War Surgery and Medicine
Experience in England
Experience in England
Investigations in England had shown that 70 per cent of psycho-neurotic casualties were constitutionally predisposed. They fell into three types:
Those displaying intellectual inferiority (high grade mental defectives).page 652
Those having inherited traits from neurotic parents (shown by family history).
Those with neurotic traits from unfortunate home surroundings and environment.
The elimination of members of these three groups from front-line troops was done by selection. It was noted that in the First World War there were one million neurotic casualties (30–34 per cent) in the British Army where selection was not practised. In the United States Army where selection was practised there were 9 per cent neurotic casualties.
Selection was adopted in Britain in 1942. It was first started in OCTUs. Every candidate for the officers' training course went through a routine method of selection—four days in selection school, where he underwent intelligence and aptitude tests and field tests. Finally a psychiatric specialist interviewed him.
Later each ordinary recruit went through selection, and many of the constitutionally predisposed were put in Category 3 at the start. This elimination of the unfit proved most satisfactory. (For 2 NZEF there was no selection.)
At the beginning of July 1942 the General Service Selection procedure was introduced into the Army, and by the end of 1942 all men were taken into the General Service and were posted to duties in the Army only after testing.
The Directorate for Selection of Personnel undertook a complete job-analysis of the multitudinous tasks in the different arms of the service, and as a result was able to lay down the standards of intelligence and other aptitudes necessary for each job, thus providing a basis for the correct posting of men in certain proportions to each type of unit. The accomplishment of this work produced a revolutionary change in the Army's utilisation of manpower and has set a standard which will, we hope, certainly be applied in industry and in social life in the post-war world. The matching of men to suitable work is as valuable a means of psychiatric prophylaxis as anything that could well be devised.
The psychiatrists and psychologists worked together—the psychiatrists seeing all men in the lower groups and the difficult cases referred to them by the psychologists.
The psychopathic tenth, those with a constitutional predisposition, with a neurotic history, personal or family, were apt to break down following dislocation of their life and the boredom so often present in the Army. As regards treatment, military occupations were more valuable than the ordinary methods of occupational therapy. The army physical training instructors were especially useful. Special placing of the neurotics in suitable army occupations was most page 653 beneficial; only 9 per cent so placed proved failures and 70 per cent very successful. In the acute war neurosis resulting from enemy action the results were even better, provided treatment was undertaken early.
Education by psychiatrists in the Army by lectures and contacts with regimental, legal, and administrative officers proved highly beneficial. Courses in psychiatry for medical officers were of great value.