Combat and operational stress control in large-scale combat operations: Moving beyond medical intervention.

Modern combat and operational stress control practices have increasingly placed responsibility on medical support while de-emphasizing the role of the unit. While advancements in telehealth have proven beneficial in recent conflicts, future wars against near-peer adversaries will likely eliminate or severely restrict this capability. Similarly, restricted movement of casualties and medical personnel will necessitate support from psychiatrically distressed and impaired within their units on the battlefield with limited medical support. Experience in the war in Ukraine supports these assumptions. This paper will examine strategies to maximize direct support for distressed and impaired personnel. This includes advances in self-care, buddy aid/peer support, and leadership actions as therapeutic interventions for combat and operational stress reactions.