An historical account of shell shock during the First World War and reforms in mental health in Australia 1914–1939

Abstract

The study of the disorders of the mind at the turn of the twentieth century offered useful knowledge about the psyche and the First World War (FWW) provided an avalanche of case studies. Prior to the war the mentally ill were treated with disdain and the social distrust of individuals who did not present as 'normal' was high. The level of diagnostic expertise of psychiatric illness by doctors and nurses was low and as a consequence medicine and nursing was ill-equipped to deal with the phenomenon initially referred to as 'shell shock'. However, the soldiers of the FWW who endured the varied and seemingly unrelated symptoms of shell-shock were respected men - occasional heroes - who were reduced to the status of 'mentals'. There is evidence that civilian trained health professionals altered their views about mental illness during the FWW but initially, the military imperatives inherent in a global conflict perpetuated the notion that mental illness was linked with defective morality. This paper provides an historical account of changes in attitude toward the mentally ill as a consequence of the FWW. The interregnum (1918-39) was a period of advancement in the field of mental health within the civilian sector. However, the imperatives of war negated these developments and there is evidence that the management of soldiers suffering from post-traumatic stress disorders in the Second World War did not benefit from the lessons learnt in the FWW.