Mental health interventions of the 528th Combat Stress Control unit to limit the numbers of psychiatric casualties on recent peacekeeping missions are discussed. Similarities and differences in the mental health support of Operation Restore Hope (Somalia) and Operation Uphold Democracy (Haiti) are reviewed. The mission to Somalia was marked by unexpected combat casualties. The mission to Haiti was marked by unexpected self-inflected casualties. Lessons learned by mental health officers serving on these missions are discussed. Recommendations for prevention of psychiatric casualties on future missions are presented.