Peculiarities of the organization of psycho-medical rehabilitation of servicemen in NATO member countries and partnership for peace countries

Abstract

The purpouse.  To discover various aspects of the organization of psycho-medical rehabilitation of military personnel in NATO member and partner countries.

Materials and methods. Scientific publications have been studied using the methods of systemic, bibliosemantic and retrospective analysis, which reflect the features of the organization of psycho-medical rehabilitation of servicemen  in the USA, Canada, Germany, France, Great Britain, Israel. A research was carried out for available sources of information from 1995 to 2017, which related to the purpose of the work and terminological phrases “Psycho-medical aid”, “Psycho-medical rehabilitation”, “Medical rehabilitation”, “Psychiatric rehabilitation”, “Psychological Rehabilitation”. Based on a thoughtful-analysis of modern sources of information, various approaches to the formation and maintenance of an appropriate level of mental health care and rehabilitation have been  summarized.

Results. The features of the organization of psycho-medical rehabilitation of servicemen in the Armed Forces of the USA, Canada, Germany, France, Great Britain, Israel have been  revealed. The importance of scientific and methodological support of the Combat and Operational Stress Control system in the US Army, which is provided by the scientific centers for the control of combat and military-professional stress of the combat environtment and the leading scientific university centers of the United States, has been shown. The most active participants in PTSD research programs in the United States are the National Institute of Mental Health (NIMH), the US Department of Veterans Affairs, the Center for Mental Health  of U.S. Department of Defense  (DCEPH TBI DCoE), the University of Military Medicine (USUHS), the Walter Reed Army Institute of Research (WRAIR). The need to introduce modern screening tools for the effectiveness of rehabilitation (Rankine scale /mRS/, special computer programs, etc.), taking into account the International Classification of Functioning and Disability, has been noted. The main trend in the organization of an effective system for maintaining the mental health of servicemen in NATO is the introduction of appropriate training programs to increase the level of psychological resilience of personnel, expanding knowledge among servicemen about cognitive, behavioral and physiological processes in combat, normalization of stress response, providing servicemen with effective coping strategies to overcome stress and assist commanders in maintaining and strengthening the mental health of subordinates.

Conclusions. It was shown that the manifestations of combat and military-professional stress, as well as its maladaptive reactions, as well as the conditions of their occurrence not only increased the risk of adverse combat injuries, but also significantly affected the course of their consequences for mental and physical health. This aspect of organization of psycho-medical rehabilitation of military personnel in the armed forces of the leading NATO member countries and partnership for peace countries is one of the fundamental aspects for implementation in the Armed Forces of Ukraine. A detailed study at a practical level requires psychological assistance techniques at the 1st Role, which, according to the experience of the British Armed Forces, can significantly preserve the mental health of servicemen. One of the important components of high-quality rehabilitation is the construction of effective communication between the system for the implementation of the medical and evacuation process of victims of physical trauma and wounds and the elements of the mental health system of servicemen. This aspect is relevant at all levels of medical care.  There is a need to improve the state system of comprehensive rehabilitation of servicemen participating in hostilities and having suffered combat and military occupational injuries and wounds. This applies to both program activities and methods of monitoring the effectiveness and quality of the ongoing rehabilitation. Such measures will make it possible to purposefully carry out measures to ensure the preservation of the physical and mental health of servicemen, ensure the prevention of PSTD, and will help maintain the readiness of personnel to perform tasks in any operational changes.