Beyond battlemind: evaluation of a new mental health training program for Canadian forces personnel participating in third-location decompression.

INTRODUCTION: Battlemind training, which improves postdeployment well-being, has been part of Canada's postdeployment Third-location Decompression (TLD) program since 2006. In 2010, a new educational program drawing on Battlemind was implemented to make it more consistent with Canada's current mental health training strategy.
METHODS: Subjects consisted of 22,113 Canadian personnel returning from Afghanistan via TLD in Cyprus; 3,024 (14%) received the new program. Pre-/post-training attitude and self-efficacy questionnaires assessed the impact of the training. In addition, a quasi-experimental approach used questionnaires administered at the end of TLD to compare the satisfaction, attitudes, and self-efficacy under the old vs. new program.
RESULTS: Pre-/post-training questionnaires showed medium to large positive effects of the training on targeted attitudes and self-efficacy (Cohen's d = 0.44-1.02). Participants completing the new program were more satisfied with the educational program (adjusted odds ratio = 3.2), perceived the TLD to be more valuable (odds ratio = 1.7), and had at least certain more favorable post-TLD attitudes and self-efficacy (d ranging from 0.00 to 0.29).
CONCLUSION: All of these findings point to the superiority of the new program. However, quasi-experimental approaches are bias-prone, and it is unknown whether these advantages will translate into meaningful improvements in well-being.