A fresh approach to combat stress

by
23 August 2007

A new post-trauma initiative is already paying dividends in the forces, reports Andy Phillips

Ministering: the Revd Simon Beveridge RN leads a service on HMS Ocean

Ministering: the Revd Simon Beveridge RN leads a service on HMS Ocean

When I was chaplain to Commando Helicopter Force in 2003, one of our helicopters crashed on the flight deck of Royal Fleet Auxiliary Argus, sending pieces of rotor blade into a party of aircraft handlers — three men were injured, one very gravely.

The immediate response to this completely unavoidable accident from Air-Sea Rescue and the ship’s medical team was superb. Yet there was another important but less dramatic response to the incident, which quietly moved into gear 12 hours later.

I joined the ship when she came alongside that night with a small team of traumatic stress practitioners trained as part of the Royal Navy/Royal Marine Trauma Risk Management project (TRIM). I had introduced the project to my unit shortly before, having run it for two years with 40 Commando. The TRIM practitioners were nothing more than ordinary members of our unit, chosen and trained for this task, in addition to their normal duties.

Having first cleared things with the ship’s captain, we assembled in the ship’s galley those who had had a direct experience of the accident. We gave a short presentation to explain what post-traumatic stress is. We were trying to reassure them that they would be experiencing a normal reaction to an abnormal event.

The following day, we ran sessions with groups of those who were most used to working together as aircraft handlers, fire teams, aircrew, or medics. We led a discussion of the incident following a set format, asking each person to say what he was thinking and feeling — before, during, and after the event.

Each talked it through from his point of view, while the group leader ensured that everyone contributed, and observed people’s response, to see whether anyone might need continuing support from the TRIM group or from medical services.

The discussions were to have a strongly cathartic effect, as stronger team members supported weaker ones. Everyone was highly complimentary of the TRIM system, which is now seen as an integral part of any Royal Navy or Marine operational deployment. But it was not always thus.

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The TRIM project was the brainchild of two army psychiatric nurses, who devised a scheme of “buddy” mentoring and monitoring within small units who were experiencing traumatic stress on operations, where they were often cut off from medical support.

Having experienced some resistance within the army at that time, the nurses approached the Royal Marines to run a trial of it. Fortunately, a Falklands War veteran, Major Cameron March RM, saw the potential of the scheme early on, and gave it his strong support.

Even so, it was to require considerable corporate courage by the Royal Marines to develop TRIM, and to overcome the natural suspicion of such a new system. This was something entirely untested, involving ordinary marines and sailors, who were sorting out problems for themselves wherever they could.

The key to getting TRIM established early on was the Royal Marine chaplains, who staked much of their personal credibility on getting it running in each Marine unit. The chaplains did the necessary training, and formed a key part of the team who sold the system to the commanding officers, and then became the managers of the new TRIM teams.

Were it not for the support of such chaplains, the TRIM project might never have got off the ground, let alone now be being launched in UK emergency services and several other armed forces around the world.

I WAS PLEASED to read that an army chaplain, the Revd Cole Maynard, has shown the necessary vision and moral courage in starting to introduce TRIM to a whole brigade in Afghanistan (News, 10 August).

He and his fellow chaplains are probably experiencing a similar suspicion of novelty that we in the Royal Marines once did. It will not be easy, and it may appear a thankless task to begin with, but I have no doubt their perseverance will pay off handsomely in the end.

In armed-forces ministry, we are fortunate in being so totally engaged with the military system of which we are a part that we can make a positive difference. Courage in conditions of physical danger is expected of us all, but equally as vital is that each of us has sufficient moral courage to fight to ensure that those in our care have the pastoral tools to do the job.

TRIM is just such a tool, and I am sure that, in time, it will be seen as indispensable in the Army and the British emergency services as it is already in the Royal Navy and Royal Marines.

TRIM may be a project run mainly by pastorally minded amateurs (like many in the Church), but I believe the Titanic was built and run by professionals, while Noah’s Ark was made and crewed by enthusiastic amateurs. When faced with hostility from medical services defending what some may perceive to be their interests, we need never sell ourselves short.

The Revd Andy Phillips RN is chaplain to RNAS Culdrose in Cornwall.

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