Marines in Afghanistan Test New Concussion Care

WASHINGTON, Jan. 27, 2011 — A new con­cus­sion care pro­gram being field­ed by the Marine Corps in Afghanistan is giv­ing psy­chi­a­trists, physi­cians and even chap­lains and sergeants a bet­ter way to treat those with the No. 1 bat­tle injury, mil­i­tary com­bat med­i­cine experts said today.

Navy Cmdr. (Dr.) Charles Ben­son, 1st Marine Expe­di­tionary Force psy­chi­a­trist and 1st Marine Division’s deputy sur­geon, and Navy Cmdr. (Dr.) Kei­th Stues­si, direc­tor of the Con­cus­sion Restora­tion Care Cen­ter at Camp Leath­er­neck in Afghanistan, spoke with Pen­ta­gon reporters in a video teleconference. 

The Navy-Marine Corps effort, launched in August and called the Oper­a­tional Stress Con­trol and Readi­ness Pro­gram, or OSCAR, has two parts, Ben­son said. 

“The first part [includes] psy­chi­a­trists and psy­chol­o­gists who we field with the com­bat team,” Ben­son explained. “These are organ­ic embed­ded assets in the division’s reg­i­ments and bat­tal­ions. They live with the troops, train with the troops and get out in the field with them.” 

Such an arrange­ment, he added, “allows the Marines to come for­ward to the psy­chol­o­gists and psy­chi­a­trists [and] kind of breaks down the bar­ri­ers and allows the [providers] to become very effec­tive at … deliv­er­ing men­tal health care.” 

The sec­ond part of the pro­gram offers spe­cial train­ing to med­ical offi­cers, corps­men, chap­lains, reli­gious per­son­nel and key lead­ers at the sergeant and first sergeant lev­el so they can deliv­er basic men­tal health care to troops in harm’s way. 

“Those folks con­stant­ly mon­i­tor their Marines,” Ben­son said, “help­ing them with sim­ple issues and under­stand­ing at what point [a Marine with an injury] needs to be referred back for more com­pre­hen­sive care.” 

Togeth­er, the pro­grams “have gen­er­at­ed quite a bit of suc­cess out here in Afghanistan,” the psy­chi­a­trist said, treat­ing con­cus­sions and mus­cu­loskele­tal injuries — the No. 1 non­bat­tle injuries of the war. 

Stues­si, a sports med­i­cine doc­tor, described a typ­i­cal Con­cus­sion Restora­tion Care Cen­ter suc­cess story. 

“I first saw Lance Cor­po­ral Smith on Jan. 3, three days after he was mede­vaced to Bas­tion Role 3 hos­pi­tal because of injuries suf­fered from [device road­side bomb] blast while on a rou­tine con­voy,” he said. 

Smith was dis­charged from the hos­pi­tal and referred to the out­pa­tient con­cus­sion cen­ter, where he com­plet­ed a ques­tion­naire about the blast and his symp­toms, and went through a neu­ro­log­ic exam and a neu­rocog­ni­tive test. 

“Lance Cor­po­ral Smith and I dis­cussed the symp­toms — a con­stant headache, dizzi­ness, trou­ble con­cen­trat­ing and sleep­ing, mod­er­ate low-back pain and occa­sion­al night­mares, along with repeat­ed thoughts of the blast,” Steussi said. “Over the next 11 days, all these symp­toms were addressed by our spe­cial­ists, who are locat­ed under one roof.” 

Smith saw a phys­i­cal ther­a­pist, an occu­pa­tion­al ther­a­pist and a psy­chol­o­gist, and then Steussi used acupunc­ture to treat Smith’s headaches and insomnia. 

Between appoint­ments, Smith stayed with oth­er Marines at a wound­ed war­rior facility. 

“Dur­ing his last vis­it,” Steussi said, Smith “was com­plete­ly asymp­to­matic” and returned to his unit. 

Although con­cus­sion is a phys­i­cal injury, Ben­son said it’s relat­ed to men­tal health. 

“When folks have a mild trau­mat­ic brain injury, some­times their symp­toms have a psy­chi­atric fla­vor,” the psy­chi­a­trist said. “They might have dif­fi­cul­ty sleep­ing or night­mares and anx­i­ety along with that. And some­times folks who have straight-up psy­chi­atric symp­toms like depres­sion might also have insom­nia and prob­lems that look a mild trau­mat­ic brain injury. 

“There’s an awful lot of over­lap and symp­to­ma­tol­ogy between the two enti­ties,” he added. “We think it’s impor­tant to work on these as a team and address both issues at the same time to try to get a Marine back on his feet and head­ing in the right direction.” 

Hav­ing psy­chi­a­trists and psy­chol­o­gists embed­ded in reg­i­ments and bat­tal­ions gives troops who might not nat­u­ral­ly turn to a men­tal health provider a range of ways to seek help, Ben­son said. 

“Most of the best OSCAR and OSCAR Exten­der Pro­gram out­reach hap­pens when it’s not real­ly a for­mal sort of thing,” he added. “It’s like when you’re sit­ting at break­fast eat­ing your toast and a Marine sits across from you and says, ‘Hey, Doc, you got a moment?’ And then you start chit-chatting. 

“Or you might be wait­ing in line or some­thing and they know you because they see you out there in the field,” he con­tin­ued. “They under­stand that you can relate to what they’re going through, and they feel more com­fort­able com­ing to chat with you.” 

Ulti­mate­ly, Ben­son added, the pro­gram should help to reduce the stig­ma attached to seek­ing men­tal health care. 

“When you’re in com­bat, when you’re deployed, you’re going to have feel­ings,” he said. “Things are going to come up. It’s best if you talk about them and seek out help.” 

Steussi said cen­ter providers have treat­ed and returned to full duty about 320 con­cus­sion patients, col­lect­ing data on each case along the way. 

“We’re in the process of review­ing the data so that in the future we can bet­ter treat Marines and sailors,” he added, “and use the infor­ma­tion to [devel­op] poli­cies for treat­ment here, out at [for­ward oper­at­ing bases] and in the field.” 

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs) 

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