Prevention is a Priority. What Are You Going to Do About It?
LTC Vikram Kambampati
A few tips on what you can do now using H2F and good leadership
Spc. Ajuze of the 394 Field Hospital signals that he is Army Strong, while completing a ruck march during his monthly battle assembly in Seagoville, Texas, on July 13, 2024. (U.S. Army Reserve Photo by 1st Lt. Harrison Gold)
So, you are an Army leader in a small unit at the platoon, company, or even battalion level. You care about the prevention of harmful behaviors like suicide, sexual assault, and substance misuse, but are wondering what you can do at your level. If you are on this website, you clearly have an interest in human performance and want to make a positive impact on the people you lead. The Holistic Health and Fitness (H2F) program offers the most feasible and effective approach you can take on a daily basis to set conditions for Soldiers to be at their best. While you may not have all the resources of larger organizations, your close contact with Soldiers and direct leadership allows you to leverage H2F pillars to improve their psychological well-being.
H2F has shown promise in reducing harmful behaviors. Active duty brigades resourced with the H2F program, compared to those without, had fewer suicidal behaviors, less severe behavioral health problems, and reductions in substance abuse problems. The 173rd Airborne Brigade combined tough physical activities with spiritual readiness training to develop cohesion and a sense of purpose amongst their paratroopers, leading to a decrease in reported sexual assaults.
From my experiences as a psychiatrist and Army leader, a few leadership behaviors are the secret sauce of such early successes involving H2F; instill purpose and cohesion, model the daily habits that build mental toughness, and demonstrably care about your Soldiers. Almost half the Soldiers I see in the clinic have psychological reactions that could have been prevented with some of the above leadership behaviors. This is a common observation amongst my colleagues and which early research studies support.
Yet, as an Army Reserve staff officer and recent field hospital commander, I know that leaders like you are drowning in too many requirements. You don’t have time to dedicate to another program. Fortunately, most units still make time for physical training (PT), and H2F enables the integration of mental and spiritual readiness activities into existing training that improve psychological well-being. Soldiers are most engaged in activities that have tangible benefits and relevancy. While stand-alone prevention classes (e.g.: ACE, ASAM, SHARP) and master resiliency training are required, they have not moved the needle. Soldiers find the H2F ethos of improving their daily performance on what matters now, rather than preventing future abstract harm, appealing.
As a leader, you can train, model, and set the conditions for developing specific psychological fitness skills. Below, I share a few specific leader behaviors paired with spiritual, mental, or sleep readiness training that I’ve done at the company level and you may try.
Instill Purpose and Cohesion by Integrating Spiritual Fitness into Training
Tough physical training can bring Soldiers together. Units with high cohesion are less likely to experience fratricidal behaviors such as sexual assault. Ostensibly to improve our field hospital’s expeditionary readiness, I asked our NCOs to plan a ruck march. This time, though, the rule was that “nobody rucks alone.” That is, everyone looks around to make sure they or someone else is rucking alongside at least one other Soldier. The ruck exemplified our daily duty in the unit: protect each other. Being a brother’s keeper gives Soldiers a sense of purpose and connection to their comrades, a key element of spiritual readiness.
Improving Soldiers’ spiritual fitness, or being resilient to life’s challenges through meaning and relationships, was one of my command priorities. It was also the most difficult to measure. Early on, I consulted with the hospital chaplain. We couldn’t think of a measure of effectiveness (MOE), so we settled on a measure of performance (MOP): participation. Her team would conduct a spiritual readiness training at least once a quarter that engaged every Soldier in the unit. We made time by using the morning PT hour on some days. There was a repeated theme as the year progressed. Every soldier has worth because they have a noble purpose to protect others in the unit.
Bring Mental Readiness into Daily Activities
Mental performance can be trained. Integrating mental performance skills training with other Soldier skills is not only efficient but makes them relevant. For example, before your unit sends live rounds downrange for individual weapons qualification Soldiers likely go through a brief refresher training on the basics of marksmanship, including breath work. Slow breathing to lower heart rate with pauses on inspiration and expiration, is box breathing. This is the same skill we can use to reduce anxiety or anger. While box breathing, add intentional awareness of your surroundings, like a sight picture when at the range or the colors of your walls when at home, and you are practicing a form of mindfulness. If you are skilled at box breathing, you can be skilled at mindfulness. If you are skilled at mindfulness, you are much more likely to manage anxiety, and anger, or get into a restful state for sleep.
As a leader, you can cue a few mental performance skills, like mindfulness, positive affirmations, gratitude, visualization, goal setting, and confident body posture throughout the day. Coaches of elite athletes often invoke positive affirmations at team meetings to enhance their players’ mental toughness and set a winning culture. Consider opening a training meeting or addressing the formation with an affirmation or a moment of gratitude. Openly model the mental readiness skills to normalize them becoming daily habits in your platoon room just like they are in elite locker rooms.
Demonstrably Care About Your Soldiers with Sleep Readiness
You can put your people first by working sleep readiness into your training schedule. According to FM 7-22, leaders set the conditions for an optimal performance culture. Require training leaders to put sleep deficit into the deliberate risk assessment and how to mitigate them for training events. If your unit was training late into the evening, consider canceling PT the next morning so your Soldiers can get enough sleep opportunities. Or, move PT to the afternoon. You are aware that sleep is key to recovery from stressors and exercise stimuli. Your Soldiers might get more physically and mentally fit by sleeping in one morning after high-tempo training than overtraining at 0600 the next day.
Protect your Soldier’s personal time. This is when they practice resiliency, recover, or just choose to live a full life with meaning. Give Soldiers predictability by continuously improving training management. If last-minute taskers always seem to come down, threatening the training schedule, try studying the variation from the planned training schedule over time and build in enough flexibility for contingencies. Too often, however, Soldiers are still in the unit late into the evening because of inadequate planning. Or, staff are still in the office working on slides at night because of a pop-up briefing. We’re consuming readiness over slides!
These are just a few things I’ve tried along my leadership journey to improve the mindset of Soldiers at the company level. As mentioned above, if I had outcomes data at all, they were MOPs, not MOEs. Yet, I share these ideas because leaders at all levels find preventing harmful behaviors to be vexing. As a small unit leader directly in front of your formations, integrating daily psychological fitness skills with good leadership behaviors will make your Soldiers safer, more resilient, and better performers.
Soldiers from the 394th Field Hospital participated in a ruck march in Seagoville, Texas, on July 13, 2024. Hospital commander Lt. Col. Vikram Kambampati provides praise to a finishing Soldier, despite the Texas heat. (U.S. Army Reserve photo by 1st Lt. Harrison Gold)
While Vikram Kambampati, MD, MPH has held a variety of clinical, leadership, and staff roles in civilian healthcare organizations and in the Army Reserve, he is a master of none. His true passion is figuring out how to work less to spend more time outside and with his family.