COSC Program Update September 2011 Patricia Powell Program Manager

1. COSC Program Update September 2011 Patricia Powell Program Manager

2. 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)

3. IOM Prevention Model USMC Treatment Providers and Resources USMC and TX Providers and Resources READY REACTING INJURED ILL USMC OSCAR STRESS CONTINUUM

4. Where Are You On The Stress Continuum? REACTING INJURED ILL READY • 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 Chaplain & Medical Responsibility Individual Responsibility Unit Leader Responsibility

5. J-MHAT 7 Assessment Recent findings regarding barriers to mental health care Note: * = USMC numbers in bold higherthan comparative US Army sample.

6. Key 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

7. 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 Readiness • 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

8. OSCAR Team Structure (Infantry) XX DIVISION OSCAR Mental Health Providers (3, full time) OSCAR Psych Techs (4, full time) III INFANTRY REGIMENTS OSCAR Mental Health Providers (2, full time) OSCAR Psych Techs (2, full time) II INFANTRY BATTALIONS OSCAR Mentors (XO, SgtMaj, and selected Marines) OSCAR Extenders (Medical Providers, Chaplain, RP and Corpsmen) I INFANTRY COMPANIES OSCAR Mentors (XO, 1stSgt, and selected Marines) OSCAR Extenders (Corpsmen)

9. OSCAR Training Structure MEF MASTER TRAINERS (56 hour course plus experience training) 100 Certified to train trainers OSCAR TEAM TRAINERS (40 hour course)200 Certified to train team members ADVANCED TEAM MEMBERS (32 hour course)~50 Mentors able to provide informal briefings and assist trainers in conducting Team Training MENTORS(6 hour course) 50–75 per Battalion Mentors able to provide informal briefings

10. OSCAR Training Value for Leaders SgtMaj Barrett, Sergeant Major of the Marine Corps 3 min

11. 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 Ahead

12. Supporting Families • 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

13. Deployment Cycle Training Way Ahead • 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

14. 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 Ahead

15. How You Can Help • Let the Marines own it • Support when asked • Partner with the RTCs • Institutionalize key concepts • Promote seeking leadership tools

16. Points of Contact Questions? Ms. Patricia Powell, Program Manager, COSC patricia.powell@usmc.mil LtCol Curt Strader, OSCAR Lead, COSC curtis.strader@usmc.mil