In Uniform & Their Right Minds

How to keep wartime mental breakdowns out of Army & Navy is today the main problem of the profession that used to busy itself healing the breakdowns of peace. When the American Psychiatric Association met in Boston last week, it explored the big job of keeping misfits out of the armed forces.

Failure to do that can be incredibly costly to humanity, to the Army & Navy, and to the U.S. Treasury. In World War I almost one-third of all casualties were disabled by mental disorders, most of them within a month after they got into the Army. About 34,000 mentally disabled veterans are still in Government hospitals. They have cost taxpayers to date more than a billion dollars.

Today psychiatrists all over the U.S. turn down from 6 to 9% of recruits as mentally unsound; they hope to keep out of the armed forces a total of 500,000 potential mental cases. The proportion of psychiatric to physical casualties, said Dr. Arthur Hiler Ruggles, the Association's president, may be cut from 30% to as low as 15%. But the 2,500 U.S. psychiatrists are not enough to examine an army of 6,000,000 men, especially since the doctors already have their hands full with 600,000 civilian cases. Some of the doctors suggested last week that their task might be eased if trained social workers were used by local draft boards to investigate local cases.

Ever Had A Fit? At induction stations, every Army recruit spends from three to six minutes with a psychiatrist at the end of his physical examination. In this short interview the eagle-eyed specialist has to spot signs of mental disorders, whether serious or merely neurotic. First the doctor makes sure that the recruit has a clean bill of mental health, is not an alcoholic nor a criminal. Men with insane relations, or those who come from broken homes, are more liable to break down than those with a good family history. The doctor taps the man's knees with a hammer and tests his eye reflexes to find out if his nervous system is sound, machine-guns him with questions. Samples:

> How much do you drink?

> Have you ever had a fit? A nervous breakdown? Fainted? Been knocked out?

> Have you wet the bed since childhood?

> How do you get along with people? With girls? How do you feel about going into the army?

The way the recruit walks into a room, the manner in which he answers these questions, may be as important as the things he says. If he seems dull, he is given a few problems from an intelligence test, must attain ten-year-old standards.

Shut the Door. Navy exams, as described by Lieut. Herbert I. Harris of the Newport Training Station, are equally strict. Recruits come before the psychiatrist when they are worn out from physical tests, completely naked, identified only by a mercurochrome number on their chests. To a tired, jittery "boot," a session with the psychiatrist is like walking the plank. Wary examiners, said Lieut. Harris, are suspicious of boys who speak up first (normal boys are silent until the doctor questions them), those who fail to close the door, or fling down their papers on the table. But regional differences, said the Lieutenant, must be accounted for: a down-east boy might be considered psychotic in The Bronx.

Principal causes for rejection in the Navy (outside of clear-cut insanity) are epilepsy, migraine and sleepwalking--all disorders especially dangerous on board ship. About five boys in every 100 are discharged at once; borderline cases are kept for a three-week observation period. Navy doctors see to it that every rejected recruit is taken in tow by social workers at home, helped to fit into useful civilian activity.

"Mama" v. "Papa." In spite of such strict psychiatric examinations, there are still about 300 more or less serious breakdowns in Army camps every week. According to a report by Dr. George Salvadore Stevenson, head of the National Committee for Mental Hygiene, there are three times as many mental breakdowns among enlisted men and the National Guard (who did not get psychiatric examinations before they were accepted) as there are among carefully screened draftees. Most of these men are victims of the most prevalent mental disorder in the U.S.--dementia praecox, a disease characterized by withdrawal from reality to a private world of fantasy. Dr. Alexander Simon of St. Elizabeth's Hospital in Washington made a study of 500 mental breakdowns in all branches of the armed forces, found that incipient cases fell into certain categories stated by Dr. Simon (rather loosely) as follows:

> "The chronic A.W.O.L.er."

> "The lad who can't stand the social gap between a private and Private First Class, the man or officer who can't stand promotion, and the one who can't stand not to be promoted."

> "The 'Mama Boys' who in peacetime (when there is no selective service) choose invariably the Navy and find that, though the sea may be 'Mama,' the Navy is definitely 'Papa, and blow up promptly in the training station with the shock of the discovery."

> "The [chronically] lonely, homesick, timid, despondent, the one who never took an order in his life, the one who can't stand teasing, cussing and dirty jokes, the alcoholic, the bad actor."

> "The Reserve Officer who thought the sergeant knew more than he did."

> "The man whose best friend went down on his sister ship."

The Federal Communications Commission asked all owners of diathermy equipment to register their machines by June 8. Reason: there are 100,000 diathermy machines, resembling cabinet-type radios, which might be converted into transmitters, used for sending short-wave impulses in code.

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