Mental health officers from the IDF’s Southern Command completed a two-day drill this week, examining new techniques for treating traumatized soldiers in the course of battle.
Maj. Noa Berezin told The Jerusalem Post on Wednesday that lessons from last summer’s war with Hamas in the Gaza Strip were incorporated into the exercise, though some techniques, based on years of practice and research studies, remain unchanged.
“We know that when there is a conflict involving high levels of clashes and many casualties, some soldiers sustain blows to their mental health. They need a framework for good care,” Berezin said.
The Southern Command has increased the number of mental health officers, and created set teams of carers with a variety of specialties, which can be mobilized at short notice.
This week’s training saw mental health officers playing the role of soldiers who suffered varying degrees of stress and psychological trauma, and practiced initial response techniques, as well as follow-up in-depth care.
Berezin said professional research indicates the need to apply the correct care approach for different stages of battle-related mental problems. “An acute stress reaction is something that occurs immediately.
If there is no improvement, it becomes a disorder. If that continues without improvement, it becomes post-traumatic stress disorder (PTSD),” she said.
“We want to intervene in the acute, initial stages, within hours or days after the exposure to a traumatic incident.
Our knowledge, based on research, is that the quicker we get involved and the more we do so, the better the prognosis,” Berezin said. Full-blown PTSD results in highly disruptive mental disorders, she added.
Later, when hostilities end, mental health workers will follow up with the soldiers to monitor their condition and advise on further treatment if needed.
Initial intervention techniques center on the concept of “grounding,” Berezin said, whereby soldiers receive missing data, make up for lost sleep, and receive basic physical care, which decreases their stress levels. “We try to return their sense of control through cognitive restoration and restore them to a sense of order and control in the reality they’re in,” the officer said. “That’s very important for someone who felt helplessness.”
During the drill, the Southern Command divided its mental health workers into three teams, whose members learned about one another’s areas of specialty, and simulated care for soldiers who experienced psychological trauma in battle.
The head of the IDF’s Mental Health Branch, Col. Keren Ginat, told the Post that six months of work had gone into the drill. “We have deployed more mental health officers, doctors, and commanders, and retrieved information from a number of sources to build new concepts,” she said.
One area of focus for the officers is to get as close as they can to the combat arena, where they can begin treatment as soon as possible.
In addition, Ginat said, combat soldiers have received an eight-hour course on how to respond if they see comrades suffering from shock or severe stress.
“If a soldier ‘disconnects,’ but receives help from his friends within a few minutes, according to a study we did, the story can end there,” she said.
A soldier suffering from severe mental stress can endanger his own life and those of his fellow unit members, she added.
Ultimately, Ginat said, a mental crisis occurs when the external environment overpowers the inner strength of an individual.
The techniques practiced in the drill are aimed at straightening the soldiers’ ability to cope with his or her combat reality, she added.
When mental health officers first encounter soldiers needing care, the conversation will be directed to factual, not emotional, aspects, as “we do not want the soldier to ‘unpackage’ everything now – he could be returning to combat. Now is not the time to fully relax, but to be functional,” Ginat said.
In the two months that followed Operation Protective Edge last year, the Mental Health Branch called hundreds of combat soldiers who might have been at risk, and carried out a telephone survey to search for trouble signs.
Eighty-five percent of respondents returned to full mental capacity, the survey found, while others were invited to receive group and individual treatment.
Twenty years ago, Ginat said, “we had to justify our actions to base commanders. Now, base commanders demand our presence. We are much more involved.” This, she added, indicated a growing legitimacy and recognition by society and the military as a whole of the need to treat mental issues related to the stress of warfare.
The growth in legitimacy, and research leading to better techniques, has led Ginat to be “very optimistic” about the future of military mental health care, she said.