Columbia University Press Psychiatric Casualties: How and Why the Military Ignores the Full Cost of War

The psychological toll of war is vast, and the social costs of war’s psychiatric casualties extend even further. Yet military mental health care suffers from extensive waiting lists, organizational scandals, spikes in veteran suicide, narcotic overprescription, shortages of mental health professionals, and inadequate treatment. The prevalence of conditions such as post–traumatic stress disorder is often underestimated, and there remains entrenched stigma and fear of being diagnosed. Even more alarming is how the military dismisses or conceals the significance and extent of the mental health crisis. The trauma experts Mark C. Russell and Charles Figley offer an impassioned and meticulous critique of the systemic failures in military mental health care in the United States. They examine the persistent disconnect between war culture, which valorizes an appearance of strength and seeks to purge weakness, and the science and treatment of trauma. Instead of reckoning with the mental health crisis, the military has neglected the needs of service members. It has discharged, prosecuted, and incarcerated a large number of people struggling with the psychological realities of war, and it has inflicted humiliation, ridicule, and shame on many more. Through a far-reaching historical account, Russell and Figley detail how the military has perpetuated a self-inflicted crisis. The book concludes with actionable prescriptions for change and a comprehensive approach to significantly improving military mental health. Review As promised, Russell and Figley once again deliver a thorough history of a neglected but critical topic. The authors continue to highlight what is most needed in behavioral health treatment for our military warriors who serve our country.--Kathryn S. Collins, University of Maryland and principal investigator, Family Informed Trauma Treatment Center Mark C. Russell and Charles Figley provide a thorough and thoughtful analysis of how the U.S. military has historically failed to adequately manage the mental health problems that inevitably occur during and in the aftermath of military action, and they suggest potential solutions to prevent repeating such failures in the future.--Brian Bride, former editor in chief of Traumatology: An International Journal Russell and Figley provide a blood-stirring and much needed examination of the many reasons that behavioral health concerns continue to affect the ranks of the military. This book should be mandatory reading for anyone concerned with the care and well-being of America's forces, from indoctrination to discharge and beyond.--Col. Jeffrey S. Yarvis, PhD, U.S. Army (retired) Russell and Figley provide a stark yet riveting investigation into the history and current status of behavioral health care in the military. Psychiatric Casualties is a must-read for all senior military and civilian leaders who have the responsibility of putting men and women in combat.--Col. M. C. Boone, United States Marine Corps About the Author Mark C. Russell is core faculty in the PsyD Program at Antioch University Seattle, where he is establishing director of the Institute of War Stress Injury, Recovery, and Social Justice. He is a former U.S. Navy commander and military clinical psychologist with over twenty-six years of military service. Charles Figley is the Paul Henry Kurzweg, MD Distinguished Chair in Disaster Mental Health; professor of social work; and director of the Traumatology Institute at Tulane University. He is the author of many books, the first of which, Stress Disorders Among Vietnam Veterans (1978), contributed to the diagnosis of PTSD. He served a tour of duty in the Vietnam War as a member of the U.S. Marine Corps.