Last Published:  07/31/19 10:05:30 AM (Central)
Responsible Element: Human Factors and Behavioral Performance (HFBP)
Status: Open

Present State:
Current ISS operations are based on a six person international crew living and working for six months in low Earth orbit. While astronauts generally thrive on these missions, there have been anecdotal evidence and research reports of psychosocial issues occurring in spaceflight, both on the ISS and in other environments. Furthermore, ISS operations are based on real-time treatment of medical events related to adverse behavioral conditions (e.g., insomnia) from ground medical personnel. Future missions, however, will be characterized by communication delays and will vastly exceed the current ISS mission duration of six months, increasing the probability of behavioral health issues. Medical treatment will depend on new approaches via asynchronous telemedicine, self-treatment methods, and/or the presence of a medically trained crewmember with skills in psychiatric medicine. The goal of BMed Gap 6 is to determine the optimal methods to treat individual behavioral health problems should they occur during exploration class missions, including the use of behavioral health medications.

An understanding of autonomous, non-pharmacological treatment methods to help remedy behavioral health problems in remote individual crewmembers is imperative due to the circumstances expected during long duration and/or distance exploration missions. To gain this understanding, it is necessary to understand the role that asynchronous telemedicine would play between a mission crewmember and a mission control mental health professional in providing support and therapy, and how such a method would compare with the efficacy of real-time, face-to-face methods. It is also important to define when cognitive behavioral therapy should be employed versus problem solving therapy versus social skills training and for which problem set. Furthermore, it is essential to define the frequency and mission stage at which coping skills and interpersonal problem solving should be implemented. Lastly, it is crucial to define when pharmacological treatment of a developing behavioral health problem should be instituted. Note: Early prediction, detection and assessment will be informed by BMed Gap 2.


The BHP element will take a multifaceted approach to closing BMed Gap 6 which involves a combination of examining research findings from related gaps and soliciting new research studies to provide missing information needed for gap closure. First, determining and understanding the key threats and indicators will be informed by BMed Gap 1, while early prediction, detection and assessment of behavioral health decrements will be informed by BMed Gap 2. Next, BMed Gap 5 will assist in providing data on selection of individuals who are more resistant to developing behavioral health problems in isolation and confinement. Lastly, BMed Gap 8 will aid in the prevention of behavioral health problems by detailing the best methods of maintaining social support from Earth to crew members. To ultimately close BMed Gap 6, however, BHP will need to conduct additional research to identify potential behavioral challenges and treatments within the context of the exploration mission environment. BHP will, therefore, solicit studies to 1) identify potential clinical behavioral challenges that may affect crewmembers during autonomous, long duration and/or distance exploration missions; 2) identify treatment options for the set of identified behavioral challenges; and 3) validate the set of identified treatment options. Lastly, based on the research findings, BHP will develop an integrated suite of treatment protocols for treating behavioral challenges experienced during exploration missions.

Target for Closure
(1) Identified set of behavioral challenges that may affect crewmembers in exploration environments.

(2) Identified set of validated non-pharmacological treatment methods for the identified behavioral challenges.

(3) Identified thresholds for implementation of pharmacological treatment of the identified behavioral challenges. (relates to BMed 2)

Risk Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders
You are here! Gap CBS-BMed6: We need to identify and validate effective treatments for adverse behavioral conditions and psychiatric disorders during exploration class missions.

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