Army Psychiatry

Having served in the U.S. Army from 1968 to 1973 during the height of the Vietnam War, I read with interest the History Notes column in the May 2 issue by Lucy Ozarin, M.D., titled “Psychiatry in War.” Dr. Ozarin described the psychiatric input into World Wars I and II, but much less after that period.

As a young community psychiatrist with a master’s degree in public health, I spent three years of my psychiatry residency at Walter Reed Army Hospital and then two years as the assistant psychiatry consultant in the Office of the Surgeon General of the Army.

Community psychiatry was growing rapidly in the U.S. Army during this time. The first community psychiatrist in the Army was the chief psychiatric consultant to the Surgeon General of the Army, Mathew Parrish, M.D., who was assisted by Billy E. Jones, M.D. I replaced Jones as the assistant psychiatry consultant. These are names known to many APA members.

During my residency, as an experiment in community psychiatry run by the Walter Reed Army Institute of Research, I was placed with the 75th Engineering Battalion at Fort Meade, Md., to see what community psychiatry had to offer to returning Vietnam veterans.

During my time in the Army surgeon general’s office, I had exceedingly interesting consultative assignments. I served on the Army Board for the Correction of Medical Records for those who were inappropriately discharged from the Army without a medical discharge. I was the only non-general officer on the Morale and Discipline Committee, a group of general officers who deliberated on how to improve morale and discipline. I was able to be present because I was a psychiatrist representing the surgeon general, not as a major. I also served on the Nuclear Surety Review Board to help determine who should be allowed to handle nuclear weapons and on the Conscientious Objector Review Board to determine who was a true conscientious objector.

During the Vietnam War, many of our psychiatric colleagues were serving throughout the world, bringing psychiatric expertise to our troops, to command, and to military dependents.

During 1971 to 1973, when many substance-abusing troops were returning from Vietnam, I traveled around the U.S. helping to set up alcohol and drug abuse programs. It was my experience that we in psychiatry were greatly appreciated and most welcome. I had the unusual experience of writing the first Army regulation on the Confidentiality of Medical Records (AR 40-42). According to AR 40-42, commanders were given only as much information as was necessary for them to deal with soldiers so that psychiatrists were able to treat these individuals. As an experiment, I was even given the opportunity of personally transporting soldiers from Ft. Meade to a methadone-maintenance program in Washington, D.C., so that they could be withdrawn from heroin while remaining on active duty.

I am sure our colleagues in the Gulf War and Iraq War will have similar stories to tell, but to my knowledge no one has written about the things I experienced during the Vietnam War, and I thought this would be of interest to colleagues.