Last month, Defense Secretary Pete Hegseth paused in front of a ballroom of service members and industry leaders at Special Operations Forces Week in Tampa, Florida, and reminded them people matter more than equipment.
That stance underpins the Defense Department's sweeping readiness push, and nowhere is that more apparent than in a new program teaching combat medics to handle battlefield behavioral health crises.
Dr. Katie Nugent, a behavioral health epidemiologist at the Walter Reed Army Institute of Research in Silver Spring, Maryland, has spent the last decade converting data into practical tools that keep warfighters in the fight.
In 2018, her team at the institute met with 23 soldiers — many of them special forces medics — to ask what concerned them most when help was hours or days away. They described sleepless teammates, quiet panic attacks and simmering conflicts as some of their top worries, admitting they sometimes stayed silent out of fear of making matters worse. The findings, later published in the Military Medicine journal, concluded that future multidomain conflicts would demand a new approach to delivering behavioral health care.
Those interviews became the seed for the Behavioral Health Guidelines for mEdic Assessment and Response training program, known as BH-GEAR. Nugent described the course as "a combat lifesaver for the mind."
In a single day of hands-on instruction, medics learn to diagnose mental distress similarly to how they learn to triage gunshot wounds. Role-playing scenarios show them how to start a structured conversation to assess a service member's mood, sleep and safety in under five minutes.
They practice asking blunt questions about suicidal or violent thoughts, then rehearse rapid, evidence-based techniques — paced breathing, grounding exercises and intervention skills — to calm a service member who can't afford to break down under fire. By day's end, they can chart a decision tree that tells them when to return a teammate to duty, call a provider or begin preparing a medical evacuation. A shorter refresher training is also offered to keep skills sharp, and a longer train-the-trainer course lets units build their own teams.
"Knowledge and confidence stay higher for at least a year, and graduates report using these skills on deployment," Nugent said.
Demand for the training now lands in Nugent's inbox several times a week. The institute's instructors recently piloted the curriculum with Army combat medic specialist trainees at the Army Medical Center of Excellence in San Antonio. They are also adapting the course for Navy hospital corpsmen and Air Force independent duty medical technicians.
In the future, Nugent envisions a tiered model of the course, in which all entry-level medics receive basic behavioral health care training and then return for more complex refresher courses as their expertise grows.
"There simply aren't enough licensed providers to cover every patrol base, especially when communications and air evacuation are contested," she said. "BH-GEAR creates an on-site asset who can prevent small problems from becoming mission-ending events."
The program also alleviates concerns Nugent raised in her 2022 needs-assessment study, noting that medics received only eight hours of behavioral health instruction during a six-week tactical combat casualty care course — even though psychiatric conditions were among the leading reasons for aeromedical evacuation from Iraq and Afghanistan.
Participants in that study said more realistic skills training for non-specialists was their top request for future deployments; BH-GEAR is built to meet that need.
Nugent's credibility comes from both the laboratory and hospital ward. She began her career on a civilian psychiatric unit, earned a master's degree in clinical psychology, added a doctorate in public health and completed a post-doctoral fellowship in psychosis research before joining the institute in 2015. Her work has influenced Army policy on resilience, suicide prevention and now medic training.
"The science is solid, the demand signal is strong and the stakes are high," she said.
For a department tasked with fielding a force that can fight tonight under any condition, BH-GEAR puts that readiness mantra into practice because, as Hegseth noted, humans remain more important than hardware. Nugent believes this program will help ensure that the humans are ready to stay in the fight.