teams" to streamline support for Marines in need and, ultimately, improve combat and operational stress outcomes.
The Marine Corps has altered the OSCAR program to become more evidence-based since RAND collected its research data, said Master Gunnery Sgt. Phillip Bush, a senior enlisted adviser for Suicide and Operational Stress Control within the Marine and Family Programs Division for Headquarters Marine Corps.
"The efforts involve continuous workforce development by equipping staff with training and support to implement new and evidence-based practices across the spectrum of the OSCAR," Bush said, in an emailed response to questions from Marine Corps Times regarding the RAND study. "An evidence-based program demonstrates effectiveness when evaluated in the target population using the most rigorous research methods."
Bush did not offer specific examples of ways the program's effectiveness had been demonstrated.
The RAND report's authors and Bush did agree that OSCAR was supported by and in keeping with the ethos of the Marine Corps. Even while Marine survey respondents reported limited effectiveness for the OSCAR program, most said they would increase the budget for OSCAR, or maintain it at its current rate.
In interviews with 18 battalion commanders, researchers found they unanimously linked combat and operational stress management to effective leadership, rather than any kind of medical or external intervention.
"Overwhelmingly, commanders voiced positive opinions of OSCAR because they view it as consistent with their existing principles of effective leadership," the study's authors wrote. "They noted how OSCAR normalizes open communication about stressful experiences and psychological reactions, provides a common language for communicating about stress, and mobilizes and reinforces peer support without involvement of external resources or authorities."
The RAND report did find that OSCAR-trained Marines were more likely to seek support for occupational stress. Among troops in trained battalions, 72 percent reported seeking support from a fellow Marine, compared with 63 percent in control battalions. They reported seeking support from a unit leader at a rate of 43 percent, compared to 36 percent for the control group.
However, Marines appeared to be more likely to reach out to peers and superiors with whom they already had a relationship, rather than to members of the designated OSCAR "team." Surveyed members of the team reported they had "seldom received consults, referrals, or requests for assistance" in the month preceding pre- and post-deployment surveys.
The report makes four primary recommendations:
- That the Marine Corps review its stress control programs to reduce duplication of efforts and training that one Marine described as "overkill."
- That officials identify changes to the design and implementation of training to increase its effectiveness, including pushing training down to the squad leader level.
- That the service Marines conduct pilot test changes to the existing OSCAR program in efforts to impact Marines' behavior and reactions in real-world scenarios.
- That the Corps expand the evidence base regarding operational stress management to learn what really works.
Improvements to the current OSCAR course reflect these RAND findings, Bush said. The Marine Corps, he said, plans to continue to use OSCAR into the future, regardless of whether troops are deploying to combat.
"OSCAR content is relatable to the entire Marine air-ground task force, to Marines who have and have not deployed, and to Marines facing the challenges of a drawdown," he said.
And more future improvements are planned for the program, Bush said. OSCAR administrators plan to integrate bio-feedback mechanisms, he said, which measure neurological responses to stressors. They'll also and improve the program's review of mental health, first aid, and tools to combat negative thinking and regulate emotions, he said.
