War Surgery and Medicine
Early Experience in 2 NZEF
Early Experience in 2 NZEF
Early in 1941 the DDMS 2 NZEF considered the number of cases of neurosis to be unduly high for the conditions of service met with up to that stage. He set up a board consisting of senior medical officers from the base hospital and the Division, under the chairmanship of a psychiatrist, to report on measures that should be taken for the prevention, treatment, and disposal of such cases, with special reference to officer personnel.
The board, after hearing evidence from medical officers representative of the divisional units and base hospitals, presented its report. It pointed out that the Force had up till then experienced no active fighting and only slight bombing, and that there had been no prolonged stress of any kind. It recalled that in the 1914–18 War early incidence of the neuroses was experienced, a large percentage of the total cases occurring in men who had no front-line service at all. This meant that a number of men were, in varying degrees, improperly adjusted to army environment and broke down readily.
In the numerous cases of anxiety state the breakdown was primarily due to an inherent and, in some cases, hereditary psychological inferiority. No amount of training would make such men efficient soldiers. Any normally adjusted man might crack under prolonged emotional stress, but in these ill-adjusted men the common associations of army life, such as separation from wife and family, restrictions on liberty, discipline, and monotony, precipitated a breakdown.
The board found that the number of cases of mental breakdown was not unduly high, and that regimental medical officers agreed that practically all the cases arose in misfits quite unsuited for service. A neuropathic condition, hereditary or acquired, was present in the majority of cases, and physical and mental fatigue was a precipitating factor. Histories of onset given by the patients had been accepted without corroboration by medical officers in charge of the cases, and in the cases of persistent cerebral contusion there was rarely any corroborative evidence of injury. There was no evidence that alcohol had been a factor in causation. In few cases was there any evidence of prolonged mental stress, and the mental diseases resembled those met with in civil life.page 633
The board recommended that at enlistment there should be an elimination of persons with previous histories of nervous or mental disorder and of head injury with persisting complaints, and that a psychiatrist should be appointed to each of the training camps in New Zealand. Strong emphasis was placed on the importance of training and discipline as a means of reducing the number of cases of breakdown. Allied to these controls were welfare measures such as food, sports, entertainment and leave.
In the matter of disposal it was recommended that generally cases of hysteria and anxiety neurosis should be evacuated to base hospital; that acute emotional shock should be treated by rest in rear areas; and that unsatisfactory cases of anxiety neurosis should be selected for return to New Zealand, undergoing vocational therapy at the convalescent depot prior to embarkation.
This report was commented on by the GOC 2 NZEF and by the DDMS. The former stressed his opinion that good feeding and entertainment were beneficial to the men, and that platoon commanders could by careful planning prevent men becoming nervy; and that medical officers should lecture the men on the need for care, warmth, and entertainment. The DDMS considered the practical point was the necessity to get confirmation of the soldier's story from the commanding officer of his unit, and forms were printed to enable facts to be elicited for the guidance of medical officers.