The ongoing, systematic collection, analysis, and interpretation of data derived from instances of medical care or medical evaluation, and the reporting of population based information for characterizing and countering threats to a population’s health, well-being, and performance.

For the purpose of this Instruction, the U.S. Army Corps of Engineers, the Naval Facilities Engineering Command, and the Air Force Center for Engineering and the Environment.

Interventions targeted to Service members with COSR or indications of a potential mental health disorder, and to units that show signs that their mission effectiveness is being affected by combat or operational stressors.

Interventions targeted to the general population or area of responsibility.

A mental health professional with training and expertise in COSC management who consults with the Combatant Command Surgeon and the Combatant Commander about matters related to combat stress such as unit cohesion, unit morale, resilience, leadership, effective communication, and perceived mission importance. Completion of grade appropriate professional Mi...

Active and Reserve Component mental health professionals or other personnel including enlisted specialists and administrative support personnel who are trained in COSC principles, including combat and operational stress first aid and application of principles to enhance combat effectiveness. Senior experienced COSC personnel serve as advisors to line comm...

 Interventions targeted to a unit or Service member whose risk is higher than average.

• Indicated prevention - Interventions targeted to Service members with COSR or indications of a potential mental health disorder, and to units that show signs that their mission effectiveness is being affected by combat or operational stressors.
• Selective prevention - Interventions targeted to a unit or Service member whose risk is hig...

Programs developed and actions taken by military leadership to prevent, identify, and manage adverse COSRs in units; enhance mission performance; increase individual and unit resilience; conserve fighting strength; prevent or minimize adverse effects of combat stress on members’ physical, psychological, behavioral, and social health; and to return t...

The physical, emotional, cognitive, or behavioral reactions, adverse consequences, or psychological injuries of Service members who have been exposed to stressful or traumatic events in combat or military operations. COSRs vary in severity as a function of operational conditions, such as intensity, duration, frequency of combat exposure, rules of engageme...

Interventions targeted to treat and follow up Service members with mental health disorders to prevent their loss from duty.

The combination of military and civilian medical systems used to provide healthcare to DOD medical beneficiaries.

Includes an involuntary loss of eligibility for the MHS, an involuntary loss of other health insurance coincident with the initiation or continuation of MHS eligibility, or termination of the provider by the Managed Care Support Contractor (MCSC) for other than cause or a change in the applicable MCSC.

An administrative review of program determinations regarding medical necessity that is internal to the medical treatment facility/dental treatment facility MTF/DTF (for direct care) or to the Managed Care Support Contractor (MCSC) (for purchased care). Progression through the successive levels of appeal occurs when the reviewing authority upholds the init...

Licensed and credentialed healthcare providers privileged to provide primary and preventive care services and to facilitate appropriate referrals for other services, including specialty services, for all active duty members and TRICARE Prime enrollees. PCMs may include physicians specialized in Family Practice, Internal Medicine, Pediatrics, and Obstetric...