NATO HFM 279
on Leveraging
Technology
in Military Mental Health
Uniformed
Services
University
Meeting #4 — Big Data & Machine Learning

Center for the Study of Traumatic Stress

PROGRAMBig Data & Machine Learning in
Military Mental HealthNovember 29–30, 2018
Embassy of Canada to the United States
Washington, D.C.

Sponsored by: The Center for the Study of Traumatic Stress
CSTSonline.org
1NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

2NATO HFM 279 on Leveraging Technology in Military Mental Health
Uniformed
Services University
Meeting #4 — Big Data & Machine Learning

Center for the Study of Traumatic Stress

PROGRAMNORTH ATLANTIC TREATY ORGANIZATION HUMAN FACTORS AND MEDICINE (HFM)

Leveraging Technology in Military Mental Health
Big Data & Machine Learning
Meeting #4
November 29–30, 2018
Embassy of Canada to the United States
Washington, D.C.

NATO Research Task Group (RTG) Mission: Identify technological advancesthat can have a direct impact on assessment, treatment, education, training, andidentification of risk to enhance force readiness through optimized performance,risk mitigation, return to duty, and more efficient health care utilization.

Sponsored by: The Center for the Study of Traumatic Stress
www.CSTSonline.org
3

NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

4NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Table of Contents
Agenda: November 29, 2018.................................................................................................... 2
Agenda: November 30, 2018.................................................................................................... 3Center for the Study of Traumatic Stress (CSTS).................................................................. 4
Embassy of Canada to the United States of America........................................................... 5
North Atlantic Treaty Organization (NATO)........................................................................ 6
Leveraging Technology in Military Mental Health............................................................... 7
Previous Meeting Summaries.................................................................................................. 9
Panel Members........................................................................................................................ 10
Speakers.................................................................................................................................... 131

NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

AgendaNovember 29, 2018
0900–0915

Welcome and Introduction — LTC Gary H. Wynn (USA)0915–0930

Overview of HFM RTG — Col Rakesh Jetly (CAN)0930–1000

A Primer on Big Data & Machine Learning — LTC Gary H. Wynn (USA)

1000–1030

Break

1030–1115

Thinking from the Big Data Perspective — Robert J. Ursano, M.D. (USA)1115–1200

The Potential Value of Big Data Analytics for Military Mental Health 			— Ronald C. Kessler, Ph.D. (USA)

1200–1330

Lunch

1330–1415

Center for the Study of Traumatic Stress: An Overview 					— CAPT Joshua C. Morganstein (USA)1415–1500

Machine Learning and Support for Prevention of Military and Veteran Suicide 		— Robert Bossarte, Ph.D. (USA)

1500–1530

Break

1530–1615

The Virtual Psychiatrist: Machine Learning Technology to Provide Expert 		Psychiatric Management — Gary Hasey, M.D. (CAN)

1615–1700

Wrap up and Discussion — Panel Members

2NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

AgendaNovember 30, 2018
0900–0915

Welcome / Check In / Issues / New Attendees Welcome — LTC Gary H. Wynn (USA)0915–0945

Exposure based Rehabilitation in Immersive Contexts (ERIC); Piloting Personalized
VR Exposure Therapy — Col Eric Vermetten (NLD)0945–1015

Harnessing the Power of the Digital Phenotype — LTC Vincent F. Capaldi (USA)1015–1045

Characterization of Military PTSD using Multiplex Proteomic Data Clustering witha Multivariate Machine Learning–Based Feature Selection Classification 		— Shawn G. Rhind, Ph.D. (CAN)

1045–1100

Break

1100–1145

Large Australian Data Studies, Outcomes of the 5 Eyes Centres of Excellence Meetingin Sydney (with Prof David Pedlar) and the Potential for Future Research— David Forbes, Ph.D. (AUS)

1145–1300

Lunch

1300–1345

Classification of PTSD and its Dissociative Subtype: A Multimodal Neuroimaging
Approach with Machine Learning — Andrew Nicholson, Ph.D. (CAN)

1345–1415

Ethical Issues around Big Data — Edmund G. Howe, M.D. (USA)1415–1445

Break

1445–1600

Closing Remarks (Wrap–up, Next Steps, Next Meeting)3

NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Center for the Study of Traumatic Stress (CSTS)
ing the effects of disaster and trauma in the civilian
community to foster human continuity and community and national resilience.

The Center for the Study of Traumatic Stress(CSTS) is one of the nation’s oldest and most highly
regarded, academic–based organizations dedicatedto advancing trauma–informed knowledge, leadership and methodologies. The Center’s work addresses a wide scope of trauma exposure from theconsequences of combat, operations other than war,
terrorism, natural and human made disasters, andpublic health threats. CSTS is a part of our nation’sfederal medical school, Uniformed Services University (USU), and its Department of Psychiatry. These
affiliations represent the Center’s history, mission
and future directions as a major contributor to ourcountry’s understanding of the impact of trauma
and the advancement of trauma–informed care.
A unique aspect and contribution of the Centeris the bridging of military and disaster psychiatry
and the integration of disaster mental health andpublic health. In applying the principles and practices for dealing with individuals and groups exposed
to extreme environments (in the military), the Center has generated and disseminated its subject matter
expertise to inform disaster preparedness, response
and recovery principles and practices across a wide
range of traumatic events and populations.
Today and into the future, the Center is uniquely positioned to respond to DoD mission relevant
activities and issues, as well as to educate regionaland national stakeholders in government, industry,healthcare, public health, and academia on mitigat-

The Center:•

Develops and carries out research programs
to extend our knowledge of the medical andpsychiatric consequences of war, deployment,
trauma, disaster and terrorism, including weaponsof mass destruction.

•

Educates and trains health care providers, leaders,
individuals and public and private agencies on
how to prevent, mitigate and respond to thenegative consequences of war, deployment,
traumatic events, disasters, and terrorism.

•

Consults with private and government agencies
on medical care of trauma victims, their families
and communities, and their recovery following
traumatic events, disasters and terrorism.

•

Maintains an archive on medical literature related
to the health consequences of traumatic events,
disasters and terrorism of individuals, families,
organizations, and communities.

•

Provides opportunities for post–doctoral trainingof medical scientists to respond to and research
the health consequences of trauma, disaster, andterrorism.

Serving our nation for 30 years
4NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Embassy of Canada to theUnited States of America
The embassy
building is at 501
Pennsylvania Avenue, Northwest,
Washington, D.C.
between the Capitol
and the White House,
just north of the
National Gallery ofArt. In addition toits diplomatic role,
the Embassy handles
consular services andassists with international businessdevelopment for the surrounding states of Virginia,
West Virginia, and Maryland.
The Embassy was officially opened by Prime
Minister Brian Mulroney on May 3, 1989. The
building houses approximately 265 Canadian
diplomatic and locally engaged staff. The Embassy
houses representatives from two provinces (Ontario
and Alberta) and 13 Canadian federal government
agencies including Foreign Affairs, International
Trade and Development Canada, Industry Canada,
Transport Canada, Public Works and Government

Services Canada,
the Department of
National Defence,
the Permanent
Mission of Canada
to the Organizationof American States,
the Royal Canadian
Mounted Police,
amongst others.
Canada has theembassy closest to
the Capitol and is
the only country
to have its embassy
along the Presidential inaugural route between the
Capitol and the White House. The Washington, D.C.
bureau of the Fox News Channel is a short distanceaway—its studio is positioned such that the Canadian flag of the embassy is usually visible out thewindow during broadcasts.
The Embassy of Canada hosts numerous events
throughout the year for visiting ministers as well as
for a wide range of diplomatic, military, and public
functions.

5NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

NATO Science and Technology Organization(STO)
The North Atlantic Treaty Organization, also
called the North Atlantic Alliance, is an intergovernmental military alliance between 29 North Americanand European countries. The organization implements the North Atlantic Treaty that was signed on 4
April 1949.
NATO was launched as part of a broader effort
to serve three purposes: deterring Soviet expansionism, forbidding the revival of nationalist militarismin Europe through a strong North American presence on the continent, and encouraging European
political integration.
NATO’s essential purpose is to safeguard thefreedom and security of its members through political and military means.

of the STO to a Board of Directors (the Science &Technology Board — STB) comprising the NATO
Nations S&T managers. The STB is chaired by theNATO Chief Scientist who is a high level recognized
S&T leader of a NATO Nation, being permanently
assigned to the NATO Headquarters in Brussels andalso serving as the Senior Scientific Advisor to theNATO leadership.
The STO is composed of the STB, the Chief Scientist, and the three executive bodies: The Office of the
Chief Scientist (NATO HQ, Brussels), The Collaboration Support Office (Paris, France), and The Centre for
Maritime Research and Experimentation (La Spezia,
Italy). The CSO supports a range of activities primarily divided among a number of technical panels. These
technical panels (and one group) include Applied
Vehicle Technology (AVT), Human Factors in Medicine (HFM), Information Systems Technology (IST),
Systems Analysis and Studies (SAS), Systems Concepts
and Integration (SCI), Sensors and Electronics Technology (SET), and the NATO Modelling and Simulation Group (NMSG).
The mission of the HFM Technical Panel, underwhich RTG 279 falls, is to provide the science andtechnology base for optimizing health, human protection, well-being and performance of the human inoperational environments with consideration of affordability. This involved understanding and ensuring
the physical, physiological, psychological and cognitive compatibility among military personnel, technological systems, missions, and environments. This isaccomplished by exchange of information, collaborative experiments and shared field trials. HFM RTG
279 is a 3 year effort with the objective of identifying
and validating technologies that will advance mental
health within military populations, thus reducing theburden.

About STO (Science and Technology) in
NATO

In NATO, S&T is defined as the selective andrigorous generation and application of state-of-theart, validated knowledge for defence and security
purposes. S&T activities embrace scientific research,technology development, transition, application andfield-testing, experimentation and a range of relatedscientific activities that include systems engineering,
operational research and analysis, synthesis, integration and validation of knowledge derived throughthe scientific method.
The STO is a NATO subsidiary body having thesame legal status as NATO itself, and created within
the framework of the North Atlantic Treaty signed
in Washington, D.C. in 1949. It has been establishedwith a view to meeting to the best advantage the collective needs of NATO, NATO Nations and partner
Nations in the fields of Science and Technology. The
STO is operated under the authority of the North
Atlantic Council which has delegated the operations
6

NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Leveraging Technology in
Military Mental Health
Background and Justification for this RTG

The relevance of this proposed RTG is the collective sharing of efforts in the domain of implementing
new technologies in mental health. The impact will bea decreased mental health burden on our militaries
through the adaptation of these emerging technologies. This could lead to the standardization of various
technologies within NATO.
This RTG will address priorities in other NATO
S&T areas including Big Data & Long Data Processing and Analysis, and Sensor Integration & Networks.
This RTG will also coordinate with relevant on–going
activities: ET–135 Precision/Personalized Mental
Health and Performance, and HFM–RTG–260 Wearable Sensors. In addition, this RTG will also addressthe 2016 NATO S&T Priority ‘Advances Human Performance and Health’ in the following areas: Human
Resiliency, Medical Solutions for Health Optimizationand Enhanced Cognitive Performance.
The outcome of this RTG will be identification oftechnological advances that can have a direct impact
on assessment, treatment, education, training, andidentification of risk. This will enhance force readinessthrough optimized performance, risk mitigation, return to duty, and more efficient health care utilization.

Leveraging technology represents the greatest
opportunity for advancing mental health in overa century. Across the NATO Alliance all partners
are contending with a significant mental healthburden and leveraging technology will be part of aconcentrated effort to mitigate its impact. Advancesin fields such as data analytics, robotics, imaging
and biomarkers, simulation, machine learning andgenomics have been leveraged in various medical
specialties, most notably in oncology, cardiology,
radiology, and surgery. Mental health is lagging behind in the application of these advances. Leveraged
technologies will augment or replace conventional
approaches across all domains of military mental
health (assessment, treatment, education, training,
and identification of risk). Taking advantage of thesetechnologies will contribute to greater force readiness and enhance assessment and treatment of the ill
and injured.
Current military mental health approaches reflect mental health in the broader community. However, given their unique populations and mandate,militaries are perfectly poised to leverage technology. Unlike civilian communities, militaries have a
mission–oriented responsibility to optimize a broad
range of aspects of a service member’s life, including
health, employment, housing and family/community. It is the unique role of the militaries that makes it
possible to effectively invest in leveraged technology.
The Exploratory Team (ET–137) concluded thatthe myriad of technologies and potential mental
health applications are too expansive to be covered
in a single RTG. As such the recommendation is tofocus an RTG on technologies for military relevant
mental health problems such as PTSD, Depression,
Substance Use Disorders and Suicidality.

Objective:

The main objective is to identify and validate
technologies that will advance mental health within
military populations thus reducing the burden.

Topics to be Covered

1. Big Data/Machine Learning
2. Neuroimaging/Biomarkers
3. Mobile and Online Interventions
4. Genomics
5. Simulation and ‘Serious Gaming’
6. Neurostimulation
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NATO HFM 279 on Leveraging Technology in Military Mental Health
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The proposed RTG will review existing technologies with regards to their applicability and suitability in the military mental health setting. The list
below outlines some of these technologies, but others could be studied as the field continues to evolve.
Each technology will be reviewed with respect toprevention, diagnosis, treatment and prediction of
military mental health disorders.
•••which is crucial for militaries that deploy troops
throughout the world. These approaches areprovider multipliers in a setting where personnel
resources are limited.

Big Data/Machine Learning: Most militaries
have incredible amounts of data in Electronic
Health Record (EHR) systems, as well as
personnel and other administrative data. These
approaches will provide a depth of analysis thathas not been possible before. This allows forrisk stratification, algorithm creation, treatment
predictions, and training need identification,
all of which may inform policy. Augmentationof datasets with alternative data streams fromsources such as wearable devices and social
media can further enhance opportunities toleverage this technology.
Neuroimaging/Biomarkers: Increased
exploration of biomarkers (e.g. hormones,
cytokines) and neuroimaging techniques (e.g.
magnetoencephalography (MEG)) has greatly
enhanced the understanding of the biologicalunderpinnings of mental health disorders.
Computational analyses of these objective
markers allows for discovery of biosignaturesthat can inform clinical care of military relevant
mental health problems.
Mobile and Online Interventions: Several new
applications have emerged that allow online
assessment as well as treatment (e.g. web–based
CBT, telemental health). There are no geographic
or temporal limitations to these approaches

8•

Genomics: Genomic analyses have facilitatedbetter understanding of the molecular biology
of PTSD, Depression, Substance Use Disorders
and Suicidality. This understanding may resultin more refined approaches. Most notably
pharmacogenomics has evolved to the point
where medication management can be fairly
specifically directed based on discrete testing.

•

Simulation and ‘Serious Gaming’: Militaries
are already familiar with Simulation and Serious
Gaming. New approaches can extend thistechnology, create more immersive environments
and incorporate live (e.g. wearables, neuro/
biofeedback) interactive modes of training.
Serious Gaming tailored to military contexts canenhance resilience, and simulation can augment
treatment response (e.g. Virtual Reality for
PTSD).

•

Neurostimulation: Biological therapies beyond
medication have existed for many years. This
field is rapidly advancing despite a controversial
history. Effective treatments such as repetitive
Transcranial Magnetic Stimulation (rTMS),
Deep Brain Stimulation (DBS), Vagal Nerve
Stimulation (VNS), transcranial Direct Current
Stimulation (tDCS), and Electroconvulsive
Therapy (ECT) stimulate regions of the brain inorder to alleviate suffering. These approaches canbe individualized to target affected regions of
the brain and are generally very well tolerated inmilitary relevant mental health disorders.

NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Summary of Meetings to Date
Research Task Group Planning (Meeting #1)
NATO Science and Technology Office
Neuilly-sur-seine, Paris, FR
19–21 April 2017

diagnosis, treatment prediction and monitoring, andprevention efforts. The second full day of meetings,
Oct 4th, was dedicated to the topic of neuroimaging
including fMRI, MEG, PET and others. The meetingconcluded with initial planning for Meeting #3.

The initial meeting of
the HFM 279 RTG panel members took placeat the NATO STO Collaboration Support Office in Paris, FR and focused on organizationand scheduling. Panelmembers reviewed thefoundational documents supporting NATO’s decision to stand up the RTG. Panel members sketchedout an initial schedule of meetings for the topics tobe covered. Tasks were assigned and interim updates
and planning meetings were scheduled. A discussion
around the possibility of producing a journal special issue from this RTG was undertaken and panel
members volunteered to explore this further.

Serious Gaming and Simulation (Meeting #3)
Marine Etablissement Amsterdam
Amsterdam, NLD
20 – 22 Feb 2018
The Serious Gaming
and Simulation Meeting took place at the
Marine Etablissementin Amsterdam, NLD.
During the course ofthis meeting, panel
members were given awide range of presentations on gamification of mental health interventions, virtual reality, full body haptic suits for military training, sensory reality pods, computer aided
therapy, and other topics. Panel members were also
treated to a tour of outstanding research facilities in
the Netherlands. The meeting concluded with initialplanning for Meeting #4.

Biomarkers and Neuroimaging (Meeting #2)
Royal Canadian Military Institute
Toronto, CA
2–4 October, 2017
The Biomarkers and
Neuroimaging Meeting
took place at the Royal
Canadian Military
Institute located in Toronto, CA. The first fullday of meetings, Oct
3rd, was dedicated to the
topic of biomarkers formilitary relevant mental health. Discussion topics
included the utility of various sources of biomarkers and the potential application of biomarkers for9NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Panel Members
Col Rakesh Jetly (CAN)
Panel Chair

and regional director of the Operational Trauma andStress Support Centre (OTSSC).
In 2006 and 2007, Col Jetly was deployed on two
separate missions to Afghanistan as the head of themental health detachment of the Canadian-led Role
Three Multinational Medical Unit. He was promoted
to Lieutenant-Colonel in 2007 and posted to Ottawa
in 2008 as the mental health advisor to the Deputy
Surgeon General.
Col Jetly was promoted to his current rank in2011 and appointed senior psychiatrist and mental
health clinical advisor to the CF Surgeon General.
He was additionally appointed in 2015 “The Canadian Forces Brigadier Jonathan C. Meakins, CBE,
RCAMC Chair in Military Mental Health”.
Col Jetly was appointed to the Order of Military
Merit as an Officer in 2009. He is also an associate
professor of psychiatry at Dalhousie University (Halifax); Queen’s University (Kingston), and the University of Ottawa. He has published numerous articles
in professional journals and presents nationally andinternationally on such topics as post-traumaticstress disorder and operational psychiatry.
Col Jetly and his wife Julie reside in Ottawa with
their three children: Sarah, Serena and Deven.

Colonel Rakesh Jetly enrolled
under the Medical Officer
Training Plan in 1989 andgraduated in 1991 from the
University of Toronto with aDoctorate in Medicine (MD).
Upon graduation, he wasposted to Canadian Forces(CF) Base Borden as a General Duty Medical Officer and Flight Surgeon.
In 1993, Col Jetly deployed as the senior medical
officer to the United Nations mission in the Golan
Heights (UNDOF) and in 1994, he deployed to
Rwanda as part of the CF humanitarian mission
In 1996, he was accepted into the University ofToronto Postgraduate Training Program in Psychiatry and was promoted to the rank of major in
1997. Upon graduation in 2000, he was certified
as a Fellow in the Royal College of Physicians andSurgeons of Canada (psychiatry) and posted to CF
Health Services Centre (Atlantic). During his tenure
in Halifax from 2000-2008, he filled various roles
including clinical director of mental health services

10

NATO HFM 279 on Leveraging Technology in Military Mental Health
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Panel Members, Continued
Col Eric Vermetten (NLD)
Panel Co-Chair

LTC Gary H. Wynn (USA)
Local Panel Host

Prof dr Vermetten, M.D.,
Ph.D. (1961), is Strategic
Advisor of Research at the
Military Mental Health Service with the Dutch Ministryof Defense, Arq Psychotrauma
Research Group and at UMC
Utrecht. He holds an endowed
chair in Psychiatry at the
Department of Psychiatry at Leiden UMC. He also
has an Adjunct Professorship at the Department of
Psychiatry of NYU School of Medicine. He is trainedin the Netherlands as well as in the USA (Stanford,
Yale and Emory) in psychiatry and neuroscience.
He has clinical as well as a research positions witha focus on medical/biological as well as psychiatricaspects of complex psychotrauma in military as wellas civilian populations. He has published over 200
papers, over 30 book chapters and edited several
books on this topic. His research is in the field ofstress, trauma, complex PTSD and neuroscience. He
is interested in the history of war and has special
focus on combining biological-based interventionsin psychotraumatology with novel technology andnovel drug developments. He is PI of a new research
initiative on a roadmap for medication-assisted psychotherapy in The Netherlands and Europe, including use of a variety of psychedelics. Prof Vermetten
is an ad hoc reviewer for numerous journals andgranting agencies. He has lectured on the topic of
PTSD, resilience, military and veterans issues as well
as novel approaches to therapy across the globe.

Dr. Wynn is Associate
Professor of Psychiatry and
Neuroscience and Assistant
Chair of the Department of
Psychiatry at the Uniformed
Services University of the
Health Sciences. He is a Scientist at the Center for the
Study of Traumatic Stress.
He is also a Distinguished Fellow of the American
Psychiatric Association and on the editorial boardsof the Journal of Neuroscience Research. Dr. Wynn
received his education at the United States Military
Academy at West Point and Uniformed Services
University of the Health Sciences. He completed adual residency in psychiatry and internal medicine at
the Walter Reed Army Medical Center in Washington,
D.C. During his military career Dr. Wynn served as a
Division Psychiatrist (2nd Infantry Division, Korea),
Assistant Chief of Inpatient Services (Walter Reed),
and as a Research Psychiatrist (Walter Reed Army
Institute of Research) prior to transitioning to the
Uniformed Services University of the Health Sciences.
Dr. Wynn has served as a frequent member of
DoD level committees and working groups on the
topics of PTSD and suicide. He currently serves as the
Chair for the DoD’s Joint Program Committee working group on Diagnosis and Treatment of PTSD. Dr.
Wynn has served as a member of VA Merit Review
Boards, National Institute of Mental Health (NIMH)
Data Safety and Monitoring Board, and as US Representative to NATO Human Factors in Medicine panels. He is a member of the Order of Military Medical
Merit and recipient of the AMEDD “A” Proficiency
Designator, the Rundell Award, the Artiss Award,
and three Meritorious Service Medals. Dr. Wynn is a
Past President of the Society of Uniformed Services
Psychiatrists. In addition, Dr. Wynn has over 70
publications, including being co-author and editor on
three books.
11NATO HFM 279 on Leveraging Technology in Military Mental Health
Meeting #4 — Big Data & Machine Learning

Panel Members, Continued
Rosemarie Huver Ph.D. (NLD)
Panel Member

Shawn G. Rhind, Ph.D. (CAN)
Panel Member

Dr. Rosemarie Huver is a
Senior Business Developer at TNO (Netherlands
Organization for Applied
Scientific Research). Rosemarie is a psychologist
with a PhD in Health Sciences. She works at TNO
Defense Safety and Security, as a partner in innovation for the Netherlands
MoD. She organizes TNO’s business team Human
Performance and Health, focusing on the initiationand development of research programs and projects.
What causes some individuals or teams tokeep up performance while others don’t? How can
we support professionals operating in challenging
conditions? And how can we protect high-risk professionals from developing negative mental healthconsequences? These are some of the questions
business team Human Performance and Health tries
to answer, focusing on Military and Police Forces.
Pursuing ‘Fit for action, fit for function, fit for life’,business team Human Performance and Healthaims at improving the performance and health (inphysical, mental, social and cognitive fields) of thoseworking in complex, demanding environments.
Rosemarie’s research interests focus on measuring and enhancing psychological resilience, wearable technology, people analytics, recruitment andselection of personnel, increasing employability,
human and organizational adaptivity, and behavioral
influence. She is passionate about discovering innovative waysfor leveraging technology for military
mental health.

Dr. Shawn Rhind earned
his doctorate in Immunobiology from the Universityof Toronto. He completed
an NSERC Postdoctoral
Fellowship with the Defence& Civil Institute of Environmental Medicine (DCIEM)
and US Army ResearchInstitute of Environmental Medicine (USARIEM),
examining biomolecular interactions between
neuro-endocrine-immune systems under severe
physiological stress and environmental extremes andtheir impact on health and performance. Today, Dr.
Rhind is a senior Defense Scientist in the Military
Operational Health Group at Defence Research andDevelopment Canada (DRDC) Toronto and an Associate Professor at the University of Toronto, where
he leads an integrative — molecular to systemic —translational research team. His research spans basic
laboratory science to human clinical trials, and iscurrently focused on elucidating the biological basis
and therapeutic countermeasures for combat-related psychological and physical trauma, including
post-traumatic stress disorder (PTSD) and battlefield care after traumatic shock and brain injury.

12NATO HFM 279 on Leveraging Technology in Military Mental Health
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Speakers
Robert J. Ursano, M.D. (USA)

Ronald C. Kessler, Ph.D. (USA)Dr. Ursano is Professor of
Psychiatry and Neuroscienceat the Uniformed Services
University School of Medicine
and founding Director of theCenter for the Study of Traumatic Stress. He is Editor of
Psychiatry, the distinguishedjournal of interpersonal andbiological processes, founded by Harry Stack Sullivan. Dr. Ursano completed twenty years of service
in USAF medical corps. He is a Distinguished Life
Fellow of the American Psychiatric Association. He
has received the Department of Defense Humanitarian Service Award, the Lifetime Achievement Awardof the International Traumatic Stress Society andthe William C. Menninger Memorial Award of theAmerican College of Physicians. He is senior editorof the Textbook of Disaster Psychiatry. Dr Ursano
was the first Chairman of the APA‘s Committee on
Psychiatric Dimensions of Disaster. His work has
greatly aided the integration of psychiatry and public health in times of disaster and terrorism.

Ronald C. Kessler is theMcNeil Family Professor of
Health Care Policy at Harvard
Medical School (HMS). His
research deals broadly with thesocial determinants of mental
illness from an epidemiologicalperspective. He is the authorof over 700 publications andthe recipient of many awards for his research, including Senior Scientist and MERIT awards from NIMH.
He has been rated as the most widely cited researcher
in the world in psychiatry for the past two decades.
He is a member of both the Institute of Medicine andNational Academy of Sciences. Kessler is the Principal
Investigator of the US National Comorbidity Survey,
the first nationally representative survey of the prevalence and correlates of mental disorders in the U.S., and
Co-Director of the World Health Organization’s World
Mental Health Survey Initiative, a series of comparative community epidemiological surveys of the prevalence and correlates of mental disorders in 30 countries around the world. He is involved in evaluating a
number of innovative programs for the prevention andtreatment of mental illness in high-risk segments of the
population. He is also the HMS PI of the STARRS-LS
program of research on risk and protective factors for
suicide among Army personnel and of the AURORA
study of adverse neuropsychiatric reactions to traumatic life events among patients presenting to emergency
departments in the wake of such events. Kessler earned
his Ph.D. in sociology from New York University, completed a postdoctoral fellowship in psychiatric epidemiology at the University of Wisconsin, and was on thefaculty at the University of Michigan before taking his
current position in 1995 at HMS.
13

NATO HFM 279 on Leveraging Technology in Military Mental Health
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Speakers, Continued
CAPT Joshua Morganstein (USA)tutes of Justice and UCLA on a study of community
resilience in the aftermath of mass shootings andworking with the U.S. Air Force to identify and manage the effects of recurrent and persistent traumaticstress exposure on personnel involved in drone
aircraft operations.

Dr. Joshua C. Morgansteincurrently serves as an Associate
Professor and Assistant Chairin the Department of Psychiatry and Assistant Director
at the Center for the Study ofTraumatic Stress. He is a Fellow
and Chair of the Committee
on the Psychiatric Dimensionsof Disaster within the American Psychiatric Association. Dr. Morganstein completed undergraduate
training at the University of Maryland at College
Park, medical school at the Uniformed Services
University, and combined Psychiatry and Family
Medicine residency training in the National Capital
Consortium. Dr. Morganstein’s operational experiences include remote overseas community mental
health care for the Pacific Air Force in Japan and deployment to Afghanistan as the lead Psychiatrist in
support of the Global War on Terrorism. He served
as Chief of Addictions Services for the Air Force’s
only dual-diagnosis treatment program and wasselected to serve as the Behavioral Health Advisor to
the Commander, Joint Task Force National Capital
Region-Medical. Following a sixteen year career asan Air Force officer, Dr. Morganstein transferred to
the Commissioned Corps of the United States Public
Health Service in 2013 to pursue his professional
interests in public health and disaster mental health.
Dr. Morganstein provides disaster mental healtheducation, consultation and training as a speakerand consultant to federal agencies and nationalorganizations. He has authored and co-authored a
range of scholarly works on the mental health effectsof various disaster events including natural disasters,
mass violence, terrorism, pandemics, climate change,
and nuclear exposure. Dr. Morganstein served in
the development of disaster mental health training
curriculum and global disaster management doctrine. He is Assistant Editor for the second edition of
the Textbook of Disaster Psychiatry. Dr. Morgansteinis currently collaborating with the National Insti-

Robert Bossarte, Ph.D. (USA)Dr. Bossarte is Director ofWest Virginia University’s
Injury Control ResearchCenter and Associate Professor in the Department of
Behavioral Medicine andPsychiatry. Dr. Bossarte
completed his Ph.D. in Sociology at the University ofNotre Dame and postdoctoral training in epidemiology as an Officer in CDC’s Epidemic Intelligence
Service program, where he worked on violence andsuicide prevention in the National Center for Injury
Prevention and Control. Dr. Bossarte’s work focuses
on developing new models for identifying risk forsuicide and linkages between advanced analytics andsuicide prevention programs.

Gary Hasey, M.D. (CAN)Dr Hasey is an Associate
Professor at McMaster University (Hamilton, Ontario) in the Departments of
Psychiatry and Behavioural
Neurosciences, Electricaland Computer Engineeringand Biomedical Engineering. He established Canada’s
first therapeutic repetitive transcranial magnetic
stimulation clinic in 1997. In partnership with St
Joseph’s Hospital and McMaster University, he andhis engineering colleagues founded Digital Medical
Technologies Inc (DME). DME’s machine learningalgorithms use electrical brain activity (EEG) and
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Speakers, Continued

clinical data to autonomously diagnose various
mental illnesses, predict the effectiveness of various
pharmacological and non-pharmacological psychiatric treatments and estimate suicide risk.

viewed scientific articles and book chapters on
various topics such as sleep disorders, traumaticbrain injury, and post stroke depression that haveappeared in several medical journals. He serves as
the Psychiatry & Clinical Psychology Disorders
Capabilities Manager and Steering Committee Chair
for Physiological Health and Performance in the
Military Operational Research Program.

LTC Vincent Capaldi (USA)LTC Vincent F. Capaldi, II,
MC, USA, is the Chief ofthe Department of Behavioral Biology, Center for
Military Psychiatry and
Neuroscience Research, at
the Walter Reed Army Institute of Research in Silver
Spring, MD. He currently
serves as an associate professor in the departmentsof Internal Medicine and Psychiatry at the Uniformed Services University of the Health Sciencesin Bethesda, MD. He is also the program director of
the National Capital Consortium combined Internal
Medicine and Psychiatry residency training programand chair of the Biomedical Ethics Committee at
Walter Reed National Military Medical Center
LTC Capaldi completed dual residency training
in Internal Medicine and Psychiatry and fellowshipin Sleep Medicine at Walter Reed National Military
Medical Center. LTC Capaldi holds board certifications from the American Board of Psychiatry and
Neurology and the American Board of Internal
Medicine to practice General Psychiatry, Internal
Medicine, and Sleep Medicine. In 2013, LTC Capaldi
was elected as a Fellow of the American Psychiatric
Association and the American College of Physicians
and currently serves at the president of the Societyof Uniformed Services Psychiatrists.
In January, 2013, LTC Capaldi was appointed
as officer in charge (OIC) of the Restoration Program at Bagram Air Field, Afghanistan. As OIC,LTC Capaldi was responsible for the comprehensive
behavioral health restoration program, all clinicaloperations, and prevention activities for over 45,000
NATO troops stationed across Afghanistan.
LTC Capaldi has published over 30 peer re-David Forbes, Ph.D. (AUS)David Forbes is the Directorof Phoenix Australia — Centre for Posttraumatic Mental
Health and Professor in the
Department of Psychiatry,
University of Melbourne. He
has over twenty-five years
experience in the assessment
and treatment of mental
health problems in trauma survivors, with a speciality in military and veteran mental health. He led
the development of the inaugural 2007 Australian
Guidelines for the Treatment of Posttraumatic Stress
Disorder (PTSD) and the revision published in2013 approved by the National Health and Medical Research Council and endorsed by colleges ofpsychiatrists, psychologists and general practitioners.
Professor Forbes is also Vice Chair of International
Society for Traumatic Stress Studies Committee forthe new PTSD Guidelines and the lead editor for
the forthcoming third edition of the ISTSS Effective
Treatments for PTSD book.
He has published 150 scientific papers in theinternational literature and sits on many Commonwealth government policy and scientific advisory
panels and academic journal editorial boards
He has a strong track record in the conduct of
research in the assessment and treatment of PTSD
and the provision of policy and service development
advice to government and agencies responsible forthe care of veteran and military personnel and trauma survivors across the community.
Professor Forbes has also a strong track record
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Speakers, Continued
in the provision of training in evidence-based treatments for PTSD and related disorders. This has also
included the development of mobile app and online
resources for practitioners and trauma survivors.

Dr. Howe joined the USU faculty in 1977 and is a
Professor in the Department of Psychiatry, Associate Professor in the Department of Medicine,
Director of Programs in Medical Ethics, and Senior
Scientist, Center for the Study of Traumatic Stress.
His research has focused on medical ethics with anemphasis on ethics in military medicine and clinicalcare at the end of life.
Dr. Howe’s professional contributions stem
primarily from his interests in ethics. He is theFounding Editor-in-Chief of The Journal of Clinical
Ethics and has served as a member of the Walter
Reed Army Medical Center, National Naval Medical
Center, and Malcolm Grow U.S. Air Force Medical
Center Ethics Committees, as well as the Ethics
Committees at Montgomery Hospice, the Visiting
Nurse Association, Springfield Psychiatric Hospital, the V.A. Hospital of Washington, D.C., and the
National Institutes of Health. He is Chair of thehuman use Institutional Review Board at USU, andthe Ethics Subcommittee of the Society of Medical
Consultants to the Armed Forces.
Dr. Howe is past Chair of International Health
Law Committee of the International Law Section of
the American Board Association, a past appointee tothe Governor’s Commission of Health Care Policy
and Financing for the State of Maryland, and present Liaison Member of the International Section of
the American Bar Association and the Commission
on Mental and Physical Disability Law. He is or has
been a consultant at NIH, OTA, HHS, FDA, theInstitute of Medicine, the US Public Health Service,
the National Science Foundation and NASA. He isa member of the CIA IRB and has been a memberof the American Red Cross IRB and several other
IRB’s. He is on the Editorial Board and/or a reviewer
for numerous publications, including NEJM and
JAMA. He is currently President of the Academy ofMedicine in Washington, D.C.

Andrew Nicholson, Ph.D. (CAN)
Dr. Andrew Nicholson(Western University) is a post-doctoral
fellow working with
Drs. Rakesh Jetly, Ruth
Lanius, and Margaret
McKinnon. Nicholson’s
research backgroundhas expanded to include
a multitude of fMRI imaging studies in the field of
PTSD, as well as EEG and PET modalities. The key
strength Nicholson brings to the Canadian researchgroup is his expertise in a plethora of technicalfMRI imaging methods, including real-time fMRI
neurofeedback, generalized psychophysiologicalinteraction analyses, resting-state effective connectivity analyses, and most recently, the application offMRI machine learning algorithms to predict PTSD
symptoms.

Edmund Howe, M.D. (USA)Dr. Edmund Howe received
his undergraduate degree at
Yale and his M.D. at Columbia. He completed an internship at Harlem Hospital andhis residency in Psychiatry at
Walter Reed Army Medical
Center. He attended Rutgers
University Law School andthen received his law degree at Catholic University.

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NATO HFM 279 on Leveraging Technology in Military Mental Health
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