Military and Disaster Psychiatry

Abstract

Property destruction, loss of life or limb, fear, confusion, and the threat of still greater loss are among the stressors that result from both natural disasters such as earthquakes and human-made acts of war or terrorism. The neurobehavioral and emotional consequences for persons caught in the destructive wake of human-made and natural disasters encompass the broad range of human response to trauma. Psychiatric interventions in military operations and in other disasters seek to prevent and mitigate the psychological consequences of trauma. Medical management and mental healthcare strategies applicable in theaters of war, like those applicable in cities destroyed by earthquakes, have been derived from experience in chaotic and austere operational environments far removed from traditional hospital or office-based psychiatric medicine. This chapter examines the operational environments of military and disaster psychiatry, and the emotional and behavioral responses associated with the events that create these environments. The principles of prevention, treatment and mitigation of post-traumatic illness on the battlefield and in the aftermath of disaster are outlined. Finally, emerging cultural, ethical and technological challenges to the practice of military and disaster psychiatry are discussed.