The role of mental health in the armed forces

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The armies of developed countries such as the United States of America, Germany, Russia, and Britain played an important role in developing the concepts of psychiatry in general and military psychology in particular. The importance of these concepts became evident in advanced armies, especially in the period between the First and Second World Wars.

The pattern of dealing with these armies during World War II changed from a primitive, stereotypical dealing with changes in behavior and mental health to a systematic scientific treatment based on the analysis and study of psychological symptoms in military and civil universities and the development of scientific foundations and necessary psychological tests and treatment to mitigate the short and long-term effects on the mental health of soldiers.

These studies and research resulted in several variables that affected the concept of mental health and military psychology in the advanced armies, including:

(1) Organizing psychological tests for soldiers during recruitment.

(2) Analyzing all the functions of the armed forces and their psychological and social impact on the soldier.

(3) Developing military education and training programs.

(4) Developing psychological research on the effects on different senses (hearing, sight, smell, etc.).

(5) Developing weapons and equipment in proportion to the psychological and moral impact on human nature.

(6) Identifying the soldiers’ tendencies and desires and benefiting from that in their guidance.

(7) Taking advantage of this research in psychological warfare.

(8) Psychological treatment and raising the morale of soldiers and their families.

After the end of the First World War, several concepts and terms emerged on which modern psychiatry is based, whether in the civil or military environment, including:

(1) Situational stress, which is the psychological stress that generates a mental disorder, whether for the normal soldier or for the soldier who is susceptible to mental illness.

(2) As a result of the concept of situational stress resulting from the circumstances surrounding the operations, the concept of treatment at the site of the emergence of psychological disorder (the battlefield) was born.

During and after World War II, hospitals were overwhelmed with psychiatric cases diagnosed with psychoneurosis, which affected the manpower of various armies.

Both psychiatry and military psychology play a vital role in advanced armies, whether during times of peace or operations. In peacetime, the mental health system begins with the recruitment and selection of manpower in the armed forces, including officers, other ranks, civilians, and members of the national service. It also highlights the role of the mental health system in developing targeted military training and moral guidance programs in the armed forces, as well as the preventive and curative role of all members of the armed forces and their families.

The importance of the mental health system in the armed forces is increasing in full-spectrum operations, as it precedes them in terms of pre-operative assessment and preparedness, and exceeds it beyond operations in terms of psychological reassessment and rehabilitation.

The mental health system may be required to focus on the psychological and social aspects of the home front and the protection of civilians and their families from the effects of war and the impact of psychological warfare on the homeland.

Recent studies in the US Army indicate that between (4-18%) of the US infantry soldiers who served in Iraq and Afghanistan suffer from psychological illnesses and post-traumatic stress for long periods after operations, and 31% of them suffer from severe fatigue during operations.

Recent psychological studies in the US Army have proven that approximately 25% of early discharge cases in some wars are due to psychological and behavioral disorders, which means that one out of every 4 discharge cases is psychological.

Psychological disorders increase on the front lines, which are usually subjected to direct hits that result in great human losses, and this atmosphere and horrific scenes generate enormous emotional pressure that exceeds the usual endurance of the soldier, whether in his civilian life or even in tactical exercises and training. This leads to psychological, physical, and social disabilities, and results in evacuation from the field and a great loss of manpower.

Psychological states during operations

– Anxiety, especially while preparing and waiting for the battle. This anxiety is accompanied by feelings of fear, hesitation, increased heartbeat, sleep disorders, and lack of concentration. If not dealt with properly, these symptoms often lead to a drop in the morale of the soldier and his fellows.

– Depression, obsession, and psychosis, which require urgent psychological treatment and evacuation to the back lines.

– Intense fear and panic, as these cases increase when large casualties occur and may lead to severe mental disorders that affect the course of the battle.

– Post-traumatic stress disorder (PTSD) cases, where the soldier becomes dazed and terrified when remembering scenes of fighting, injuries, and corpses, and is unable to focus and think, so he loses control of his emotions, which leads to a negative impact on the soldier’s efficiency at work and major social problems.

– Psychotic cases such as schizophrenia and bipolar disease, especially in soldiers who have a history of mental illness or a genetic predisposition to this type of disorder, such cases require urgent evacuation and permanent discharge from military action.

– Cases of fatigue due to lack of sleep as a result of sleep disorders during operations.

–  Personality disorders, which are more evident under the pressures of war, such cases drove advanced armies, especially the US Army, to develop complex personality test models to help in choosing leaders because of their vital impact on the success of the mission.

–  Disorders resulting from the use of drugs and narcotics of various types, especially stimulant pills such as Captagon and others.

–  Increasing rates of suicide during and after military operations in most of the advanced armies, require an increase in religious awareness and exploiting the intellectual aspect of our culture to contain and limit the problem, especially in future generations.

Colonel Dr. Ali Khamis Al-Badwawi (Consultant of Psychiatry) – Department head of Psychiatry at Zayed Military Hospital in Abu Dhabi

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