Culture in Mind

Mental health, culture, and ethnicity

Mental Health and the Culture of War

What happens to the mind when war happens?

The article that follows below was written for Veteran's Day but is perfectly suited for Memorial Day as we honor those who have served their country by putting life, limb and mental well-being at risk. (I have changed the graphic to be more suitable for Memorial Day)

War and Mental Health

Today in honor of Veteran's Day I am doing a  post on the impact of war on mental health and what veterans who were mentally injured in battle need to become well again. No data. No clinical definitions. Just a brief note on how war impacts mental health (and sometimes this is in response to how war impacts physical health, e.g. loss of a limb or sight etc).

It does not take a degree in psychology or social work to know that war cannot be good for mental health: perpetual and intermittent violence, fear, torture, death, noise, stress, destruction, suspicion, and being far away from social support systems, creates a cauldron that can lead to temporary or permanent mental illnesses in both the returning victim; and also in family members who stay at home.

Anxiety and Stress

The anxiety caused by leaving already creates a vulnerability in the soldier, whether they are going to be on the front lines or in the back office. Saying goodbye to friends, family, routine, careers and going somewhere you know you may never return from, or may never return the same. Leaving their support system behind to face the most challenging time of your life makes a soldier very vulnerable.

Combat involves high stress levels and the possibility of killing not only other soldiers, but also women and children who are unintended victims. Staying in the storm of battle for long deployments of up to a year stresses the brain's ability to cope with the culture of war: the different norms, expectations, bonds, rules etc.

The Research

Dr. Karen Seal and her colleagues found that up to 1/3 of returning U.S. soldiers had a mental illness or a psycho-social disorder, and more than 1/2 of those were diagnosed with more than one disorder at a time, with the most common combination being Post Traumatic Stress Disorder and depression; substance use was also common. Returning veterans are also at high risk for suicide and for inflicting violence on their family members. Veterans are  at high risk of homelessness because of the mental illnesses they suffer from being at war and their inability to reintegrate into 'normal life'.

The Impact on Civilians

Let us not forget what war does to civilians who are part of the battlefield; the children, the women, the men, the elderly whose lives are at risk every hour of every day. Who leave home and are not sure if they will return. The guilt of surviving when other family members have been killed. Studies have shown that civilians suffer an increase in mental illness during and after war. Again, this is not a very surprising result. And the families left behind when soldiers leave home to go to the battlefield also suffer the stress of not knowing when, or if, their loved ones will return. The spouses left behind must take on all the responsibilities of the household. Though the technological gifts of Skype allow loved ones on the battlefield to connect with home, this does not replace 'being there'.

Mental Health Resoures

There are mental health resources for mliitary families as there are for soldiers and these are provided by the military who have their own cadre of mental health professionals - some on bases around the world and others attached to the battlefield. However, soldiers are often afraid of being stigmatized if they are diagnosed with a mental illness and of losing their eligibility for active duty due to their diagnosis. And at the same time the Veterans Administration - an organization that provides support for military veterans, has been overwhelmed by the extent of the impact of war on the mental health of soldiers, and have been sued by two veterans groups for the delays in assessment and treatment of returning veterans.

The Selling of War

The challenge of finding people willing to sacrifice their lives for their country means that the 'culture of war' must be 'marketed' as a lifestyle; a lifestyle that, despite what's shown in the ads on TV, in reality means death, destruction, missing limbs, damaged hearing, lives destroyed. There really is no way to prepare someone for war, even with the technologically advanced simulated games that some soldiers get to play before they go. Death on screen is not the same as death in real life.

Coming Home

When they return home soldiers need to feel as if their country appreciates the sacrifice they made on everyone's behalf. Families who get primed for their loved one's return still cannot know what it will be like until they are home. They need the support of their communities to help them cope with their 'new' family roles and routines. The Veteran's Administration must be funded and staffed to support the health and social welfare of returning veteran's transition back home.

Today in his Veteran's Day speech at Arlington cemetery, President Obama also called for businesses to hire veterans. On various talk shows today, veteran's talked about the need for employers be willing to provide flexibility and support for veterans in the workplace. President Obama wants the country to say thank you in ways that are more concrete and helpful and less symbolic. 

President Obama knows that saying thank you one day a year is not enough. Veterans deserve more.

Ruth C. White, Ph.D., M.S.W., and M.P.H., is the author of Bipolar 101 and is an associate clinical professor at the School of Social Work at the University of Southern California. 

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