Mental Hygiene: Through the Looking Glass

When I began Mental Hygiene,  my recently completed novel about Vietnam era duty in a Mental Hygiene Clinic at Fort Jackson, SC, I had no idea the direct relevance it would have to the recent flood of articles about mental health in today's military.  

The latest piece, in New York Magazine, The Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Effexor, Valium, Klonopin, Ativan, Restoril, Xanax, Adderall, Ritalin, Haldol, Risperdal, Seroquel, Ambien, Lunesta, Elavil, Trazodone War, by Jennifer Senior, brought back all the feelings of guilt and shame from my real-life experience as an Army Psych Tech in 1967-68.  I have come to realize all too clearly that what I had created in Mental Hygiene, was a preamble to an indictment of mental health treatment in today's military culture.  I am convinced that voluntary cannon fodder is in many ways preferable, only because it does not dissent.

In Mental Hygiene the novel, darkly comedic scenes help to relieve the theme of mental health gone wrong.  It's every man for himself in a world where there are only two types of draftees; those who are waiting to go to Vietnam and those who are already there.  The stakes are high and the draft requirements low as the Nation gears up to half a million troops in an unpopular war.  No one escapes unscathed, even in the fictional Mental Hygiene.

Today's volunteer military faces a mirror problem, but there is no comic relief  in its smaller numbers and multiple deployments for longer tours of duty.  Despite better training than its preceding draft military, its troops are worn down like unmaintained high performance cars, broken and discarded into civilian life and the VA system.  

Ms. Senior's article states: “If we include accidental death, which frequently is the result of high-risk behavior (e.g., drinking and driving, drug overdose), we find that less young men and women die in combat than die by their own actions. Simply stated, we are often more dangerous to ourselves than the enemy.”  In other words, nearly as many soldiers are dying at home today as are dying abroad.

To be fair, the US Military has put in place new regulations that require asking each returning deployed troop via written form if he or she is suffering any psychological difficulties.  When polled,  most troops with symptoms admitted denying them because of fear of being delayed from getting back home, or fear of being flagged as a coward or weakling.  Ms. Senior further states that,  "For most of the past decade, the Army has downplayed the collateral damage this war has had on our soldiers’ nerves. Until The Nation brought the practice to light last spring, the Army sometimes assigned the label of 'personality disorder' to those suffering from post-traumatic stress, often rendering them ineligible for disability." 

From my own personal experience, fictionalized in Mental Hygiene, it's been going on a lot longer than most of the last decade!

Many articles place the percentage of returning troops with Post Traumatic Stress Disorder (PTSD) at 1 in 3.  In spite of a study by the National Health Institute, that number has remained static.  Mental Hygiene Clinics continue to "process" troops with prescription drugs without addressing back to back deployments in a culture that rewards denial.  That's the way it was 40+ years ago and still counting.

The officer in charge of the clinic in Mental Hygiene comments,  "There’ll be patients who are in dire need of long-term therapy, with excellent prospects of recovery. Forget that fact. We are in the processing business here.  If we can patch them together or medicate them to health long enough to ship them to the next stop, good."  He could have said the same thing today.  It's not about recognizing the problem, it's about the primary purpose of one's actions.