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Military Health System

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Combat and Operational Stress Control (COSC)

Service members experience a variety of physical, emotional, cognitive, and behavioral reactions, adverse consequences, or psychological injuries following exposure to stressful or traumatic events in combat or military operations. The Department of Defense (DOD) requires that each service implement combat and operational stress control (COSC) policies and programs to prevent, identify, and manage the effects of these combat and operational stress reactions (COSRs) in order to 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 return the unit or service member to duty.

In support of Department of Defense Instruction (DoDI) 6490.05, “Maintenance of Psychological Health in Military Operations,” dated Nov. 22, 2011 (updated 2013), the Psychological Health Center of Excellence (PHCoE) is tasked with overseeing the COSC mission. PHCoE works with representatives across the military services to optimize the efficiency and effectiveness of COSC policies and programs. The Center leads the following activities:

  • Develop and standardize required COSC data collection metrics
  • Promote COSC initiatives that prepare service members for military operations, support them during periods of transition, enhance psychological resilience, and reduce stigma associated with seeking mental health care assistance
  • Align COSC policies and programs with related psychological health and readiness policies, practices and systems within DOD
  • Determine common DOD-wide COSC program goals
  • Identify opportunities for COSC interoperability and joint application
  • Identify evidence-based COSC-related programs and practices for recommended use by the services, as applicable
  • Conduct annual monitoring of the quality and effectiveness of the services’ COSC programs, in coordination with the services’ quality assurance monitors.

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Last Updated: January 05, 2022
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