Transcript Outcomes

INTRODUCTION
Medical Officer Royal Navy
1965-1996
The Role of the
Military Psychiatrist
1. Personnel selection
2. Officer selection
3. Mental dullness
4. Treatment and disposal of psychiatric cases
5. Forward psychiatry
6. Morale and discipline
7. Rehabilitation and repatriation of POWs
8. Organisation of military psychiatry at home and
overseas
Ahrenfeldt: “Psychiatry in the British Army in WWII” (1958)
Battle Injuries in British
Casualties
21 Neuro Psychiatric 4.1%
Non-Penetrating 8.3%
Trench
Foot (NFCI)
14.6%
70
43
270
112
Burns 21.7%
Penetrating 52.3%
Total 516
The Coping Spectrum
COPING
NOT
COPING
SELECTION
“If screening is to weed out all
those likely to develop a psychiatric
disorder, all should be weeded out”
Anderson R. S. (Ed)
Neuropsychiatry in World War II,
(Vol. I ). Washington, DC: Office of
the Surgeon General 1996, p. 391
Training
•
•
•
•
Basic
Team
Realistic
Retraining / Reselection?
STRESS
• “The confusion created when one’s
mind overrides the body’s basic desire
to choke the living s1t out of some
asshole who richly deserves it”
PTSD
• Post Traumatic Stress Disorder 1980+:
an evolving concept
• History: Nostalgia etc
• Incidence: variable
• Recognition: comrades and family
• Co-morbid disorders: Alcohol, somatic
symptoms, depression.
Coping with Stress after Combat
Guilt
Memories
Shame
Avoidance
Loss of control
Normal feelings
and emotions
Which may be
experienced
Distress
Anger
Numbing
Sadness
Arousal
What you can do
Where to find help
Family
and social
relationships
When to seek help
Morale
“The general sense of well-being felt by
the group with confidence in their own
ability to survive environmental stress,
faith in their leader, and an overall sense
of cohesiveness amongst their number.”
Labuc
Groups at Risk
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Injured survivors
Non-injured survivors
Those who might have been there
Relatives of the dead
Relatives of 1, 2 and 3
Rescuers
Witnesses
Medical teams
Command
Carers
Correspondents
Retraumatised
ANO?
QUESTIONS