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Mark C. Russell, Ph.D., ABPP Headshot

Marginalization of Military Women, Minorities, and War Stress Casualties -- Part I

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Recently I was interviewed by AP reporters for another disturbing story of military sexual trauma (MST). As a proud and concerned parent of a daughter actively enlisted in the Navy, and sons enlisted in the Marine Corps and Navy, who are both war veterans, there are clear parallels between how the military negligently deals with those exposed to MST and war stress.

Tragically, what is true for the military is also the painful reality for how the private sector treats millions of female and male survivors of sexual assault and mental illness. I hope this will connect the dots for our Commander-in-Chief, Congress, and the general public on the signature social justice issue of our time: The eradication of mental health stigma and disparity!

The Historically Marginalized

Women and African Americans have served honorably in the U.S. military in every war since the American Revolution. Combatants suffering from war stress injuries have been documented since at least the 16th century, whereas mental healthcare specialists emerged during the U.S. Civil War, and officially served with distinction since the First World War (WWI:1914). What else do these three diverse segments of American population have in common? Plenty! For example, immoral oppression, societal discrimination, and inequality of women and African-Americans is widely known -- less well-publicized is the destructive impact of benign neglect perpetrated on the mentally ill, particularly veterans returning with war stress injuries, as well as the damaging disparity between medical and mental healthcare responsible for generations of preventable wartime crises.

However, American women, African-Americans, and mental health clinicians also share the dubious distinction of being summarily dismissed from the military at war's end -- a discriminatory personnel policy that was ended after the Second World War (WWII) when major contributions to the war effort by each marginalized group could no longer be denied. Therefore by order of the president and Congress, in 1946 the military revised its unjust policies, establishing permanent integration of women, African-Americans, and mental health providers [1].

Impetus for Major Societal Reforms

The aforementioned post-WWII social justice initiatives eventually paved the way for the long overdue national penance reflected in civil rights legislation, constitutional amendments, and the National Mental Health Parity Act (1946)-the latter intended to eradicate antiquated, harmful "dualistic" beliefs about the separate nature and legitimacy of mental and physical health, leading to injurious mental health stigma and disparity.

To be certain, the U.S. military entered WWII as the chief protagonist for perpetuating mental health stigma, prejudice, and disparity after reaching the faulty conclusion that the dishonorable epidemic of war stress casualties from the First World War (WWI: 1918), which led to over 69,000 pensions for neuropsychiatric disability had nothing to do with toxicity of industrial warfare, but instead, reflected personal weakness aided by the rise of a psychiatric culture of victims [1]-a popular perspective today.

Consequently, the American military embarked on a grand social experiment of aggressively screening out the morally, intellectually, physically, and emotionally weak from entering the military. By 1943, over 1.6 million volunteers were rejected on the grounds they were vulnerable to mental breakdown after 5-years of combat [1]. Moreover, the Army dismantled the weakening influence of its mental health services. Thus the U.S. military was the most physically and psychiatrically fit and resilient the world has ever known.

Predictably, the American experiment ended in dismal failure, as 604,000 of America's strongest soldiers returned home to join the ranks of the neuropsychiatrically disabled. Additionally, the phenomena known as 'Old Sergeant's Syndrome' [2] re-emerged on the battlefield, whereby senior, battle-tested, and decorated leaders succumbed to the cumulative effects of war stress. By 1943, the U.S. military reconstituted its mental health services and adopted a de-stigmatizing universal paradigm that 'every human being is vulnerable to transient breakdown' due to the ravages of war stress.

Tragically, the American military maintains its harmful prejudice and stigma toward those suffering from chronic war/traumatic stress injuries, with a faulty misleading paradigm that less than 5-10 percent of veterans develop debilitating stress injuries, and those who do, are typically predisposed, greedy, cowardly, and/or naively suggestible to 'pseudo-illness' from the corrosive influence of permissive Western culture.

The full re-learning of war trauma lessons from the WWI generation requires the eradication of antiquated dualistic beliefs, stigma, and disparity of mental healthcare by acknowledging the inevitability and legitimacy of invisible wounds. However, the military's re-awakening occurred too late to prevent the ensuing mental health crisis in the 1940-1950s. Enlightened military leaders with a heavy conscience, were determined to end the cycle of self-inflicted crises of national ignorance by publishing two volumes of "lessons learned" with the explicit purpose that future generations would never again neglect doing what is right [1]- a similar social justice vein responsible for the permanent integration of military women, African Americans, and mental health clinicians.

Unmistakable progress has been made over the decades to correct social injustice perpetrated on marginalized Americans, including our gay and lesbian citizens. However, the plight of the mentally ill, stigma, and disparity have flourished in the 21st century -- responsible for the systematic neglect and preventable crisis as reported by the Department of Defense Task Force on Mental Health in 2007 with impunity.

Cultural Stigma of Inferiority and Weakness

Historically, American women, African-Americans, war stress casualties and their healers also share the common burden of being perceived by mainstream, white European male dominated military culture as "inherently inferior and weak." The most feared taboo in warrior cultures is to be labeled as "weak" and "cowardly." American society has condoned open discrimination against women, African-Americans, and the mentally ill because they were viewed as intellectually, morally, physically, and emotionally weak compared to their white male counterparts. However, during times of extended war, it became expedient to tolerate inclusion of such inferior beings in order to fight and win wars.

However, there was a limit to the military's tolerance of the weak. This is why at war's end, women, African-Americans and mental health practitioners were quickly purged from the rank and file until 1946.

Summary

The second part of this blog will examine the previously unrecognized parallels between the crises of MST and mental healthcare. Specifically, what are the common sociocultural barriers responsible for under-reporting, under-investigating, under-prosecuting, and perpetuating stigma and injustice?

References

[1] Glass, A. J., & Bernucci, R. J. (1966). Medical Department United States Army. Neuropsychiatry in World War II volume I: Zone of interior. Washington DC: Office of the Surgeon General, Department of the Army.
[2] Sobel, R. (1947). The "old sergeant" syndrome. Psychiatry, 10, 315-321.