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Mark C. Russell, Ph.D., ABPP

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Why We Need an Institute of War Stress Injury,Recovery, and Social Justice

Posted: 10/18/2013 11:04 am

American society has been trapped reliving a pattern of mostly preventable behavioral health crises following every major war since the 20th century.

Awareness of this vicious self-perpetuating cycle motivated Second World War (WWII; 1939-1945) military leaders to painfully reflect on their failure to learn from previous generations of hard-won war trauma lessons, "Further, and most important, there was the documented history of World War I, as well as accounts from other previous wars, which provided abundant evidence that combat would produce large numbers of psychiatric casualties" (Glass, 1966a; p. 17); however, the authors conclude, "Despite the foregoing data that were available to responsible authorities, there was no effective plan or real preparation for the utilization of psychiatry by the Army in World War II. Facilities for the care and treatment of psychiatric cases were only barely sufficient for the small peacetime Army" (Glass, 1966a; p. 18).

Recognizing its culpability in replicating a generational crisis of unmet mental health and social needs of its warrior class, U.S. Army Surgeon General, Leonard D. Heaton (1966) gave this stern warning in the massive two-volume Army Medical Department compilation of psychiatric lessons since the First World War (WWI; 1914-1918): "With this information so readily available, there can be little excuse for repetition of error in future wars, should they occur" (cited in Glass & Bernucci, 1966; p. xiv).

And yet, hard-won common sense lessons as the need for adequate planning and preparation for inevitable spectrum of war stress injury; the need for adequate supply of well-trained specialists; zero tolerance for mental health stigma and prejudice; ready access to early identification and high quality intervention prior to military separation; transitional support during social reintegration for veterans and their family members; and eliminating the disparity between physical and mental healthcare have repeatedly been ignored by each successive generation, with predictable, tragic outcomes.

June 16, 2007 -- National Groundhog Day in the 21st century

Invisible to the national consciousness, on 16 June, 2007, nearly six years into the first major American war of the 21st century, a congressionally mandated Department of Defense (DoD) Task Force on Mental Health publicly unveils its greatly delayed findings depicting an urgent mental health crisis that DoD and Department of Veterans Health Affairs (VA) had steadfastly denied as late as May 2007 (e.g., Kilpatrick, 2007; Zoroya, 2007). The Task Force was mandated by Congress two years earlier amid gross discordance between DoD/VA reassurances and numerous reports of a major mental health crisis including the filing of a 2006 DoD Inspector's General grievance from a military whistleblower (Russell, 2006a; Zoroya, 2007).

Echoing an all-too-familiar verdict on military mental health care:

"The Task Force arrived at a single finding underpinning all others: The Military Health System lacks the fiscal resources and the fully-trained personnel to fulfill its mission to support psychological health in PEACETIME (our emphasis) or fulfill the enhanced requirements imposed during times of conflict" (DoD Task Force, 2007; p.ES.2)

Indistinguishable from generations of other post-war analyses, the military Task Force report climaxes with a fervent appeal to end the cycle of failure to learn so-called "psychiatric lessons of war" pontificating:

"The time for action is now. The human and financial costs of un-addressed problems will rise dramatically over time. Our nation learned this lesson, at a tragic cost, in the years following the Vietnam War. Fully investing in prevention, early intervention, and effective treatment are responsibilities incumbent upon us as we endeavor to fulfill our obligation to our military service members" (DoD Task Force, 2007; p. 63)

But in actuality, we have never learned the lessons that can end the cycle of wartime crises -- in fact, we have never even asked the hard questions.

Despite the obvious circularity, with equally transparent life-ruining consequences, and a $1 trillion price tag estimated by Harvard University economists, to date, there have been no academic, journalistic, presidential, congressional, or military investigations into the pattern of preventable wartime behavioral crises that each military cohort has documented since the First World War (WWI: 1914-1918).

The Institute of War Stress Injury, Recovery, and Social Justice

To reverse this tragic trend, on Veterans Day week in November 2012, Antioch University Seattle's (AUS) Institute of War Stress Injury, Recovery, and Social Justice was established as the only domestic or international entity, dedicated to investigating and ending this tragic cycle, supported by a distinguished advisory board. However, in the national landscape wherein most institutions of higher learning are experiencing financial constraints, the Institute of War Stress was scrutinized in a cost-benefit analysis that initially led to its dissolution in September 2013. Proving even a university founded on the premise of social justice as embodied by Antioch's founder Horace Mann's famous dictum to "be ashamed to die without winning some victory for humanity" is vulnerable to the economic winds. Tragically, as replicated throughout most federal, state, and city governments across the nation, mental health programs and services are typically the first to be cut.

Fortunately, under the leadership of AUS's new president, Brian Baird, a former U.S. Congressman, Antioch underwent a much-needed soul searching that resulted in not only resurrecting, but strengthening the fledgling Institute.

In the weeks, months, and years to come, Antioch's Institute will be publishing the preliminary results from its investigation into the causes of this, and previous wartime crises. Most importantly, identifying and correcting the underlying causes of wartime crises, will serve a critical role in helping transform the larger national mental health crisis, in a similar way that racial, gender, and sexual orientation integration in the military have led civilian practice-that's why we need Antioch's Institute of War Stress Injury, Recovery, and Social Justice more now, than ever before!

 
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