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. 2007 Dec;97(12):2132-42.
doi: 10.2105/AJPH.2006.090910. Epub 2007 Oct 30.

War & military mental health: the US psychiatric response in the 20th century

Hans Pols  1 , Stephanie Oak
Affiliations

War & military mental health: the US psychiatric response in the 20th century

Hans Pols et al. Am J Public Health. 2007 Dec.

Abstract

Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future.

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Figures

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The face of a soldier from Ghost Troop, 2nd Armored Cavalry Regiment, shows strain in the aftermath of the Battle of the 73 Easting during Operation Desert Storm, Iraq, February 26, 1991. Source. Photo by Vince Crawley. Reprinted with permission from Stars and Stripes, 1991, 2006.
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Thomas W. Salmon in his office in France during World War I. Source. Courtesy of Oskar Diethelm Library, Institute for the History of Psychiatry, Weill Medical College of Cornell University.
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A soldier relieves tensions during a psychiatric interview. Source. US National Archives and Records Administration, Washington, DC.
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Operation Georgia, in which US Marines blew up bunkers and tunnels used by the Viet Cong. Source. US National Archives and Records Administration, Washington, DC.
See this image and copyright information in PMC

References

    1. Lack of moral fiber was introduced by the British Royal Air Force at the beginning of World War II to stigmatize and discharge aircrew that refused to fly missions without a medical excuse. We use the phrase here in its more general meaning. For the British Royal Air Force use, see Edgar Jones, “‘LMF’: The Use of Psychiatric Stigma in the Royal Air Force During the Second World War,” Journal of Military History 70 (2006): 439–58.
    1. The dual role of military psychiatrists who serve the military and treat their patients can lead to ethical conflicts. These ethical conflicts for military physicians in general are explored in: Victor W. Sidel and Barry S. Levy, “Physician-Soldier: A Moral Dilemma?” in Military Medical Ethics, ed. T. E. Beam and L. R. Sparacino (Washington, DC: Borden Institute, Walter Reed Army Medical Center, 2003).
    1. For general overviews see: Jones Edgar and Simon Wessely, Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War (London: Psychology Press, 2005); Ben Shephard, A War of Nerves: Soldiers and Psychiatrists, 1914–1994 (London: Jonathan Cape, 2000); and Rock et al., “U.S. Army Combat Psychiatry.”
    1. Salmon Thomas W., The Care and Treatment of Mental Diseases and War Neuroses (“Shell Shock”) in the British Army (New York: War Work Committee of the National Committee for Mental Hygiene, 1917), 47.
    1. Edward A. Strecker, “Military Psychiatry: World War I, 1917–1918,” in One Hundred Years of American Psychiatry, ed. J. K. Hall (New York: Columbia University Press for the American Psychiatric Association, 1944).

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