Military Psychology and Combat Resilience Program

Executive Summary

Modern war produces psychological casualties on the scale of physical ones. Around 30 percent of Ukrainian soldiers returning from the front report PTSD-class symptoms (Kyiv Independent, Institute of Psychiatry). The Chatham House Super-Sparta study (April 2026) found Israeli reservist turnout falling from 100 percent at the start of the Gaza war to 75 to 85 percent in 2026, 41 percent losing civilian jobs, and around half with PTSD-class symptoms. Drone warfare adds a new presentation: operators exposed daily to first-person video of their own kills. Lithuania's Defence Medical Service has limited military-specialised psychology, and the 17,000-strong Riflemen Union has no structured peer-support pipeline. Reference models exist: the US Army's Walter Reed Behavioural Health institute and its Star Behavioural Health Providers civilian network, the UK Defence Medical Services mental health team, Ukraine's wartime scaling, and Israel as a cautionary sustainment case. The recommended next step is a feasibility study by the Ministry of National Defence with Vilnius University Faculty of Medicine and Santaros klinikos, covering clinical scope, integration with existing psychiatric services, the Riflemen Union gap, and a drone-operator protocol. Final scale and structure are for Lithuania to determine.

The Problem

Russia's reconstitution timeline points to offensive readiness toward the end of the decade, and the Iran war of March-April 2026 produced a 39-day intense-strike window in which the Israeli home front absorbed mass-trauma exposure with degraded reservist availability. Lithuanian doctrine assumes the Riflemen Union and total national mobilisation will hold the line in the first 72 hours of any Russian incursion — the same window in which combat-stress reaction is most treatable. The country has no doctrine for that first 72 hours of mass-casualty psychology and no surge capacity to deliver it.

The Defence Medical Service inside the Ministry of National Defence has limited military-specialised psychology billets. Civilian psychiatric capacity sits in Vilnius University Hospital Santaros klinikos and the Faculty of Medicine, but the bridge between civilian clinical care and forward unit support is missing. The roughly 17,000-strong Riflemen Union has no formal peer-support training pipeline. There is no protocol for the drone-operator trauma profile — persistent visual exposure to first-person kill footage — which is now standard work inside Lithuanian and Ukrainian unmanned units.

Without action: Sustained combat or a single intense strike window degrades force availability faster than the casualty count alone implies. Reservist turnout falls, as it did in Israel after eighteen months. Trained drone operators burn out. Long-term disability costs accumulate. Allied counterparts see a mobilisation system without a sustainment system behind it.