The Darker Side of Military Mental Healthcare Part Two: Five Harmful Strategies to Manage Its Mental Health Dilemma

Abstract

This is the second part of our analysis of the military’s mental health care dilemma. Since the First World War, military and government officials have been quite wary of mass psychiatric attrition and escalating pension costs from warzones. Specifically, the military worries about unknown repercussions should war stress injuries be de-stigmatized and treated equally as physical wounds, as required per the military’s own documented lessons learned. Leaders fear that so-called evacuation syndromes would spread, thereby depleting the fighting force for invalid reasons, eroding unit morale, and providing an acceptable escape from one’s military duties instead of the disapproval deserved, thus jeopardizing the military’s primary mission to fight and win wars, as well as risk possible financial strain in societies dealing with too many psychiatrically disabled veterans. Consequently, the military routinely admits to ignoring its war trauma lessons, resulting in a generational pattern of self-inflicted crises, including suicide epidemics. Moreover, besides neglecting such lessons, the military has adopted various approaches over time to reduce the possibility of evacuation syndromes by aggressively preventing psychiatric attrition, treatment, and disability pensions. After an extensive review of the war stress literature, we identified 10 overarching strategies the military has employed in order to resist fully learning from its lessons on the psychiatric realities of modern warfare by eliminating, minimizing, and/or concealing its mental health problem. Part two of the article series examines the following avoidance strategies intended to prevent psychiatric attrition and disability pensions: (1) Cruel and Inhumane Handling; (2) Legal Prosecution, Incarceration, and Executions; (3) Weaponizing Stigma to Humiliate, Ridicule, and Shame into Submission; (4) Denying the Realities of Mental Health; and (5) Screening and Purging Weakness. We argue that by not accepting the realities of the combat stressors, no effective methods for assessment and treatment of the stress reactions, not to mention prevention methods, have emerged that contributes to alleviating the veteran suicide and mental health crises.

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