Field Manual No. 8-51: Combat Stress Control in a Theater of Operations

Appendix B
Example B-5. Format For Combat Stress Control Estimate

Headquarters, Department of the Army, Washington, DC

Combat Stress Control Estimate Of The Situation
References:

Maps, overlays, charts, and other departments required to understand the plan. Reference to a map will include the map series number and country or geographic area, if required; sheet number and name, if required; and scale.

1. Mission (Statement of the specific CSC mission in conformity with the operations in which the supported troops are engaged.)

2. Situation and Considerations

a. Enemy situation

(1) Strength and disposition.

(2) Combat efficiency (how skilled and stubborn).

(3) Capabilities (note especially the artillery and air threat, armor and mobility, continuous operations, NBC and DE, rear battle threat, electronic warfare and misinformation capability, and target detection capability).

(4) Logistics situation.

(5) State of health.

(6) Weapons (note especially any recently introduced "surprise" or "terror" weapons, or weapons which our troops judge especially dangerous and superior to ours).

b. Friendly situation.

(1) Strength and disposition.

(2) Combat efficiency (note areas such as level of training, confidence in leaders, unit cohesion, and unit determination).

(3) Present and projected operations (What is the tactical plan of the commander? How long has the unit been in combat? How long is it expected to go without respite? Is the operation or attack versus defense? Is the operation mobile versus static or slow moving?)

(4) Logistics situation (What is the confidence level in availability and resupply of ammunition, food, water, maintenance, medical support, and evacuation?).

(5)Weapons (note the confidence in superiority of weapons over enemy's weapons).

(6) Defeating his first and second echelon and rear area forces.

c. Characteristics of the area of operations.

(1) Terrain (how strange, unfamiliar, difficult , restrictive versus exposed, such as jungle, desert, mountain, urban).

(2) Weather (especially wet, cold, or hot).

(3) Civilian population (friendly versus neutral versus hostile versus belligerent; likelihood of civilian casualties, especially women and children).

(4) Flora and fauna (perceived as dangerous?).

(5) Local resources (availability of buildings for shelter?).

(6) Other.

d. Strengths to be supported (and their organic MH/CSC assets):

(1) Army (divisions? separate bridges? ACRs? corps units?).

(2) Air Force (liaison personnel in Army units? forward airfields?).

(3) Navy (personnel ashore?).

(4) Marines (supported by Navy medicine? attached to Army?).

(5) Allied Forces.

(6) Coalition forces.

(7) Enemy prisoners of war.

(8) Indigenous civilians.

(9) Detainees (US military personnel confined in military police facilities).

(10) Internees.

(11) Others (such as US military families not evacuated before hostilities).

e. Health of the command.

(1) Acclimation of troops to weather, strangeness, culture.

(2) Presence of disease (especially preventable "diseases of loneliness or negligence," such as sexually transmitted disease, cold injury, diarrhea, infections related to poor hygiene or failure to protect).

(3) Status of immunizations.

(4) Status of nutrition.

(5) Clothing and equipment (adequate for climate?).

(6) Fatigue (sleep loss, physical overwork, jet lag).

(7) Morale (sense of purpose, support by country? rest and recuperation chances?).

(8) Status of training (especially tough, realistic).

(9) Other (such as concerns about families in the theater or left abruptly in rapid deployment; lack of support for the war on the home front).

f. Assumptions. (Assumptions may be required as a basis for initiating or preparing the estimate. Assumptions are modified as factual data becomes available.)

g. Special factors. (Emphasize items of special importance in the particular operation to be supported, such as the unique conditions to be encountered in the event of NBC warfare.)

3. Combat Stress Control Analysis

a. Patients' estimates. (Indicate rates and numbers by type of unit/division.)

(1) Number of patients anticipated (such as BFCs, misconduct stress behaviors, holding and hospital patients, as well as consultation work load and cases who can be treated and released to duty).

(2) Distribution within the AO (space).

(3) Distribution in time during the operation.

(4) Areas of patient density.

(5) Possible mass casualties.

(6) Lines of patient drift and evacuation.

b. Support requirements. (Consider separately the estimated support requirements for:)

(1) Patient evacuation and medical regulation (using nonmedical transport before ground ambulance or before air ambulance).

(2) Hospitalization (where to send the few who need it?).

(3) Health service logistics, to include blood management.

(4) Medical laboratory services (drug screening capability? NP diagnostics?).

(5) Dental services (for BFCs and staff).

(6) Veterinary services (local food inspection? care for unit mascots?).

(7) Preventive medicine services.

(8) Area medical support.

(9) Command, control, and communications (critical to dispersed CSC).

(10) Others such as field feeding.

c. Resources available. (Consider Air Force/Naval support in addition to:)

(1) Mental health personnel organic to US Army CSC/MH sections and medical units.

(2) Attached CSC/MH medical units and personnel.

(3) Supporting CSC units and medical units.

(4) Air Force (air transportable hospitals with "combat stress units").

(5) Navy (supporting Marines? fleet hospitals ashore? shipboard?).

(6) Allied CSC-equivalent units or elements.

(7) Civil public health capabilities and resources. (Civil affairs personnel are responsible for obtaining hot-nation support.)

(8) Retained medical/MH health personnel.

(9) Medical supplies and equipment.

(10) Medical (CSC/MH) troop ceiling.

d. Course of action. (As a result of the above considerations and analysis, determine and list all logical COA which will support the commander's OPLAN and accomplish the HSS/CSC mission. Consider all SOPs, policies, and procedures in effect. Courses of action are expressed in terms of what, when, where, how and why.)

4. Evaluation and Comparison of Courses of Action

a. Compare the probable outcome of each COA to determine which one offers the best chance of success. This may be done in two steps:

(1) Determine and state those anticipated difficulties or difficulty patterns which will have a different effect on the COA listed.

(2) Evaluate each COA against each significant difficulty or difficulty pattern to determine strengths and weaknesses inherent in each.

b. Compare all COA listed in terms of significant advantages and disadvantages, or in terms of the major considerations that emerged during the above evaluation.

5. Conclusions

a. Indicate whether the mission set forth in paragraph 1 can (cannot) be supported.

b. Indicate which COA can best be supported from the CSC standpoint.

c. List the limitations and deficiencies in the preferred COA that must be brought to the commander's attention.

d. List factors adversely affecting the CSC health of the command. 

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