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Research Questions

  1. How did OSCAR affect Marines' attitudes toward stress response and recovery?
  2. How did OSCAR affect Marines' mental health?
  3. Did Marines perceive any stigma around seeking help for mental health?
  4. What were Marines' general mental health and alcohol use like pre- and postdeployment and with and without OSCAR training?
  5. What were Marine leaders' perceptions of whether OSCAR training improved attitudes toward stress response and recovery, unit cohesion and morale, and the stigma of mental health and health seeking?
  6. How did leaders perceive their abilities to prevent, identify, and manage combat stress problems in the unit?

The Marine Corps Operational Stress Control and Readiness (OSCAR) program embeds mental health personnel within Marine Corps units and extends their reach by training officers and noncommissioned officers to recognize Marines showing signs of stress and intervene early. RAND Corporation researchers conducted an outcome evaluation of the OSCAR program that included four components: (1) a quasi-experimental study that compared Marines in OSCAR-trained and non–OSCAR-trained battalions on a wide array of stress-related outcomes before and after deployment, (2) a longitudinal pre- and postdeployment survey of perceptions of OSCAR among Marines who attended OSCAR training, (3) focus groups with Marines, and (4) semistructured interviews with commanding officers of battalions that had received OSCAR training. Results indicated that, after the authors adjust for a wide array of baseline characteristics and deployment experiences, Marines in OSCAR-trained battalions were more likely than those in non–OSCAR-trained battalions to report having sought help with stress problems from a peer, leader, or corpsman — behavior that is consistent with OSCAR goals. In addition, Marines considered OSCAR a valuable tool for enhancing combat and operational stress response and recovery efforts in the Marine Corps. However, this evaluation did not find evidence that OSCAR affected the key mental health outcomes it was designed to address. Thus, the results of this evaluation do not support the continuation of OSCAR in its current form. Based on lessons learned about OSCAR from this evaluation, other research, and best practices for program improvement and implementation, recommendations for improving combat and operational stress training in the Marine Corps are offered.

Key Findings

OSCAR Increases the Use of Support for Stress Problems, but There Was No Evidence of an Impact on Marines' Mental Health Status or Any Other Outcomes

  • The effects of OSCAR on support-seeking behavior persisted after adjustment for baseline characteristics and deployment experiences.
  • This evaluation did not find evidence that OSCAR had an impact on mental health stigma or mental health outcomes.

OSCAR Is Perceived as a Useful Tool for Combat and Operational Stress Control

  • Battalion commanders valued OSCAR because it aligns well with their understanding of their roles as leaders.
  • Officers and enlisted Marines voiced support for the principles that underlie OSCAR — in particular, the emphasis on peer support and avoidance of medical intervention through early identification and management of stress and mental health problems.

Potential Problems Were Identified

  • Many Marines complained of having received too much training on combat and operational stress.
  • Some Marines suggested that annual trainings, regardless of deployment, would help to keep Marines in a state of readiness for future combat deployments.
  • Significant variation in outcomes across OSCAR-trained battalions might indicate that OSCAR was not implemented consistently across the battalions.

Recommendations

  • Review and streamline Marine Corps combat and operational stress–control training programs.
  • Identify and reduce duplication of effort in combat and operational stress–control trainings.
  • Enhance the use of a common language for concepts related to combat and operational stress control across combat and operational stress–control training programs.
  • Ensure that combat and operational stress–control program trainers have combat experience.
  • Identify potential changes to the design and implementation of combat and operational stress–control training.
  • Consider providing combat and operational stress–control training to all Marines in the chain of command, down to the level of squad leader.
  • Integrate combat and operational stress–control training into the deployment cycle and maintain it regularly among nondeploying troops.
  • Pilot-test changes to combat and operational stress–control training.
  • Expand the evidence base regarding operational stress management.
  • Examine patterns of support-seeking and help-seeking in more detail.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Development and Description of the Operational Stress Control and Readiness Program

  • Chapter Three

    Evaluation of OSCAR's Impact on Help-Seeking and Mental Health: Individual Marine Survey

  • Chapter Four

    OSCAR Team Members' Perceptions of OSCAR's Impact on Combat and Operational Stress Control: OSCAR Team Member Survey

  • Chapter Five

    Officers' and Enlisted Marines' Perspectives on OSCAR: Focus Groups with Marines

  • Chapter Six

    Commanding Officers' Perceptions of OSCAR: Interviews with Battalion Commanding Officers

  • Chapter Seven

    Conclusions and Recommendations

  • Appendix A

    Theoretical Background of OSCAR

  • Appendix B

    Pre- and Postassessment of January 2010 Operational Stress Control and Readiness Training

  • Appendix C

    Detailed Description of Individual Marine Survey Methods

  • Appendix D

    Supplemental Descriptive Statistics from the Individual Marine Survey

  • Appendix E

    Sensitivity Analyses for the Individual Marine Survey

  • Appendix F

    Attrition Analysis for OSCAR Team Member Survey

This research was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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