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Psychiatric Casualties

How and Why the Military Ignores the
Full Cost of War

Mark Russell and Charles Figley


Dr. Charles Figley, the Paul Henry Kurzweg Distinguished Chair in Disaster Mental Health,  Professor and Associate Dean for Research in the Tulane School of Social Work, and Director of  the Tulane’s award-winning Traumatology Institute, has a new book, co-authored with Dr. Mark  Russell, military and trauma expert.

Psychiatric Casualties: How and Why the Military Ignores the Full Cost of War courageously explores the dark side of military mental health and the paradoxical nature of, and challenges in, this  tragic situation.

The authors point out that the toll of war is huge and the prevalence of post traumatic stress is  underestimated, covered over by stigma and fears of being diagnosed, contributing to a culture  with excessive waiting times for veterans, high rates of suicide and addictions, inadequate  treatment and organizational scandals.

The two trauma experts offer a courageous critique of the ongoing failures in military mental  health care in the United States. They take a hard and honest look at the war culture and the  denial of the mental health crisis in the military and the suffering of service members.

In Psychiatric Casualties the authors write, “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 over-prescription, 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 contents:
Introduction: The Genesis of the Military’s Mental Health Dilemma
1. A War to Die For: Casualty Trends of Modern Warfare
2. The Dark Side of Military Mental Health: A History of Self-Inflicted Wounds
3. Cruel and Inhumane Handling: The First Dark-Side Strategy
4. Legal Prosecution, Incarceration, and Executions of Mental Illness: The Second Dark-Side Strategy
5. Humiliate, Ridicule, and Shame into Submission: The Third Dark-Side Strategy
6. Denying the Psychiatric Reality of War: The Fourth Dark-Side Strategy
7. Purging Weakness: The Fifth Dark-Side Strategy
8. Delay, Deceive, and Delay Again: The Sixth Dark-Side Strategy
9. Faulty Diagnosis and Backdoor Discharges: The Seventh DarkSide Strategy
10. Avoiding Responsibility and Accountability: The Eighth Dark-Side Strategy
11. Inadequate, Experimental, or Harmful Treatment: The Ninth DarkSide Strategy
12. Perpetuating Neglect, Indifference, and Self-Inflicted Crises: The Tenth Dark-Side Strategy
13. Toward a Resilient and Mentally Healthy Military
14. Transforming Military Mental Healthcare: Three Options for Change

“We are eager to reach military members and families as well as military veterans to join our  cause and help improve the situation significantly,” Figley said in a Tulane interview with Barri Bronston..Figley served a tour of duty in the Vietnam War as a member of the U.S. Marine  Corps. And later, as a noted professor at Purdue University, he had a front-row seat to the  failures of military mental health in the United States, reported Bronston.

“Military mental health is mismanaged, disorganized and often ignored and misunderstood,”  said Figley. “The prevalence of conditions such as post–traumatic stress disorder is often underestimated, with the military dismissing or concealing the significance and extent of the  mental health crisis.”

So far, he said the response to the book has been positive, he told Bronston. “Among other  good signs: A documentary has emerged and will be released in September; Military Times  interviewed us, and the article should be out shortly; there has been no negative response so  far.”

As part of their mission to raise awareness of the problem, Figley and Russell appeared in June  in a Facebook Live show titled “Championing Mental Health.” Featured were clips from the documentary “Stranger At Home: The Untold Story of American Military Mental Health,” which  will be released in September.

Figley has published more 160 refereed journal articles and 25 books as pioneer trauma scholar and practitioner. His Encyclopedia of Trauma was named as an Outstanding Academic Title for  the 2013-2014 academic year by Choice, a publication of the American Library Association. The  work is an interdisciplinary guide, bringing together concepts from the humanities, all of the  social sciences, and most of the professional fields, for understanding human responses to  traumatic events.

Dr. Figley enjoys, “A sense of satisfaction of informing psychology and helping psychologists.  Also, I learn lots from practitioners struggling with critical issues never addressed by  researchers,” he explained.

Another of Figley’s books First Do No SELF Harm has garnered high praise, “… because it  addresses––finally––the high prices physicians and medical students pay in managing work- related stress,” he explained. His work has had far-reaching influence. Recently, he was named  the 2021 Distinguished Psychologist by the Louisiana Psychological Association.