Impact of a NATO Exercise on Soldiers’ Service Conditions and Mental Health

Auswirkungen einer NATO-Übung auf die Dienstbedingungen und die psychische Gesundheit der Soldaten

Felix Weinreich^a, Wynand Korterink^a, Philipp Georg Schnadthorst^a

^a I. Deutsch-Niederländisches Corps, Münster

Summary

Background: The geopolitical events of recent years have led NATO to focus on regional defense plans to prepare for Article 5 scenarios. The soldiers of the 1 German Netherlands Corps (1GNC) perform their service in the function of a rapidly deployable headquarters and are subject to special requirements for this purpose. This paper aims to assess the impact of a NATO exercise on soldiers’ conditions of service and mental health.

Methods: Observational cohort study on two locations with two rounds of data collection, which includes the adapted Culture of Care Barometer (aCoCB), the translated Military Mental Health Tracker (MMHT), and questions to measure conditions of service. Using the ROBINS-I tool, the risk of bias varied, with instances of low, moderate, and severe risks identified. Level of evidence: III (AHCPR).

Results: Out of 89 returned questionnaires (35.6 % response rate), 73 were analyzed statistically. The aCoCB and MMHT showed statistically significant positive correlations in average values pre- and post-exercise. The group analysis of “number of exercises” in the aCoCB showed a significant difference between the subgroups “2–3” and “≥4”, with higher mean values in subgroup “≥4”. The MMHT revealed a significant disparity between the mean values of subgroups “≤1” and “≥4” in the group “years spent in 1GNC. Higher mean values were measured in subgroup “≥4”. Factor analysis of both tools indicated positive correlations across all factors. The average values and differences in the individual questions were analyzed in detail.

Conclusion: Our study conclusively demonstrates that NATO soldiers experience has a positive impact while practicing in an isolated environment. The insights gained are essential for soldiers´ improving processes and advising commanders on mitigating adverse effects. Structured questionnaires are essential for surveying soldiers’ service and mental health conditions, which are fundamental to mission success. It is important to note that military exercises in bunkers do not require any special preparation, unlike isolation practices in the Navy, space travel, or remote expeditions. Controlled exercises like Steadfast Jupiter 2023 (STJU23) provide invaluable observations that must not be overlooked.

Keywords: Culture of Care Barometer (CoCB); Military Mental Health Tracker (MMHT); conditions of service; mental health; NATO exercises; German-Netherlands Corps

Zusammenfassung

Hintergrund: Die geopolitischen Ereignisse der letzten Jahre haben dazu geführt, dass sich die NATO auf regionale Verteidigungspläne konzentriert um sich auf Artikel 5-Szenarien vorzubereiten. Die Soldaten des I. Deutsch-Niederländischen Korps erfüllen den Auftrag eines schnell verlegbaren NATO-Hauptquartiers. Dabei unterliegen sie besonderen Anforderungen. Ziel dieser Arbeit ist es, die Auswirkungen einer NATO-Übung auf die Dienstbedingungen und die psychische Gesundheit von Soldaten zu untersuchen.

Methoden: Beobachtende Kohortenstudie an zwei unterschiedlichen Standorten mit Datenerfassung vor und nach Übungsvorhaben. Dabei wurden das angepasste Culture of Care Barometer (aCoCB), der übersetzte Military Mental Health Tracker (MMHT) und Fragen zur Messung der Dienstumgebung verwendet. Mit dem ROBINS-I-Tool variierte das Risiko einer Ver­zerrung, wobei Fälle von geringem, mittlerem und schwerem Risiko identifiziert wurden. Evidenzgrad: III (AHCPR).

Ergebnisse: Von den 89 zurückgesandten Fragebögen (Rücklaufquote 35,6 %) wurden 73 statistisch ausgewertet. Die Studie ergab statistisch signifikante positive Korrelationen in den Durchschnittswerten von aCoCB und MMHT vor und nach der Übung. Die Gruppenanalyse „Anzahl der Übungen“ im aCoCB ergab einen signifikanten Unterschied zwischen den Untergruppen „2–3“ und „≥ 4“, mit höheren Mittelwerten in der Untergruppe „≥ 4“. Das MMHT zeigte einen signifikanten Unterschied zwischen den Mittelwerten der Untergruppen „≤ 1“ und „≥ 4“ in der Gruppe „in 1GNC verbrachte Jahre“. Höhere Mittelwerte wurden in der Untergruppe „≥ 4“ gemessen. Die Faktorenanalyse beider Fragebögen ergab einen positiven Zusammenhang mit statistischer Signifikanz. Die Durchschnittswerte und Unterschiede in den einzelnen Fragen wurden detailliert analysiert.

Schlussfolgerung: Unsere Studie zeigt, dass die Erfahrung der NATO-Soldaten eine positive Auswirkung auf deren Erleben während der Teilnahme an einer Übung in isolierter Umgebung hat. Die gewonnenen Erkenntnisse sind wichtig, um Prozesse zu verbessern und die Kommandeure hinsichtlich der Verminderung nachteiliger Effekte zu beraten. Strukturierte Fragebögen sind für die Erhebung der Dienstbedingungen und des psychischen Gesundheitszustands von Soldaten geeignet. Diese sind für den Erfolg eines Einsatzes von grundlegender Bedeutung. Es ist wichtig zu beachten, dass militärische Übungen von Soldaten in Bunkern im Gegensatz zu Isolationsübungen in der Marine, in der Raumfahrt oder bei abgelegenen Expeditionen keine besondere Vorbereitung durchlaufen. Kontrollierte Übungen wie Steadfast Jupiter 2023 (STJU23) liefern daher unschätzbare Beobachtungen, die nicht unbeachtet gelassen werden dürfen.

Schlüsselwörter:Culture of Care Barometer (CoCB), Military Mental Health Tracker (MMHT), Dienstbedingungen, psychische Gesundheit, NATO-Übungen, Deutsch-Niederländisches Korps

Introduction

The 1 German-Netherlands Corps (1GNC) is a multinational high-readiness headquarters within the NATO force structure. It was established in 1995 by the German and Dutch defense ministries at Münster (Figure 1). 1GNC is capable of rapid deployment in various fields of operations, including humanitarian aid, deterrence operations, and warfighting [1]. These challenging tasks demand high commitment and mental resilience from soldiers and employees [1]. In the rapidly changing geopolitical landscape, the role of NATO headquarters such as 1GNC is becoming increasingly important as global tensions escalate. As conflicts and crises grow in various global hotspots, NATO’s role in maintaining peace and security becomes increasingly vital.

Figure 1: Uniforms of all participating nations in 1GNC (The Public Affairs Office (PAO, 1GNC) took and released the photo.)

Steadfast Jupiter 2023 (STJU23) was one of the most extensive NATO exercises, spanning over 27 locations across Europe and North America [12]. Nearly 7.000 military and civilian personnel participated following a 20-month preparation period, during which almost 2.500 injects were executed to test NATO’s procedures and command structure on strategical, tactical, and operational levels [12].

The medical community within NATO is responsible for various tasks, including supporting high-intensity warfighting and humanitarian assistance. This helps to ensure that in an Article 5 scenario any challenges related to providing the best medical care are met with the highest NATO standards [12, 13]. 1GNC’s participation in essential exercises like STJU23 demonstrates NATO’s commitment to a strong deterrent and defense posture. These exercises go beyond demonstrating military strength. They ensure NATO’s readiness for various scenarios, including high-intensity warfare and humanitarian assistance.

The task assigned to 1GNC within the exercise STJU23 presented valuable challenges for its personnel, processes, and equipment (Figure 2). In addition to the professional aspects of the exercise, the conditions of service presented a significant challenge. Two command posts (CPs) were established and staffed during the exercise, each attending different tasks. The unique environment of a deep bunker compounded extended daily duty hours. For this purpose, 1GNC used a NATO bunker facility (Castlegate), initially planned and built during the Cold War and currently serving as an alternative headquarter for the highest NATO command structure [11]. Due to security regulations and location, service, meals, sleep, leisure, and limited privacy provided a distinctive and challenging setting for 1GNC soldiers (Figure 3).

Figure 2: Multinational command staff during a briefing at STJU23 at the joint operations center (JOC) in Castlegate (The Public Affairs Office (PAO, 1GNC) took and released the photo.)

Figure 3: The group sleeping room in the Castlegate bunker complex is an example of challenging training conditions due to the lack of privacy. (The Public Affairs Office (PAO, 1GNC) took and released the photo.)

Human factors are crucial in a high-readiness warfighting NATO Headquarters (Figure 4) – a domain often overshadowed by technological and strategic considerations. Identifying relevant factors to prepare service conditions for upcoming challenges is key [7]. This involves a comprehensive assessment of personnel readiness, mental health, psychological resilience, and team dynamics. Utilizing metrics and performance indicators can provide valuable insights into personnel preparation levels. Providing scientifically based guidance and expertise is equally important to ensure effective decision-making at the leadership level. This involves developing methodologies and methods to assess human factors and offering evidence-based recommendations. Supporting the commander with this information ensures that decisions are made with a comprehensive understanding of the human elements involved.

Figure 4: 1GNC Soldiers at a workstation in a crowded office

(The Public Affairs Office (PAO, 1GNC) took and released the photo.)

This paper examines soldiers’ conditions of service and mental health more closely. By highlighting these factors, we seek to spark more research and discussion, contribute to a deeper understanding, and potentially enhance the well-being and performance of NATO soldiers.

Methods

Study Population

Multinational soldiers from 1GNC voluntarily participated in this study in preparation for and during the NATO exercise STJU23. An informational sheet describing the study’s design and objectives was distributed along with a declaration of consent for participation, developed in close coordination with our legal department. Additionally, we collected limited primary data in groups of “number of exercises” and “years spent in 1GNC”, each divided into three subgroups. No further basic data was collected to ensure the participants’ anonymity. Anonymization was achieved by generating an alphanumeric identification code that allowed individual questionnaires to be unmistakably assigned to a participant. This identification code matched questionnaires filled out before and during the exercise to the same individual.

Design of the Study

This study was conducted at two locations, and two rounds of data collection were performed over two weeks. The study’s aim was explained to the participants during a presentation immediately before data collection, and an opportunity for questions was created. The cohort was observed without blinding, randomization, or intervention. To assess and openly communicate the quality of this study design, we used the “Risk of Bias in Non-randomized Studies of Interventions”-tool (ROBINS-I) and the level of evidence according to the Agency for Health Care Policy and Research (AHCPR) [8][18].

Culture of Care Barometer

The Culture of Care Barometer (CoCB), a scientifically evaluated questionnaire, is crucial for measuring working conditions and facilitating organizational benchmarking [14]. The questionnaire includes 30 questions, and the responses were rated on a five-point Likert scale from “strongly disagree” to “strongly agree” (1 =^ strongly disagree; 2 =^ disagree; 3=^ neither; 4 =^ agree; 5 =^ strongly agree). This diagnostic self-assessment instrument, used for benchmarking and exploring various aspects of care culture within organizations, was adapted for our study to suit the unique military context of 1GNC better. Terms like ‘co-workers’ and ‘organization’ were replaced with ‘colleagues’ and ‘1GNC’ to accurately reflect the camaraderie and specific environment of the military setting. Additionally, ‘line manager’, ‘colleagues’, and ‘managers’ were changed to ‘superior’, ‘comrades’, and ‘flag officers’, aligning with the hierarchical and structured nature of the military command. This customization ensures that the questionnaire resonates more effectively with the unique work environment and culture of 1GNC, leading to more accurate and relatable responses and capture of the conditions of service (adapted Culture of Care Barometer (aCoCB). Additionally, we performed a factor analysis on the following levels: factor 1 (organizational values – macro level), factor 2 (team support – meso level), factor 3 (relationships with colleagues – micro level), and factor 4 (job constraints – micro level) [14]. Each question was assigned a predetermined loading and applied to the factors [14].

Military Mental Health Tracker

The Military Mental Health Tracker 3.0 (MMHT) is a comprehensive Dutch questionnaire developed to facilitate daily feedback and intervention in military settings [2][6]. Comprising 26 questions divided into four factors (control, resilience, motivation, and self-confidence), it addresses various aspects of mental health relevant to military personnel. For our study, we translated these questions into English to ensure accessibility and clarity for the participants. The responses were measured on a nuanced seven-point scale, ranging from 1 for “strongly disagree” to 7 for “strongly agree” (1 =^ strongly disagree - 4 =^ neither - 7 =^ strongly agree). This scale allows for a detailed assessment of the mental health status and needs of military members, providing valuable insights for both immediate and long-term mental health support strategies. The predefined factors are also statistically evaluated and presented.

Assessing Conditions of Service

Additionally, we included seven questions specifically designed to evaluate conditions of service. The responses to these questions were captured using a five-point scale, ranging from 1 for “strongly disagree” to 5 for “strongly agree” (1 =^ strongly disagree; 2=^ disagree; 3 =^ neither; 4 =^ agree; 5=^ strongly agree). This scale allowed for a nuanced assessment of the work environment from the participants’ perspective.

Statistical Assessment

In this study, data collection and preliminary graphical analyses, including creating Boxplots, were performed using Excel 2023 (Microsoft Deutschland GmbH, Munich, Germany). Subsequent statistical analyses were conducted using R statistical software (R Foundation for Statistical Computing, Vienna, Austria). The Shapiro-Wilk test, histograms, and QQ plots were initially used to assess the data distribution. These tests indicated a deviation from normal distribution, leading to the adoption of non-parametric approaches for statistical evaluation. We used the Wilcoxon Signed Rank test (WSR) to assess the relationship between dependent variables. Spearman’s rank correlation coefficient (rho value) and Kruskal-Wallis H test (H value) were employed for assessing statistical significance, with a threshold set at p < 0.05. Moreover, the effect size was estimated using Cohen’s d, and paired t-tests were used where appropriate to compare dependent samples.

Results

Study Population

In this study, out of 250 distributed questionnaire sets, we received 89 answered questionnaires back for evaluation, resulting in a response rate of 35.6 % (89/250). The responses included 61 participants from Castlegate and 28 from Münster. We encountered minor data issues, such as single unanswered or unclearly answered questions, in 50 questionnaires (56.2 % overall; 52.5 % from Castlegate and 64.3 % from Münster), but these data sets were used for statistical analysis. Major data issues, including multiple unanswered or unclearly answered questions, were noted in up to 24 questionnaires (26.9 % overall; 14.8 % from Castlegate and 53.6 % from Münster), which were excluded from the statistical evaluation depending on the affiliation to the sub-questionnaire (aCoCB, MMHT). Consequently, for the aCoCB, 73 questionnaires were deemed suitable for statistical analysis (56 from Castlegate and 17 from Münster) (Figure 5). For the MMHT, we included 67 questionnaires in statistical analysis (54 from Castlegate and 13 from Münster) (Figure 6).

Figure 6: Results of the Military Mental Health Tracker .

N: Number of data points; M: mean value; MD: median; SD: standard deviation; Spearman: Spearman’s rank correlation coefficient; ρ: Spearman’s Rho; p: null-hypothesis significance testing (p-value); WSR: Wilcoxon rank-sum test; r: effect size

The groups resulting from the baseline parameters regarding experience with NATO exercises and tenure in 1GNC environment for the aCoCB were as follows: 14 soldiers had participated in ≤1 exercise, 16 in 2–3 exercises and 39 in ≥4 exercises; 29 soldiers had spent ≤1 year in 1GNC, 17 had spent 2–3 years and 19 had ≥4 years of experience (Figure 7). For 21.5 % of the participants, STJU23 was their first exercise, while 56.9 % had already participated in more than four NATO exercises. The distribution for the MMHT is mentioned in Figure 8.

Figure 7:Group and subgroup analysis of the adapted Culture of Care Barometer

N: Number of data points; M: mean value; MD: median; SD: standard deviation; H-Test: Kruskal-Wallis test; p: null-hypothesis significance testing (p-value); H: test statistic; η²: effect size

The level of evidence, based on the criteria set by the Agency for Health Care Policy and Research (AHCPR), is categorized as Level III [8]. The risk of bias, assessed using the ROBINS-I tool, indicates varying degrees across different categories: 3 instances of low risk, 2 of moderate risk and 2 of severe risk [18] (Table 1).

 

Table 1:Assessment of the risk of bias following ROBINS-I

Results of the adapted Culture of Care Barometer

The study’s results were categorized based on the two locations: Castlegate and the HQ in Münster (Figure 5). A comparison between the average values of the aCoCB before and after the exercise showed a correlation with statistical significance in all localities. The WSR did not show a statistically significant trend in the average values before and after exercise. The mean and median of the study population from Castlegate showed a slight increase, whereas in Münster, there was a slight decrease in the mean and a slight increase in the median.

The aCoCB’s average values were grouped and analyzed according to basic data (Figure 7). This shows that the middle subgroup (number of exercises: “2–3”) had the lowest mean values and median of the average aCoCB result. A similar picture appears in the group “Years spent in 1GNC”. Study participants in the subgroup with the highest “number of exercises” or the subgroup “years spent in 1GNC” showed the highest average values. The Kruskal-Wallis Test considering the “numbers of exercises” showed a medium effect between the subgroups “2–3” and “≥ 4”, which indicates that these two subgroups differ significantly in terms of their average values. When looking at the “years spent in 1GNC”, this statistical difference is not significant.

The statistical analysis of aCoCB’s factors is presented in figure 9 and was created by summarizing the questions and applying a predefined loading [14]. All factors positively correlated when comparing the mean values recorded before and after the exercise. The best results were achieved in the parameters of factor 3 (relationships with colleagues). In factor 3 before STJU23, the mean value was 2.99, and the median was 3.06. After the exercise, the mean value increased slightly to 3.02, and the median remained unchanged at 3.06. No relevant changes in the mean value and median before and after the exercise could be detected.

In addition to the overall analysis, we conducted a detailed examination of the responses to each question (see table 3 in supplementary material published in the e-paper-version of this article). This approach allowed us to engage in more nuanced discussions with colleagues in 1GNC and to evaluate specific aspects of the battle rhythm and its impact on sections’ service processes in greater depth.

Results of the Military Mental Health Tracker

The MMHT results were analyzed similarly to the aCoCB. Comparing the average values before and after the exercise, we have seen a positive correlation with statistical significance (Figure 6). The mean value and median were lowest in Münster before the exercise, but they increased in both locations afterward.

The average values achieved in the MMHT were analyzed according to the groups (Figure 8). These two box plots demonstrate that as the number of exercises and years spent in 1GNC increase, the mean and median values also increase. This trend is also reflected in a decrease in the standard deviation and the maximum average values. The Kruskal-Wallis test for the “number of exercises” showed no significant difference between the average values of any pair of subgroups. However, the subgroup “years spent in 1GNC” showed a significant difference between the mean values of subgroups “≤1” and “≥4”.

Figure 8: Group and subgroup analysis of the Military Mental Health Tracker.

N: Number of data points; M: mean value; MD: median; SD: standard deviation; H-Test: Kruskal-Wallis test; p: null-hypothesis significance testing (p-value); H: test statistic; η2: effect size

Figure 9: Factor analysis of the adapted Culture of Care Barometer

N: Number of data points; M: mean value; MD: median; SD: standard deviation; Spearman: Spearman’s rank correlation coefficient; ρ: Spearman’s Rho; p: null-hypothesis significance testing (p-value)

The factors already defined by the authors of the MMHT were also included in the differentiated analysis of the study results (Figure 10). The average values of the MMHT scores before and after the exercise increased in all factors. In contrast, the median increased in the “control” factor, decreased in the “resilience” factor, and remained the same in the “motivation” and “self-confidence” factors. The lowest value for mean value and median was in the “control” factor. There was a positive correlation with statistical significance in all factors of the MMHT.

Figure 10:Factor analysis of the Military Mental Health Tracker

N: Number of data points; M: mean value; MD: median; SD: standard deviation; Spearman: Spearman’s rank correlation coefficient; ρ: Spearman’s Rho; p: null-hypothesis significance testing (p-value)

We detailly analyzed individual responses to each question in the Military mental health tracker (see table 4 in supplementary material published in the e-paper-version of this article).

Results of the Conditions of Service Questions

The conditions of service were covered by seven questions and were analyzed individually according to the respective location (Table 2). Question 1 achieved a higher average value in Münster (Castlegate 3.15; Münster 3.35), whereas questions 2–7 achieved higher values in Castlegate. Question 6 achieved the highest average score (Castlegate 4.05; Münster 3.65), although this also showed the most significant difference (∆ = 0.40) between the localities.

 

Table 2:Conditions of service – single questions

First column: single questions to assess conditions of service; second and third column: mean values of single questions on both locations

Discussion

The statements and conclusions we discuss below relate to the soldiers’ conditions of service and mental health. The primary data we collected to assess representativeness was limited due to anonymization, so that, for example, gender, age, and nationality were not recorded. The distribution of the “number of exercises” and “years spent in 1GNC” corresponds to the usual picture of staffing posts on this command level, so representativeness can be concluded from these, albeit limited, parameters.

There is a low response rate and limited data quality for various reasons. The questionnaire was handed out immediately before the exercise and, therefore, immediately at the start of the measurement. An information event could have been held before the exercise to increase understanding and willingness to participate, potentially improving the quality and quantity of data. However, this was impossible due to the limited time required for questionnaire preparation due to exercise preparations. The entire questionnaire is relatively extensive, with a total of 119 individual questions (two times 30 questions of aCoCB, two times 26 questions of MMHT, and one time seven questions for conditions of service), which were divided into 63 questions before the exercise and 56 questions after the exercise. This means that the number of questions at both measurement times is higher than the general recommendation for designing a questionnaire [3]. In summary, if the survey were to be carried out again, the problems of data quality and quantity could be improved by a previous information event and by reducing the number of questions.

The CoCB is already used by employees in the healthcare sector worldwide to record workplace-related factors in a structured manner and benchmark them organizationally [14][21]. A transfer and validation into the military setting has not yet been published. The MMHT has been used in the Dutch national context as a daily assessment and intervention tool [2][6]. A validating study in the multinational NATO environment would be desirable for both questionnaires.

The significance concerning the comparability of the locations is limited due to the different numbers for statistical analysis usable questionnaire results (52 from Castlegate and 13 from Münster). However, there was a lower mean value and median in Münster in all sections of the questionnaire, both before and after the exercise (Figures 5 and 6). This observation could be justified because a new CP concept was used in exercise STJU23, which significantly changed the service processes. The soldiers at the Münster location were most affected by these changes. The soldiers in Castlegate served in an uncomfortable environment (NATO bunker), whereas in Münster, they worked in the familiar premises of 1GNC Headquarters. We interpret these circumstances as moving to an unfamiliar environment during a NATO exercise could positively impact conditions of service. The exercise duration and the resulting measurement times (before and after STJU23) are relatively short at two weeks. This means the applicability to soldiers operating in an article 5 scenario is limited, as these missions could last significantly longer.

When looking at the experience parameters (“number of exercises”; “years spent in 1GNC”), we found that in both questionnaires (aCoCB and MMHT), the most experienced soldiers achieved the highest mean value and median, both before and after the exercise (Figure 7 and 8). We conclude that the experience gained at 1GNC has positive influences that could be improved through specific training and education. The inexperienced soldiers achieved average results in measuring the experience level in the aCoCB and the worst values in the MMHT, although this was still well above average. The positive feelings that arise from facing an unknown challenge during a NATO exercise for the first time while familiarizing oneself with a new role could be very beneficial.Changing locations and exercise scenarios do not harm service and mental health conditions.

We attempted to draw more specific conclusions using factor analysis of the aCoCB and the MMHT (Figures 9 and 10). In the aCoCB, the factor analysis showed the highest values in factor 3 (relationships with colleagues) and the lowest in factor 2 (team support). “Self-confidence” achieved the highest mean value and median, and “control” had the lowest values in the factor analysis of the MMHT. These high values of “relationship with colleagues” can be understood as an expression of an intact comradeship, whereas “team support” can be an expression of still unclear work processes due to the new CP concept, which is also reflected by the factor “control” of the MMHT. In our opinion, the factor analysis of aCoCB or MMHT proves helpful but is not crucial.

Regarding internal quality management, the individual questions (aCoCB, MMHT, and conditions of service) were analyzed. The results were available to the soldiers and commanding officers (see table 2 as an example, aCoCB, MMHT are published in the online version of this article under wmm-online.de). The indicators recorded this way could be used to critically review and improve internal departmental processes. The identity and culture of 1GNC (Together strong) were reflected by high average scores inappropriate questions (aCoCB questions 20, 23 & 26; MMHT question 23) [1]. The negative influences of the exercise can also be measured by a drop in average values for appropriate questions (aCoCB questions 1 & 3; MMHT questions 7 & 15). Finally, valuable indicators were obtained by analyzing the individual questions.

In the in-depth literature search, we found no publications on the soldier’s conditions of service and mental health in NATO exercises or missions. Research into the psychological effects of potentially stressful conditions of service, such as those experienced in space and aviation, work under extreme climatic conditions, and submarine and bunker military services, is becoming increasingly important [7][15][16][17]. Wądołowska highlights the critical role of psychological support in high-stress military functions [20]. Other studies examined the physiological and psychological adaptations in isolated environments (Antarctica) akin to those experienced by military personnel in similar conditions [4][9]. The severity and duration of the environmental stressors determine the severity of the cognitive limitations [7]. The need for research into the resilience of soldiers has already been recognized in various places and is being developed [10]. The different areas can have the following common stressors: limited private communication, cramped living space without privacy, limited medical care, extended day shifts, and daily routines dictated by others [15]. These stressors could negatively impact the performance of assigned duties, as well as mental and physical health, and thus endanger the success of the mission [15].

Strategies to reduce the adverse effects caused by stressors are established and are continually being developed. The importance of resilience and self-care in high-stress and politically complex environments relevant to personnel in NATO exercises is also an important factor [5]. Furthermore, research provides insight into the effects of military exercises on cognitive performance, emphasizing the need for effective cognitive load management and recovery strategies in the military [19]. In space travel, this burden is mitigated through a selection of interpersonally compatible crews, pre-mission team training, and the implementation of tools for self-monitoring psychological parameters [17]. The importance of compatibility of interpersonal characteristics is also described for submarine crews [16]. This extensive preparation might not be possible for NATO soldiers in an Article 5 scenario.

In the future, NATO exercises should record the conditions of service and the resulting mental stress on soldiers, as these factors can have a decisive influence on service performance, the commander’s effectiveness, and warfighting capacity. Questionnaire-based surveys have been indicated to be suitable for further investigations.

Takeaway message

• 1GNC’s ability to serve as a high-readiness warfighting headquarters depends on its soldiers’ conditions of service and mental health.
• Questionnaires can record these relevant factors and evaluate them scientifically.
• It is desirable and we plan to conduct the survey again with improvements to the questionnaires to increase data quality and quantity.
• The results of these questionnaires can provide helpful insights and indicators for optimizing departmental processes and improving the commander’s effectiveness.

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Manuscript Data

Citation

Weinreich F, Korterink W, Schnadthorst PG: Impact of a NATO exercise on soldiers’ conditions of service and mental health. WMM 2024; 68(7-8): 324-333.

DOI: https://doi.org/10.48701/opus4-322

For the Authors

Lieutenant Colonel (MC) Dr. Philipp Georg Schnadthorst, MD

1 German-Netherlands Corps

Schlossplatz 15, D-48143 Münster

E-Mail: philippschnadthorst@bundeswehr.org

Manuskriptdaten

Zitierweise

Weinreich F, Korterink W, Schnadthorst PG: [Auswirkungen einer NATO-Übung auf die Dienstbedingungen und die psychische Gesundheit der Soldaten]. WMM 2024; 68(7-8): 324-333.

DOI: https://doi.org/10.48701/opus4-322

Für die Verfasser

Oberfeldarzt Dr. Philipp Georg Schnadthorst

I. Deutsch-Niederländisches Korps

Schlossplatz 15, 48143 Münster

E-Mail: philippschnadthorst@bundeswehr.org

Supplementary material

The two questionnaires used in our study (aCoCB and MMHT) are presented in detail in this supplementary material. For each individual question, the average value before and after the exercise is shown, as well as the change between the survey points. With this information we engaged in more nuanced discussions with colleagues in 1GNC to evaluate specific aspects of the battle rhythm and its impact on sections’ service processes in greater depth.

 

 

Table 3: Adapted Culture of Care Barometer

First column: single questions of adapted CoCB; second column: mean values of single questions before and after STJU23; third column: difference values

Table 4: Military Mental Health Tracker

First column: single questions of MMHT; second column: mean values of single questions before and after STJU23; third column: difference values.