This is a study of the experiences of mentally ill World War I servicemen in England. It follows their medical and psychiatric treatment during and after the war and their dealings with the Ministry of Pensions in particular.
At first blush, this may appear to be a dry and academic subject, but author Peter Barham shows that he cares about the people concerned. He does this not by engaging in polemic, but by trying to tell the stories of these “forgotten” men as fully as possible, from hospital admission records, service records, intake interviews, and family correspondence or, when available, appeals to such bodies as the Ministry of Pensions from the serviceman himself.
Barham retains the original clinical language of the times, which includes “lunatic” and “imbecile” and other words that strike 21st century readers as unkind at best and unprofessional at worst. Nevertheless, such terms appear to have been in common use. For example, intake notes at a facility called Netley D Block (Imbecile Ward), which served as a clearinghouse, include entries such as: “He is dull, plaintive and stupid. Speech thick.” “Idiot.” “He presents the type of low-class defective. He squints. His features are asymmetrical. Has a stammer in his speech. Says he cannot drill… His attitude and manner are not convincing. Much of this is a put on.” (p. 52)
While the issue of what was called at the time “shell shock” comes up, the book deals with the broader issue of mental illness in serviceman and ex-servicemen. One of the things Barham asserts is that public sentiment had an effect on the policy of the government toward mentally ill ex-servicemen. There had been a feeling that mental illness was due to moral failing, but the public also felt that men who “lost their minds” in service to their country were owed something in return in the form of disability pensions. Next came the issue of whether the mental illness was due to their military service or whether it was “constitutional,” i.e., whether the serviceman was insane to begin with, had a family history of insanity and so forth or some mixture of the two. This was not a simple matter. Factors such as class, rank and family members or (for the lucky ones) members of parliament advocating for the serviceman in question could help determine outcome.
All of the things that one associates with more recent wars—violence toward family members, suicide, difficulty in adjusting to peacetime—are present in the population studied. Author Barham writes sometimes with poignant images and sometimes with biting sarcasm to make these people all the more immediate to the reader. A section dealing with suicide is titled “A Cap Floating on a Pond.” (p. 120) There is the story of Herbert J, who enlisted under age in August 1914 and was invalided with a diagnosis of “feeblemindedness” after receiving a head wound. He later married. In the 1960s, he was still having nightmares about day the Germans broke through the lines and he received his head wound. These nightmares became so debilitating, he feared to leave the house and at times didn’t get out of bed.
While I would have preferred a bit more population statistics in relation to what percentage of men returning from war reported mental illness, for example, I realize this is a fairly narrow study. World War I was unique in many respect in that it was modern warfare without antibiotics, that chemical weapons were used and that toward the end (indeed, it has been argued that it hastened its end), the 1918 flu pandemic attacked young adults in particular. It is nevertheless universal in some respects as to the toll modern warfare takes on the minds and bodies of the warrior.
This is a well-written, interesting book that should appeal to history buffs and perhaps to health care workers, particularly those in the mental health care field.