How will Mars crews fare psychologically? How will they relate to one another, and will they be able to maintain healthy relationships with their families on earth? What might be some of the rewards or joys that they will experience? In this paper, drawing largely from the experience of NASA, we explore techniques for fostering psychological and social adaptation to the unprecedented demands of a future Mars mission.

1. Introduction

Mars astronauts will be tough, resourceful, and well prepared, but there remains the risk that danger, frustration, relentless scrutiny by the media, worries about family on earth and many other stressors will lead to deteriorating performance, personal unhappiness, and interpersonal frictions (Ball & Evans, 2001; Brady, 2005; Connors, Harrison & Akins, 1985; Harrison, 2001, 2005; Kanas & Fedderson, 1971; Kanas & Manzey, 2008). Anxiety, depression, sleep disorders, impulsive behaviors, interpersonal tensions, outright hostility, cross-cultural misunderstandings, impaired concentration and memory, reduced problem solving ability, social withdrawal, and excessive concerns about health have occurred in space (Shepanek, 2005). Although infrequent, greater problems such as rage, impulsive behavior and schizophrenia have materialized in other extreme settings such as submarines and Antarctica (Shepanek, 2006).

We can also expect some positive psychological consequences during the mission (Suedfeld, 2005). Spacefarers have expressed satisfaction at their skills, membership in an elite team, and some have undergone almost mystical transformational experiences (White, 1987). Discussing his experiences in space, Walter Cunningham (1977, p. 27) once stated “It caused me to confidently seek a challenge wherever I can find one, to charge ahead and never look back…that feeling of omnipotence is worth all that it takes to get there.” Edgar Mitchell was exhilarated by his experiences in space. He felt that the cosmos and everyone in it were connected, and wondered if the cosmos itself were conscious. On his return he became more introspective and devoted himself to reconciling science, religion, and the inner world of experience (Mitchell & Williams, 1996).

Still, there is reason to linger on risks and countermeasures. A psychiatric episode en route to Mars would not only result in the temporary or even permanent loss of the services of a valued crewmember, but place extra stress on other crewmembers who have to look after that person and assume his or her duties. Even minor problems are disconcerting as there is always a risk that they could cascade out of control.

Common sense measures such as keeping busy, physical workouts, constructive use of free time, and attaining goals all contribute to mental and emotional well being. Maintaining a confidential diary offers an opportunity to vent and reflect. By talking to one another, astronauts can gain support and encouragement, develop fresh perspectives, and conduct reality checks. Sometimes astronauts step forward to mediate and resolve interpersonal conflicts. A little “alone time” and play can do wonders, even as they do on earth.

2. Selection

Astronaut selection is aimed at predicting successful human performance in spaceflight. It involves developing a pool of candidates, evaluating them against pre-selected criteria and then choosing those who will be highly qualified for a mission after they have undergone training (NASA, 2010). A forthcoming summary of psychological selection of astronauts provides both a historical overview and new ideas for choosing crew members for Mars (Woolford, et. al., in press).

Since the beginnings of the American space program, there have been at least some elements of psychological selection (Link, 1965) and today the US, along with every other country with an astronaut program, has its own criteria and selection procedures. In the US, early evaluations involved both organizational and clinical approaches.

However, as early as the 1960s interest in the psychological assessment of astronauts waned. By the early 1980’s Jones and Annes (1983) wrote that no psychological testing was being done. There still was screening by expert aviation psychiatrists, but this was done in the absence of specific objective rating criteria. In the mid 1980’s NASA hired both a psychiatrist and a psychologist to work in the operational arena and this initiated many improvements (Santy, 1994). Select-out criteria were developed based on the thencurrent American Psychiatric Association’s Diagnostic and Statistical Manual. Select-in characteristics including aptitude, motivation and sensitivity were defined. More thought was given to the psychological mix of the crew and interfaces with the known tasks of the astronaut. Since the mid 1980’s, NASA’s in-house experts have also utilized external consultants to help assess candidate suitability in the area of behavioral medicine The selection process continues to be reviewed by in-house experts and external reviewers and is regularly updated (Woolford, et., al., in press).

The current selection model again combines industrial–organizational techniques with clinical and medical techniques as was done during the late 1950’s. Galarza and Holland (1999) listed the critical psychological proficiencies needed for space flight as determined by subject matter experts, including astronauts: emotional and mental stability, working effectively under stress, group living, teamwork, ability to cope with prolonged family separations, motivation, judgment/decision making, conscientiousness, communication, leadership. Recent astronaut selection cycles have assessed all of these psychological proficiencies (Hysong, et. al, 2007). Selection procedures for choosing crew members for Mars will need to be as complex as the early American selection process. Furthermore, some of the group and field exercises used in the selection programs of international partners should increase the likelihood of accurate prediction.

The lure of being on the first Mars crew should yield a very large and enthusiastic group of applicants. Like their predecessors, successful applicants will undergo several rounds of record checks and application screenings before proceeding to tests and interviews. Candidates for a Mars mission will have passed the future equivalent of updated physical and medical standards as found in NASA STD 3001.vol. 1 (NASA, 2007) or its international equivalent, including limits on radiation exposure. Because the mission is for an unprecedented three years, careful attention will be given to possible psychiatric problems. In some extreme environments including Antarctica and space, some researchers have found increases in the symptoms of depression and anxiety (Kanas, 1985, Shepanek, 2005). Butt these symptoms are not invariable consequences of isolation and confinement (Leon, et al., 1989; Palinkas, 1992; Suedfeld & Steel, 2000). Reports from field studies in which the selected candidates had undergone prior psychological screening prior to deployment suggest a 1-4% rate of psychiatric incidence (Gunderson, 1968; Palinkas, 1992; Palinkas et. al, 2000).

Future selection procedures must reckon with the possibility of psychiatric problems arising in the normative age group of astronauts. For example, if Mars astronauts are in the 30-40 year age group, it is very unlikely that they would develop schizophrenia on a trip to Mars. However, the National Institute of Mental Health (NIMH) reports that the median ages for generalized anxiety disorder and depression or dysthymic disorder are in the early 30’s (NIMH, 2010). In the absence of meticulous screening, symptoms and signs of diseases such as Huntington’s chorea or Parkinson’s disease could appear without recourse to earth based treatments. By departure time genetic markers and engineering may be used to detect and/or prevent the onset of a terminal or seriously disabling condition.

New techniques for combining statistical and clinical prediction (Steel, 2005) and expanding data bases that identify the kinds of attributes that are associated with success in spaceflight and other demanding environments (Musson & Helmreich, 2005) will be of great value. Proper expansion of the data base to make it useful for Mars will require increased participation in psychological research on the part of current astronauts and cosmonauts.

Kraft, et. al. (2003) provide a nice summary of recorded interpersonal conflict in spaceflight. These conflicts include personality clashes, personal antagonisms and disagreements, cross cultural misunderstandings, and conflicts with mission control. They conclude by underscoring the importance of group selection as well as individual selection. It follows that it may be useful to select two or more crews for preparation: the lengthy training period will allow a final selection on the basis of team performance, as well as provide insurance against the potentially catastrophic effects of losing a team member shortly before lift-off. Simply replacing one crewmember with another is not always advisable since the newcomer will not be fully integrated into the team. The disadvantages of developing multiple crews include cost, and the enormous pressures on each potential crew to be selected for the first mission to Mars.

3. Training

NASA has always provided extensive and demanding training to insure that the crew members are ready to do their difficult jobs and to provide an extra margin of safety. Training occurs in class rooms, in mock-ups and in simulators, and in space itself. From the opening of the Space Agency’s doors, NASA developed an amazing array of training devices and techniques, has improved them for each generation of missions, and will do so again in preparation for Mars. We also expect training in underwater environments, remote locations in the desert, and Polar Regions such as Devon Island, Canada and the Antarctic. Some of these are considered particularly useful because of their geological similarities to Mars.

Simulations provide an opportunity for data collection as well as for preparing future space crews. The Russian and European space agencies have been masters at conducting long term simulations. One important study, sponsored by the ESA and conducted in Russia involved three Russians, two of whom were cosmonauts (Sandal, 2001). Known as HUBES (Human Behavior Under Extended Space Missions) this involved 135 days in a Mir simulator in Moscow. Work and other activities were patterned as closely as possible after that of an actual mission, and even included two “off nominal” periods of 48 hours of sleep deprivation and continuous effort. Over time, the patterns of communication changed, with a reduction in joking and an increase in negative emotional expressions (criticism of the self, other crew members, or the situation). The pair of cosmonauts grew close, at the expense of the non-cosmonaut, whom they described as obstinate, opinionated, and talkative. This HUBES crew demonstrated antagonism towards one of the mission control teams, and blamed their hostility on the outsiders’ “bad mood.” Currently ESA and the Russian Institute for Biomedical Problems are partners in conducting a 500 day Mars simulation for a crew of six (ESA, 2010).

Space itself is an obvious test bed and training ground. On an orbital facility, Marsbound astronauts could learn to adjust to microgravity and receive tutoring from experienced astronauts. Currently the International Space Station is scheduled to receive astronauts and cosmonauts through 2020 and could help to train Mars spacefarers to live and work in a microgravity environment. Weighing against prolonged in-flight training is the problem that total exposure to space radiation has to be limited, so dosages received before embarking reduce the acceptable level of exposure during the Mars mission itself.

Training in psychological competencies is essential in human spaceflight (Bessone, 2008). The behavioral experts within the international partners of ISS have agreed upon a number of behaviors and skills for human competency. Each of these includes knowledge and attitudes as well as behaviors, and they together form the basis for a training flow. Psychosocial competencies include self care management, communication, cross-cultural skills, teamwork and group living, leadership, conflict management, situational awareness, and decision making/problem solving (in other words, substantial training is aimed at bolstering the same skills sought during selection). Although there are variations, each of the countries involved in low orbital flight train their crew members in psychosocial competencies, an essential competency for a mission to Mars.

4. Psychological Support

We cannot overstate the contribution of routine and good communication with the family in maintaining an approximation to normal earth life and facilitating psychosocial adaptation to space. Astronauts need regular contact with and reminders of their families and loved ones. The NASA space agency currently makes these opportunities available, with families participating in these events (Johnson, 2010).

While different space agencies have their own programs for psychological support, we focus on NASA’s program. These support activities have emerged over the past decade and will continue to evolve. They are based on feedback from astronauts, sound research (Schmidt, et. al., 2009; Slack, et. al., 2009; Whitmore, et. al., 2010), the limitations of the ISS, and current technology. Today’s psychological support efforts provide a basis for developing a program for astronauts bound for Mars.

NASA offers psychological support before, during, and after missions (Beven et. al., 2008; Fiedler & Sipes, 2010; Schmidt et al., 2009; Sipes & Fiedler, 2007; Sipes & Vander Ark, 2005; Slack et al, 2009). Preflight preparation includes training and briefings in the diverse areas described in preceding sections. Before the astronaut is in orbit families are briefed on upcoming ISS-earth family teleconferences and prepared for the psychological concomitants of long distance separation and issues that are likely to arise following the astronauts’ return. Families also help decide what will go in the crew care packages (containers of personal items that are sent to the astronauts on resupply missions). While mission support personnel may not be able to deliver crew care packages to a Mars crew in real time, it would be possible to have such packages on board to be opened on birthdays, anniversaries, and special achievements including disembarkation on Mars. In addition to crew care packages and offering extensive communication with people on the ground, current in-flight psychological support services include electronic pictures, streaming videos, movies, e-books and music library, e-mail, psychological support hardware and software, and mandated semi-monthly video conferences with a behavioral health clinician. Approximately a month before the end of their mission astronauts are reminded of the kinds of stresses that are likely to arise on their return home. After their return astronauts undergo a series of debriefings intended to fine-tune the psychological support program as well as benefit the returnees and their families. Astronauts and their families are eligible for counseling and other psychological support services after the mission.

Debriefings will have to be extensive following multi-year flights. In comparison to returning from a relatively brief flight astronauts returning from Mars are more likely to discover that their children will be older and facing different developmental challenges; that mishaps and tragedies involving family and friends have occurred; and that the world as a whole will be different. Mars psychological support teams will want detailed feedback to improve their services and useful information about increasing the positive aspects of spaceflight.

We can learn also from the US military’s extensive program in supporting families and reunions after long deployment (Office of the Secretary of Defense, 2010). Although spacefarers may not have undergone the physically traumatic events so often experienced by deployed military, the spacefarers’ families left behind will need to thrive and develop a modified family structure. While the returning Mars traveler will be a public hero, the family will probably be ignored except for the occasional human interest story. It may be difficult for the family to regain equilibrium.

Mechanisms for measuring and alleviating stress will be even more important in a flight to Mars than they are now. Some researchers are developing means to monitor stress through the analysis of facial expressions (Dinges et al., 2005) while others continue to study voice stress analysis (Johannes, et al., 2000; Lieberman et al., 2005). The commercial market has several prototype computer assisted or mobile phone applications that can be modified to fit the behavioral health needs of spacefarers. There are phone applications for stress or depression monitoring, cognitive re-appraisal, and interventions (Matthews, et al, 2008; Morris et al, 2010). By the time of a Mars mission we may be able to “watch astronauts think” during selection and training and in flight (Genik, Green, Graydon & Armstrong, 2005). Candidate technologies under study include functional neuroimaging electroencephalography, magnetic resonance imaging, and near-infrared spectography. Such devices may allow the detection of incipient neuropsychiatric dysfunction but the technology must be refined and lightweight portable equipment built.

Other researchers are using film clips and computers to provide mental health resources to people in space (Carter, Buckey, Greenhalgh, Holland, & Hegel, 2005). They are developing a “virtual space station” which serves as a portal to multi-media based training, psychological assessment, and guidance resources. This includes informative vignettes, background reading, helpful hints and other resources to help users manage conflict and alleviate depression. Advantages of on-board digital devices include first, that nobody other than the individual user knows that the portal has been entered, and second, users on Mars missions will not be frustrated by communications delays associated with tapping behavioral health resources based on Earth.

5. Conclusion

In the late 1950’s the human space program began selecting, training and supporting astronauts. Long before that, governments and wealthy individuals funded explorers to systematically survey and discover new areas of the world. Historians, explorers, and academics have all contributed to an understanding of what it is like to embark on a mission to the unknown and what qualities are needed by the individual, the leader, and the crew (Nansen, 2008; Stuster 2004). Much less has been written about the infrastructure that supported explorers and or how their families survived. Today we have formal programs for psychological services. Since the terms psychology and psychiatry were not recorded until at least the mid 17th to 18th century (dates vary by source, see etymonline.com or dictionary.reference.com), we can assume that the responsibilities that psychologists feel today were either ignored or, or more likely performed by other professionals (such as ship’s doctor or priest) during centuries of earth based exploration. In the future, psychological services may be performed by professionals and technicians that we have trouble imagining today.