Confronting the Mental Health Challenges of Large-Scale Combat Operations

The Department of Defense predicts that future conflicts will involve large-scale combat operations (LSCOs) characterized by high-intensity warfare between technologically advanced nations. These conflicts may result in prolonged exposure to violence, increasing the risk of severe mental health consequences for military personnel, veterans, and civilians. Research on past wars and ongoing conflicts, such as the war in Ukraine, demonstrates the heightened risks of post-traumatic stress disorder, depression, moral injury, and compassion fatigue in LSCOs. Unlike previous conflicts in Iraq and Afghanistan, LSCOs may involve prolonged deployments, limited medical evacuations, and greater use of cyber and psychological warfare, exacerbating psychological distress. Given these anticipated threats, we urge mental health professionals to proactively address the anticipated mental health challenges associated with LSCOs. Preemptive strategies may include predeployment resilience training, increased access to deployable and telehealth mental health resources, and targeted interventions for preventing and mitigating moral injury. Additionally, civilian populations in conflict zones may experience displacement and exposure to violence. Given the long-term psychological impact of large-scale warfare, ongoing mental health program development and evaluation is needed to support affected populations. By anticipating these challenges posed by LSCOs, mental health professionals can implement strategic interventions to mitigate their psychological burden on service members, veterans, and civilians.