Facing far forward: Mental health in large-scale combat operations

29/10/2026

AI Summary

LSCO severely disrupts traditional mental health care due to restricted mobility, contested logistics, communication breakdowns, drone threat and prolonged field care.
Foundational COSC principles Proximity, Immediacy, Expectancy and Simplicity must be reimagined to preserve warfighter readiness and operational effectiveness.
Shift to leader-led interventions, peer-to-peer support, and training medics and corpsmen in evidence-informed rapid intervention protocols and policy priorities.

TL;DR (AI Generated)

Large-Scale Combat Operations (LSCO) present unprecedented challenges to the provision of medical and mental health care on the battlefield.

We highlight possible shifts in conceptualizing mental health care, including relying on leader-led interventions, peer-to-peer support and the training of non-specialty medical personnel (e.g. medics and corpsmen) to manage acute combat stress reactions using evidence-informed, rapid-intervention protocols.

Ultimately, the goal is to synthesize current research, lessons learned from global operations, and conceptual frameworks to establish priorities for mental health training, intervention development, and policy in preparation for managing mental health in LSCO environments.

Basic summary

Mil Psychol. 2026;38(6):749-755. doi: 10.1080/08995605.2026.2737912. Epub 2026 Oct 28.

ABSTRACT

Large-Scale Combat Operations (LSCO) present unprecedented challenges to the provision of medical and mental health care on the battlefield. Characterized by restricted mobility, contested logistics, disrupted communication, drone attacks, subterranean environments and the necessity for prolonged field care, the LSCO environment will severely disrupt traditional models of combat and operational stress control (COSC) that rely on far-forward specialty providers and fixed facilities. This article introduces a special issue of Military Psychology dedicated to reviewing mental health in LSCO. By outlining the anticipated psychological demands of future near-peer conflicts, the goal of this special issue is to facilitate a shared and comprehensive understanding of possible threats and lay the groundwork for a way ahead to manage mental health in LSCO. Specifically, to maintain warfighter readiness and operational effectiveness, foundational COSC principles – Proximity, Immediacy, Expectancy, and Simplicity – must be reimagined. We highlight possible shifts in conceptualizing mental health care, including relying on leader-led interventions, peer-to-peer support and the training of non-specialty medical personnel (e.g. medics and corpsmen) to manage acute combat stress reactions using evidence-informed, rapid-intervention protocols. Ultimately, the goal is to synthesize current research, lessons learned from global operations, and conceptual frameworks to establish priorities for mental health training, intervention development, and policy in preparation for managing mental health in LSCO environments.

PMID:42949983 | DOI:10.1080/08995605.2026.2737912

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