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AJPH First Look, published online ahead of print Oct 30, 2007
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December 2007, Vol 97, No. 12 | American Journal of Public Health 2132-2142
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.090910

PUBLIC HEALTH THEN AND NOW

WAR & Military Mental Health: The US Psychiatric Response in the 20th Century

Hans Pols, PhD and Stephanie Oak, BMed, FRANZCP

Hans Pols is with the University of Sydney, Sydney, Australia. Stephanie Oak is with the Hunter New England Mental Health Services, Newcastle, Australia, and the School of Medicine and Public Health at the University of Newcastle, Newcastle.

Correspondence: Requests for reprints should be sent to Hans Pols, Unit for History and Philosophy of Science, Carslaw F07, University of Sydney NSW 2006, Australia (e-mail: h.pols{at}usyd.edu.au).

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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Copyright © 2007 by the American Public Health Association