Neuropsychiatry in World War II
Volume I
Zone of Interior
Contents
Part I
INTRODUCTION
Chapter
I. Army Psychiatry Before World War II (Colonel Albert J. Glass, MC, USA (Ret.))
Historical Note
World War I
Lessons of World War I
Psychiatry, 1920-30
Psychiatry, 1930-40
Mobilization Period
Mobilization of Civilian Psychiatry
Part II
ADMINISTRATIVE CONSIDERATIONS IN THE SURGEON GENERAL`S OFFICE
II. Status and Development (Malcolm J. Farrell, M.D.)
Early Organization
Changing Concepts
Neuropsychiatry Division
III. Professional Personnel (Malcolm J. Farrell, M.D., and Ivan C. Berlien, M.D.)
Distribution and Utilization of Psychiatrists
Classification and Assignment
Continued Shortages
Psychiatric Workload Versus Psychiatric Manpower
Conclusion
IV. Education and Training (William C. Menninger, M.D.)
Need for Training in Military Psychiatry
The School of Military Neuropsychiatry
Military Psychiatric Training in Civilian Schools
What the Schools Accomplished
Psychiatric Training in Oversea Theaters
Training of Paramedical Psychiatric Personnel
Psychiatric Education of General Medical Officers
Orientation in Mental Health
Training Films
V. The Consultant System (William C. Menninger, M.D., Malcolm J. Farrell, M.D., and Henry W. Brosin, M.D.)
The Need for Consultants
Development in Zone of Interior
The Assignment of Psychiatric Consultants
General Functions of the Consultant
Personnel Problems in the Service Command
Problems of Newly Inducted Physicians
Consultant Conferences
Civilian Consultants
Recommendations and Conclusions
VI. Liaison With Other Agencies (Malcolm J. Farrell, M.D.)
Scope
Office of the Secretary of War
Personnel Division, G-1
Military Intelligence Division, G-2
Training Division, G-3
Headquarters, Army Service Forces
Military Training Division, Army Service Forces
Information and Education Division, Army Service Forces
Headquarters, Army Ground Forces
Headquarters, Army Air Forces
Liaison With Other Divisions, Surgeon General`s Office
Miscellaneous, Technical, and Other Agencies
VII. Public Relations (William C. Menninger, M.D.)
Absence of Public Relations Planning
Vacillating Policies and Publicity Blackout
Publicity Blackout Continues
Publicity Blackout Slackened Under Pressure
Effort Toward Further Liberalization of Publicity Releases
Restrictions Lifted as War Ends
Conclusion
VIII. Selection and Induction (Ivan C. Berlien, M.D., and Raymond W. Waggoner, M.D.)
Historical Note
1939-41 Philosophy of Selection
Organization of Psychiatry During Mobilization
Physical and Mental Standards
Physical Profile Serial System
Medical Survey Program
Neuropsychiatric Screening Adjunct
Effectiveness of the Neuropsychiatric Screening
Part III
MILITARY PSYCHIATRY IN PRACTICE
IX. Hospitalization and Disposition (Norman Q. Brill, M.D.)
Initial Problems
Liberal Discharge Policy
Reversal of Liberal Discharge Policy
Liberal Discharge Policy Reestablished
Final Policy
Psychiatric Nomenclature
Line-of-Duty Determination of Neuropsychiatric Disorders
Special Problems
Frequency of Neuropsychiatric Disorders
World War II Mean Strengths
X. Station and Regional Hospitals (Norman Q. Brill, M.D.)
Organization and Functions
Physical Facilities
Personnel
Clinical Problems
Disposition
Treatment
Convalescent Hospitals
Group Psychotherapy
Final Policy
XI. General Hospitals (Henry W. Brosin, M.D.)
Historical Note
Development of Physical Facilities
Personnel
Policies and Conflicts
Functions and Operations
Treatment
XII. Troops in Transit (Morris M. Kessler, M.D.)
Historical Note
Ports of Embarkation
Troopships en Route Overseas
Transportation of Mental Patients to Zone of Interior
Debarkation of Mental Patients
XIII. The Mental Hygiene Consultation Services (Manfred S. Guttmacher, M.D.)
Historical Note
Origin and Development
Expansion of Consultation Services
Personnel
Consolidation of Efforts
Operation
Location and Psychiatric Staff
Conclusion
XIV. Preventive Psychiatry (John W. Appel, M.D.)
General Considerations
Scope of Problem
Need for Preventive Psychiatry
Epidemiology of Military Psychiatric Disorders
Application in Zone of Interior
Preventive Psychiatry in Combat Theaters
Army Authorities and Psychiatry
Summary
XV. The Women`s Army Corps (Margaret D. Craighill, M.D.)
Development
Relationship to Medical Services
Procurement
Enlistment Physical Examination Procedures
Mental Hygiene Consultation Services
Health Education
Utilization of WAC Personnel
Oversea Assignment
The Psychiatric Problem
Specific Problems of Female Military Personnel
Termination Problems
Summary and Conclusions
XVI. Forensic Military Psychiatry (Lieutenant Colonel Robert J. Bernucci, MC, USA (Ret.))
Historical Note
Military Jurisdiction
Psychiatric Evaluation of the Accused
Psychiatric Responsibilities in Administrative Procedures
Critique
XVII. Psychiatry in the Army Correctional System (Ivan C. Berlien, M.D.)
General Considerations
Organizational Background
Psychiatric Services
Restoration to Duty
Mental Responsibility
Changes in the Rehabilitation Process
Training of Correctional Personnel
Group Therapy
Psychiatry and Clemency
Hospitalization for Psychotic Prisoners
Statistical Data
XVIII. Neurology (William H. Everts, M.D.)
Coordination of Neurology Activities
Disqualification for Neurological Reasons
Organization in Zone of Interior
Organization Overseas
Admission and Disposition
Common Clinical Disorders
Neurological Disorders in Allied Repatriates and Japanese Prisoners of War
Summary
Part IV
SUPPORTING SERVICES AND PERSONNEL
XIX. Clinical Psychology (Morton A. Seidenfeld, Ph. D.)
Historical Note
Development of Clinical Psychology Program in World War II
Procurement
Professional Training
Relationships With The Adjutant General and The Surgeon General
Functions and Duties
Mental and Educational Deficiency
Psychological Tests
Summary
XX. Psychiatric Social Work (Daniel E. O`Keefe, Ph. D.)
Historical Note
Early Efforts
Extension of Psychiatric Social Work
Specification Serial Number 263 Established
Training
Standards of Practice
Convalescent Hospitals
General and Special Hospitals
Miscellaneous Activities
Psychiatric Social Work Branch, Surgeon General`s Office
Officer Psychiatric Social Workers
Statistics
Summary and Recommendations
XXI. The Neuropsychiatric Nurse (Lieutenant Colonel Charlotte R. Rodeman, ANC, USA (Ret.))
General Considerations
In service Training
Oversea Theaters
Neuropsychiatric Nursing on Hospital Ships
Neuropsychiatric Nursing in the Army Air Forces
Conclusion
XXII. Occupational Therapy in Neuropsychiatry (Major Wilma L. West, AMSC, USAR)
Early Problems
Problems in Program Development
Development of Specific Programs
In Retrospect
XXIII. Reconditioning of Psychiatric Patients (Colonel Edward F. Quinn, Jr., MSC, USA (Ret.))
Background
Evolution of Reconditioning
Principles and Aims
Organization and Operation
Conclusion
XXIV. The Chaplain (Harold E. Berger, B.D.)
Historical Note
Uniqueness of Role
Functions
Need for Psychiatric Indoctrination
XXV. The Technicians (Lieutenant Colonel Charlotte R. Rodeman, ANC, USA (Ret.), Morton A. Seidenfeld, Ph. D. and Myron J. Rockmore, M.A.)
Section I. The Neuropsychiatric Technician
Development and Difficulties
Zone of Interior
Oversea Theaters
Summary
Section II. Psychology Technicians
Selection
Training
Summary
Section III. Psychiatric Social Work Technician
Need for Technicians
Qualifications
Training
Assignment
Part V
THE POSTWAR PERIOD
The Soil for Potential Problems
Divergent Views on Potential Problems
Analysis and Methods of Attacking the Problems
The Veteran Goes to School
Error in Crime Prediction
Social and Economic Help
XXVII. The Psychiatric Patient After Discharge(Norman Q. Brill, M.D., and Herbert I. Kupper, M.D.)
Misconceptions About Psychoneurosis
Post discharge Adjustment During the War
Residuals of Wartime Psychiatric Illness
Post discharge Psychiatric Illness
XXVIII. Lessons Learned (Colonel Albert J. Glass, MC, USA (Ret.))
Magnitude of Psychiatric Disorders in Modern Warfare
Organization of Psychiatry for War
Psychiatric Screening
Gain in Illness
Consultation Services
Diagnosis and Disposition
The Making of Wartime Military Psychiatrists
Summary
APPENDIXES
Disqualifications for Neuropsychiatric Reasons: World Wars I and II
Discharges for Neuropsychiatric Reasons: World Wars I and II
General Comment
B. Mobilization Regulations Pertaining to Mental and Nervous Diseases and Neurological Disorder
C. Meeting of Neuropsychiatric Consultants, Office of The Surgeon General
D. Report of the Special Committee to the Secretary of War on Induction
E. Neuropsychiatric Problem in the Army
F. Calendar of Significant Events
Illustrations
Figure
11. Col. Ernest H. Parsons, MC, Commanding Officer, 312th Station Hospital (NP), European Theater of Operations, U.S. Army
12. Maj. (later Lt. Col.) Jackson M. Thomas, MC, Director, School of Military Neuropsychiatry, European Theater of Operations, U.S. Army
14. Lt. Col. (later Col.) Edward G. Billings, MC, Neuropsychiatric Consultant, South Pacific Area
15. Lt. Col. Paul L. Schroeder, MC, Neuropsychiatric Consultant, Fourth Service Command
16. Col. Lauren H. Smith, MC, Neuropsychiatric Consultant, Ninth Service Command
17. Col. S. Alan Challman, MC, Neuropsychiatric Consultant, Southwest Pacific Area
18. Lt. Col. Joseph S. Skobba, Neuropsychiatric Consultant, Fourth and Fifteenth U.S. Armies
19. Lt. Col. Calvin S. Drayer, MC, Neuropsychiatric Consultant, Fifth U.S. Army
21. Service Command Neuropsychiatric Consultants Meeting, Surgeon General`s Office, 12-13 May 1944
23. Neuropsychiatric Consultants to the Secretary of War
25. Meeting of American, Canadian, and British psychiatrists in Montreal, Canada, 16 November 1943
27. A neuropsychiatric attendant bringing a tray of food to a mental patient in a paranoid state
28. A disturbed patient in a seclusion room
29. Floor plan of a typical neuropsychiatric ward
31. Neuropsychiatric Section, Water Reed General Hospital, Washington, D.C., 1934
32. Neuropsychiatric Section, Brooke General Hospital, Fort Sam Houston, Tex.
35. Nurses admiring what their patients had accomplished aboard ship
37. Articles made of leather in the Arts and Crafts Exhibit
38. A ward on the U.S. Army Hospital Ship Emily H. M. Weder
39. The U.S. Army Hospital Ship Larkspur, arriving at Charleston, S.C., 1944
40. Army Ground Forces Retraining Center psychiatrists` meeting, North Camp Hood, Tex., March 1944
41. A patient with camptocormia reporting to the neuropsychiatric clinic
42. Lt. Col. Margaret D. Craighill, MC
43. Lt. Col. Margaret D. Craighill, MC (left), and Col. Oveta Culp Hobby, Director, WAC (right)
44. Conference, WAC Staff Directors, Major Commands, Fort Des Moines, Iowa, 18 September 1945
45. Cartoon, `Grin and Bear It`
46. A psychiatric social work officer giving an orientation lecture, U.S. Disciplinary Barracks
49. A disciplinary and adjustment board meeting at a U.S. disciplinary barracks
50. Typical appearance of Japanese prisoner-of-war patients, New Bilibid Prison, 1945
56. Floor plan, occupational therapy facilities
57. Miniature model building in occupational therapy
58. Training chart showing materials and equipment used in the wetpack
59. Neuropsychiatric technicians preparing the bed for a patient to receive a wetpack
60. Neuropsychiatric technicians wrapping a patient in the wetpack
61. Neuropsychiatric technicians securing the last blanket of a wet sheet pack
62. Neuropsychiatric technician assisting nurse with a patient in a `continuous tub`
63. Neuropsychiatric technician, watching the `continuous tub` patient, prevents dehydration by forcing liquids
64. Neuropsychiatric technician demonstrates one of the hazards of the neuropsychiatric ward
65. Intake interview by a psychiatric social worker assistant
Charts
Number
2. Admission rates for neuropsychiatric disorders, U.S. Army, by year and month, 1942-45
4. Number of neuropsychiatric patients remaining in hospitals, 1943-45 (as of end of month)
7. Admission rates for neuropsychiatric disorders, for selected areas, U.S. Army, 1944
12. Medical rejection rates of WAAC and WAC candidates, by diagnosis
14. Admissions for all Army personnel and for the WAC, in the United States, June 1944-December 1945
15. Admission rates for psychiatric conditions, by broad diagnostic categories and year, 1917-59
Tables
1. Disqualification and discharge rates for neuropsychiatric reasons, at selected induction stations, 1943
2. Disability discharges for neuropsychiatric conditions, by diagnosis and year, U.S. Army, worldwide, 1942-45
3. Discharge rates of enlisted men on certificates of disability for discharge for neuropsychiatric conditions, by broad diagnostic categories and month, U.S. Army, worldwide, 1942-45
4. Relationship between discharges for disability for neuropsychiatric conditions and disability for all nonbattle diseases and injuries, U.S. Army, worldwide, 1942-45
5. Neuropsychiatric patients evacuated from overseas, by month, 1943-45
6. Admissions for neuropsychiatric conditions, by diagnosis and year, U.S. Army, worldwide, 1942-45
7. Admissions for neuropsychiatric disorders, by broad diagnostic categories, month, and year, U.S. Army, worldwide, 1942-45
8. Admission rates for neuropsychiatric disorders, by broad diagnostic categories, month, and year, U.S. Army, worldwide, 1942-45
9. Percent distribution of admissions for neuropsychiatric disorders and psychiatric disorders, by diagnosis, U.S. Army, 1942-45
10. Neuropyschiatric patients remaining in hospital: number and percent of all remaining hospital patients, by year, month, and percent distribution by closed and open wards, U.S. Army, continental United States, 1943-45
13. Mean Army strengths, total Army and enlisted men, by year, 1942-45
16. Admission rates for psychiatric conditions, by rank, U.S. Army, worldwide, 1942-45
17. Disposition of neuropsychiatric cases from convalescent hospitals, 11 May-29 June 1945
22. Admissions for neuropsychiatric conditions, by diagnosis and year, U.S. Army, overseas, 1942-45
29. Indexes of morbidity, by length of foreign service
30. Accessions of personnel in the Women`s Army Corps (WAAC and WAC), 1942-45
35. Medical rejection rates of Waacs, by service command and diagnosis, April through July 1943
36. Rejections of white WAC candidates, by specific diagnosis, October 1943 through March 1944
39. Medical rejection rates of Wacs, by service command and diagnosis, October through December 1943
43. Percent distribution of white WAC separations, by diagnosis, October 1943 through October 1944
47. Discharges for disability and pregnancy of Waacs and Wacs, by year, 1942-46
58. Distribution of the general prisoners, by place of confinement and crimes committed, 1945
60. Admissions for neurological conditions, by diagnosis and year, U.S. Army, worldwide, 1942-45
61. Separations for neurological conditions, U.S. Army, by diagnosis and year, worldwide, 1942-45
64. Military effectiveness of special training unit graduates and the control group
65. Occupational Therapy Program at Mason General Hospital, 1944-45
66. Admission rates for psychiatric conditions, by broad diagnostic categories and year, 1917-59