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The Legacy of Shell Shock on the Modern World

By Jac, Year 9

Picture the scene: 100 years back, a strong man writhing in the muddy trenches as shells poured down around him.  A gun pointing at him by his own side for cowardice and trying to escape the prison that had ruined his life - the trenches.  A new illness was sweeping the front, not a physical one made by shells and bullets, but a mental one, which affects everybody.

To understand fully how this situation arose we must first go back to the dark ages to see how our perception of mental illness has changed.  For much of history, mental illness has been misunderstood: in the early days it was a sign of being possessed by demons. These people were then cared for by their family with primitive methods such as their family just making sure that they were fed and drank plenty of water. However, these people needed proper medical care using drugs but they were just given herbal remedies or whatever was available to them that they thought could help. These methods were more to try and keep the people from causing any harm to themselves or others, rather than to treat them.

As numbers increased, asylums began to sprout up all over the country and the attitude was that everybody could be cured and they would try everything to cure them and put them back into normal society.  Then the industrial revolution came and mental health problems sky rocketed because of the high stress and unhealthy conditions of factory life.  The sheer numbers of the mentally ill was staggering: it went from 10,000 to 100,000 people inside the asylums and it was like a switch for mental health that turned it into an incurable disease.

Suddenly the men and women who entered the asylums never came out again and were more like toy soldiers gathering dust in a warehouse.  They were viewed more as dangerous criminals who should be kept from society, rather than people who had to be helped to re-enter the society. Horrible and dangerous operations, which wouldn’t be performed on sane people, were performed on them because they were seen differently in this society. They were the devil of the age rather than the angel who had fallen from grace and needed help to get back on the right path. These operations include ones such as removing part of their brain, because the doctors thought that part of their brains weren’t working properly, and by removing that part, they would be suddenly cured. They didn’t consider stress or other factors in the cause of their illness. Many of these doctors did not really have a full enough understanding of mental health to try such drastic measures. It was too early a time for mental illness to surface: the medical world wasn’t ready for disease of the body let alone those of the ever so complex mind.

Then World War One came and the men - medical professionals and the people at home - were not ready or prepared for the horrors that were to come their way and ultimately change the way we look at many things today. The British Expeditionary Force went off to fight on the 28 July and one month into the horrible fighting that would follow, men started to come home, not in coffins, not as heroes as they were promised, but as shaking wrecks plagued by the horrors of their ordeal and not able to talk about it and share the burden. Strong, sturdy men, the crème of the British crop, turned into shivering wrecks at the sight or even earshot of a large crashing noise that would trigger horrible flashbacks of the operations and ordeals that their commanders had sent them on. The Generals shrugged it off as “Sheer Cowardice” and said that it was just men trying to escape the war and their duties to King and Country, no different to a deserter or somebody who caused themselves purposeful harm. How could they get it so far wrong? How could we, as the public not notice these men thrown away like broken toys, never to be used again? Surely that is what they were to the British Army, pawns in a massive chess game that were shot and forgotten, when they could no longer follow orders and climb into No Man’s Land to fight and to die. After all, it is now believed that at least some of the 306 men that were killed officially for desertion through a court martial and a firing squad were actually suffering from shell shock and there was nothing that they could really do to stop themselves from at least trying to escape their worst nightmare. This point is echoed by psychologist Dr Petra Boynton who said in an interview with the BBC that, even 90 years ago, there was no excuse for killing soldiers who were so obviously under the most extreme stress.

After a while the British began to realise that these men were not all simply cowards because there was simply too much connecting them together: the loss of one or more senses, the inability to stop shaking, or simply the fact that they just couldn’t speak. Many medical professionals had a try at naming what had caused this terrible problem for the British forces, and one view was that it was caused by unseen nerve damage caused by the constant and repetitive shelling in the trenches of WW1. This explanation seemed to tick all the boxes apart from one, the fact that many men who were affected by shell shock actually began to show symptoms when they were nowhere near the front line and the repetitive shelling that took place there. Eventually the doctors and psychiatrists came up with the only prognosis they could - that the disease was not physical but mental and thus all the cases began to add up during the war and after of soldiers who presented symptoms after the armistice. By the end of the war the British Army had dealt with over 80,000 men who had to be discharged due to their mental state, which came out at a much higher toll for the officers compared to the ordinary soldiers. There was one officer to every 30 men in an ordinary infantry battalion; however, in terms of the number of soldiers diagnosed with shell shock, one officer to every six ordinary soldiers was recorded, a drastic difference.

This left the British Army with one final problem: how were they to look after so many of these men? This meant that they had to classify the symptoms for shell shock under the recommendations of Dr Myers, which ultimately led to many disputes about how these men were to be treated. For example, if you were classified as your shell shock being a sickness of the mind caused by the terror and exhaustion of the war, then you were not entitled to a war pension. However, many of these men still couldn’t work because how can you work if you could break down into uncontrollable shaking or the inability to speak at any moment. How was this fair, our brave and valiant men who had given everything to our country with no obligation just be left to themselves? Surely this was our time to do everything for them and let us be the ones to step in at their darkest moment? In my opinion this really put a shadow over the meaning of the First World War and its meaning of sacrifice- you giving everything for your country and your country giving nothing.

However, ultimately the situation with shell shock really prepared us for the many horrors to come on the modern battlefield and warned us of a new devil, one that we cannot see, mental health. This is why we must now look forward at our modern day forces and the precautions they take and what they have learnt, so that never again will so many suffer for this country in such a devastating manner.
Now in the modern day every possible precaution is taken to try and prevent Post-traumatic stress disorder (PTSD) coming to rear its ugly head in the hearts of our brave and valiant soldiers who give everything to this country. One of the main precautions is the fact that all troops both receive training to spot the early signs of PTSD in their fellow soldiers and themselves. I also found out that all of the Army units who return home from a tour of duty must first complete a process called decompression in Cyprus which is designed to help the soldiers transfer from the life of a soldier to that of a civilian to help reduce the risks of many of the soldiers developing mental health problems such as post-traumatic stress disorder. The Army is also desperately trying to help the soldiers who already are plagued with the devil of mental health by setting up outpatient centres where military personnel go to have check-ups and to receive help with any problems they may be having with reliving the traumatic experiences of their tour. These sessions may include speech therapy where the soldier speaks about what is plaguing him so that he can feel more at peace and begin to get over the trauma. They may also include in the most severe cases the person being given drugs such as antidepressants and Diazepam to help the person restore balance to the chemicals in their brain and live in peace for at least a couple of hours a day.

However, this system is not foolproof like the Army would like you to believe as Panorama found out when they spoke to the relatives of Lance Sgt Dan Collins of the Welsh guards, who tragically hung himself due to his problems, and they revealed the problems behind this scheme. For example, many of the soldiers not living near these specialist bases at which they could see a military psychiatrist would have to endure a long. On arrival, they often would have to see a different psychiatrist every time and would only see each one a maximum of three times. That meant that Collins constantly had to start again and his therapy was constantly halted. His girlfriend of the time said that most of the time these trips actually made him feel worse and that the frustration built up for him as he constantly felt little improvement. Then the army declared that he was fit for service again even though it was clear to his family that he wasn’t, which resulted in him being drugged up in an NHS ward and being released again into a world that he no longer felt that he wanted to live in.

His mother made one simple plea, that nobody else should have to go through this and that the British Army should do more to stop these terrible situations from happening again by simply setting up specific wards to help deal with these men. She pointed out that they would still be treated differently if they had received a large physical wound from battle.
However, is this an isolated incident? I think not. Panorama found other cases like this so it is clear that despite its best efforts, the British Army has still not managed to make the idea of mental health the same as a physical injury, but it is progressing in the right direction as all the protocols and ideals are in place; it is just their implementation that is the problem. However in the general sense most of those who are now suffering from mental health are receiving in the most part the best possible treatment that they can to get them back on their feet so I believe that the tragic incidences of shell shock in WW1 really have made us more aware and more prepared for the horrors of mental illness.

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