Occupational Mental Health in the Military through the Adler-Castro Model: A Comparative Documentary Review (2020-2025).

OBJECTIVE

To evaluate how research published from 2020 to 2025 operationalizes and tests key dimensions of the Adler-Castro occupational mental health model for the military-linking operational demands, organizational resources, and mental health outcomes.

METHODS

The authors conducted a comparative documentary review following IMRaD conventions and PRISMA guidance for search/selection reporting, 1242 screening indexed literature (PubMed/MEDLINE, Scopus, Google Scholar) within 2020-2025 and extracting study design, context, model variables (leadership, cohesion, identity/culture, system capacity), outcomes (symptoms, functioning, utilization), and reported effect sizes to compare the direction and magnitude of associations across the corpus.

RESULTS

Twenty studies met inclusion criteria. Supportive, well‑being-oriented leader behaviors were associated with substantially lower odds of depression and anxiety; a cluster trial of platoon‑leader training reduced problematic anger. Soldiers' COVID‑19 concerns tracked with poorer mental health. Increased psychiatry capacity at military installations corresponded to higher probabilities of mental health visits. Across sociocultural domains, moral injury and facets of military identity were linked to post-traumatic stress disorder, depression, and functional impairment.

CONCLUSIONS

Contemporary evidence largely aligns with the Adler-Castro model although indicating a needed extension to incorporate contextual demands (e.g., pandemic, housing) as a distinct construct influencing risk and access. Several leader-focused interventions, strengthened clinical capacity in military installations, and programs attentive to identity and moral injury are recommended, with rigorous evaluation.