PM2ch48.pdf

MILITARY PREVENTIVE MEDICINE:

MOBILIZATION AND DEPLOYMENT

Volume 2

Section 8: Postdeployment

The medical and psychological effects of deployment do not necessarily dissipate once the deployment is over. Service

members and their families make significant, though incompletely understood, sacrifices during deployment and may

need to make major readjustments after the deployment ends. This is not a new phenomenon, but it has been much

better illuminated in the wake of the Persian Gulf War.

Department of Defense Photograph: Defense Visual Information Center photo identification number DDST9209054.

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Psychological Aspects of Deployment and Reunion

Chapter 48

PSYCHOLOGICAL ASPECTS OF

DEPLOYMENT AND REUNION

JAMES E. MCCARROLL, P H D, MPH; KENNETH J. HOFFMAN, MD, MPH; THOMAS A. GRIEGER, MD;

AND HARRY C. HOLLOWAY, MD

INTRODUCTION

THE NATURE OF CURRENT MILITARY OPERATIONS

Military Operations from World War II to the Post–Cold War Environment

Current US National Strategy

Environmental, Psychological, and Moral Factors in Operational Stress

STRESSORS IN MAJOR DEPLOYMENTS IN THE 1990 S

The Persian Gulf War: Operations Desert Shield and Desert Storm

Somalia: Operations Restore Hope and Continue Hope

Haiti: Operation Uphold Democracy

Bosnia: Operation Joint Endeavor

PSYCHOLOGICAL EFFECTS OF PREDEPLOYMENT, DEPLOYMENT, AND

REUNION ON THE SERVICE MEMBER

Predeployment

Deployment

Reunion

PSYCHOLOGICAL EFFECTS OF PREDEPLOYMENT, DEPLOYMENT, AND

REUNION ON FAMILY MEMBERS

Spouses

Children

SURVEILLANCE RESEARCH DURING DEPLOYMENT

Surveillance Research in the Baltic States

Post-Bosnia Medical and Psychological Surveillance

Psychometric Tests and Epidemiology

COMMAND AND MEDICAL CONSULTATION

Infectious Diseases

Chemical and Biological Agents

Prophylactic Medications

PREVENTION AND TREATMENT OPTIONS

Preventive Interventions

Training of Medical Professionals

Booklets, Pamphlets, Training Manuals, and Models

Debriefing as a Preventive Mental Health Strategy

Use of Psychotropic Medications

THE NEED FOR RESEARCH ON REUNION ISSUES

SUMMARY

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Military Preventive Medicine: Mobilization and Deployment, Volume 2

J.E. McCarroll ; Colonel (Retired), MS, US Army; Research Professor, Department of Psychiatry, Uniformed Services University of

the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799

K.J. Hoffman ; Colonel, Medical Corps, US Army; Medical Director, Population Health Programs, Office of the Assistant Secretary

of Defense (Health Affairs)/TRICARE Management Activity, 5111 Leesburg Pike, Falls Church, VA 22041

T. A. Grieger ; Captain, Medical Corps, US Navy; Associate Professor, Department of Psychiatry, Uniformed Services University of

the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799

H.C. Holloway ; Colonel (Retired), Medical Corps, US Army; Professor of Psychiatry, Department of Psychiatry, Uniformed Services

University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799

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Psychological Aspects of Deployment and Reunion

INTRODUCTION

A deployment is a military operation in which

the service member is sent from the home station,

usually as a part of a military unit, to a distant lo-

cation to accomplish a special mission. Routine

training is not included in this definition. Families

are not permitted to accompany him or her. Both

deployment and reunion are often stressful for ser-

vice members and their families. An increased

knowledge of the stresses of predeployment, de-

ployment, and reunion will help commanders and

medical personnel develop preventive measures to

counter them. In this chapter we present a brief his-

tory of deployments in the post–Cold War environ-

ment and give illustrations of the stressors in four

of the most prominent recent ones: the Persian Gulf

Wa r, Somalia, Haiti, and Bosnia. We present and dis-

cuss deployment issues that affect service members

and family members and the command and medi-

cal actions that might be taken to prevent or ame-

liorate them.

THE NATURE OF CURRENT MILITARY OPERATIONS

Military Operations from World War II to the

Post–Cold War Environment

Large numbers of US personnel were assigned to

installations in Europe and Asia to preclude overt

aggression by Communist forces. The US Navy and

Air Force developed and deployed highly advanced

weapons platforms. Deployments could generally

be planned and careers scheduled around deploy-

ment cycles, particularly in the Navy. Even though

separation from families and the high tempo of

training took their toll, there was seldom a direct

threat of loss of life and limb, as compared with war.

With the fall of the Soviet Union and the collapse

of the Warsaw Pact in 1989, multiple areas of re-

gional instability became the focus of US political

leadership. The military forces of the United States

have taken on new missions and roles that challenge

the capabilities and ingenuity of service members

and their military and civilian leaders. Much of the

deployment effort is now shared by active duty and

reserve units, which are often activated and de-

ployed for several months. Differences in training,

experience, and equipment between active duty and

reserve units and the short-notice activation of units

have proved highly disruptive to both the military

and family environments.

There have been substantial modifications in the

nature of military operations since World War II,

with a broadened spectrum of experiences for service

members and their families. World War II typified

the long-duration war in which there were peaks

and valleys of combat intensity. Massive numbers

of personnel, ships, and aircraft were engaged in

battle theaters throughout the world. Soldiers, sail-

ors, and Marines were involved for the duration of

the war or until a wound or other medical or psy-

chiatric condition required their evacuation.

The Korean and Vietnam wars were more limited

in scope, even though the Korean War involved

large-scale land and air campaigns, and the Vietnam

War lasted longer than World War II. The overall

mission, politically and militarily, in both these latter

conflicts was less clearly defined than it was in

World War II. Both represented combat phases of

the much-longer global Cold War between the

United States and its allies and the Soviet bloc of

nations. The desire to limit the spread of communism

was balanced by the fear of extensive involvement

in a land war against the communist superpowers.

Ground efforts were limited geographically and

bombing missions for aircraft were tightly controlled.

Politically, the Cold War was marked primarily

by postures of conventional warfare, wars of national

liberation, terrorist groups of various ideological

commitments, and nuclear deterrence. The world

was roughly divided into a Western bloc plus Japan

and other Pacific nations; a Communist block that

included the Soviet Union, the Warsaw Pact nations,

and the People’s Republic of China; and third-world

countries, many of which varied in their alliances

between the Western and Communist blocs. Mili-

tarily, it was characterized by global deployment.

Current US National Strategy

The National Security Strategy for the United

States was outlined in a White House publication. 1

The United States must be able to respond to cri-

ses, such as threats to vital national interests. These

interests are of broad, overriding importance to the

survival, safety, and vitality of the nation, and they

affect both national well-being and the character of

the world. Among these are humanitarian crises,

natural disasters, and manmade disasters or gross

violations of human rights that demand action. For

the foreseeable future, the United States and its al-

lies must be able to deter and defeat large-scale

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