Behavioral health

Abstract

Experience gained from test pilots, high-altitude balloonists, and animals sent on rocket flights was the starting point for understanding astronaut adaptation and performance in space. Psychology played a significant role in Project Mercury, but before that effort was complete, official interest in such topics as astronaut selection, psychosocial adjustment, group dynamics, and psychological support all but disappeared. Interest was rekindled when astronauts joined cosmonauts on Mir and then became full partners on the International Space Station. We review reasons for this period of minimal involvement in the space program and suggest that the “right stuff” image worked against psychology and psychiatry until the mid-1990s, when space station expeditions brought the challenges of long-duration missions into focus. Evidence of renewed interest included the advent of the National Space Biomedical Research Institute, the development of NASA’s Bioastronautics Critical Path Roadmap, and the new Human Research Program. In 2001, Safe Passage: Astronaut Care for Exploration Missions drew attention to behavioral health, a perspective on psychosocial adjustment that depends not only an absence of neuropsychiatric dysfunction but on the presence of positive interactions with the physical and social environments. We trace the history and current status of astronaut selection and psychological support, two essential ingredients for maintaining behavioral health, from Mercury to the ISS. Behavioral health is important because it reduces risk, helps optimize performance, and contributes to the welfare of astronauts, their coworkers, and their families. We conclude with a brief outline for a comprehensive and continuing program in spaceflight behavioral health.