Is the Military’s Century-Old Frontline Psychiatry Policy Harmful to Veterans and Their Families? Part Three of a Systematic Review

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• 作者：Mark C. Russell ; Charles R. Figley
• 关键词：War stress ; PTSD ; Military ; Veterans ; Combat stress control ; Forward psychiatry ; Combat psychiatry ; Combat and operational stress control ; Combat stress reactions ; Mental health
• 刊名：Psychological Injury and Law
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：10
• 期：1
• 页码：72-95
• 全文大小：
• 刊物主题：Law and Psychology; Clinical Psychology; Psychology, general;
• 出版者：Springer US
• ISSN：1938-9728
• 卷排序：10

文摘

The explicit mission of the military’s 100-year-old frontline psychiatry doctrine is to ensure that upwards to 95% of deployed service members diagnosed with war stress injury and/or psychiatric disorder are prevented from leaving war zones, unless they are either grossly incapacitated or pose imminent safety risks to self or others. In the final segment of this comprehensive three-part review, we examine systematically evidence that the military’s mental health policies may be harmful to veterans and their families in order to address unanswered clinical, moral, and legal questions. Our analysis reviews, empirical studies on the health effects from cumulative exposure to war stress, previously classified reports on frontline psychiatry, prevalence and treatment of mental health conditions among deployed personnel, risk and protective factors of combat-related post-traumatic stress disorder (PTSD), and prospective deployment research on health outcomes. There has not been the proper research undertaken comparing in situ treatment vs. evaluation, so conclusions are limited. Nevertheless, results show there is a body of evidence that repeated exposure to war stress appears associated a wide variety of long-term adverse medical, psychiatric, and social outcomes. The current findings, combined with our two previous reviews, provide support for the conclusion that veterans and their families appear possibly more likely to be harmed than helped by the US military’s policies and procedures. In this regard, it appears that frontline psychiatry is perhaps contributing to a generational cycle of self-inflicted wartime behavioral health crises. Several corrective actions including possible class action, as has happened in the UK, and a call for national independent inquiries with congressional oversight should be done.