Health Care Opportunity 12. Performing clinical studies on anemia, immunity, wound infection, and wound healing as part of every space mission.

Mental Health Issues

The transition to long-duration space missions will require greater emphasis on ways to prevent and successfully manage an array of challenges to the cognitive capacities and emotional stabilities of astronauts who will find themselves in an isolated, confined, and hazardous environment. They will be devoid of much of what supports their emotional well-being on Earth and will need to develop and maintain new coping strategies appropriate to the unique environment of space beyond Earth orbit.

Current data on the psychiatric sequelae of long stays in surly environments come primarily from studies of military personnel on submarine duty, Antarctic field scientists, and Biosphere inhabitants (Billica, 2000), as well as more limited experience on the Russian space station Mir. These data suggest that the incidence of discernible psychiatric symptomatologies, including depression, anxiety, substance abuse, and psychosis, ranges from 3 to 13 percent per person per year, depending on the setting (see Tables 3–2 to 3–7). Transposed to a six- or seven-member space crew on a 3-year mission, the likelihood that psychiatric problems will arise on such an expedition is not insignificant but is less than 54 percent—(3 percent/year)×(six astronauts/year)×(a 3-year mission)—per astronaut during a 3-year mission among a space crew when one extrapolates from the crude available data on behavioral disturbances in space.

Such problems can range from simple boredom and fatigue to acute stress reactions, profound depression, and overt psychosis. Some mental health problems may become more likely over time as the cumulative effects of environmental and interpersonal stressors are magnified by the extended duration of the mission.

The NASA Experience to Date

Almost all of NASA’s behavioral medicine experience with space travelers thus far has been with flights of relatively short duration (i.e., 2 to 3 weeks), where emergent signs and symptoms have included evidence of stress, anxiety, diminished concentration, depressed mood, malaise, and fatigue. These problems have been identified in less than 2 percent of astronauts, and their effects on individual and crew performance have reportedly



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