ROYAL NAVAL PSYCHIATRY: ORGANIZATION,
METHODS AND OUTCOMES, 1900–1945
By Edgar Jones
and Neil Greenberg
Breakdown at sea: surface vessels
Low levels of psychiatric
casualties in the navy was considered a function in part of
selection ‘since the Navy and the Air Force get the first pick of
recruits, whereas the Army must take all that remain and
consequently the average level of intelligence in Army recruits
tends to be lower than in the other two services’. The
protective effect of high morale was predicated on two distinctive
factors: first, the notion of the ship’s company united by their
loyalty to each other, and secondly, the fact that once at sea there
was no opportunity for evacuation. Reporting sick to the ship’s
doctor did not improve a sailor’s chances of survival and jumping
overboard often resulted in almost certain death. In naval action,
Surgeon Captain C. H. Joynt observed, ‘the safest activity is
steady devotion to duty rather than flight’.....
.....For the Royal Navy, hazardous operations such as Arctic
convoys, which carried a significant risk of death in testing
conditions, saw a significant number of stress related disorders.
The medical officer of HMS Eclipse recorded on his return to the UK:
‘since our visit to North Russia, with its action with enemy
surface craft and the unrest of daily bombing attacks, there has
been a marked increase in the sick parade’. The medical officer
of HMS Leda concluded that because of the mental and physical
demands of these convoys no one should sail them for longer than
eighteen months. One medical officer recorded that the ‘prolonged
and repeated stress and strain’ led to an ‘increase in the
numbers attending the sick bay and, collectively, by the development
of apathy and listlessness which had previously been quite foreign
to the nature of the ship’s company’.
Senior officers appear to have been at particular risk. At the end
of a year’s service in Arctic waters, for example, nine officers,
all with good records, were invalided from a single warship. By 1943
it was recognized that for a number of destroyers and smaller
vessels, captains had been left in command beyond the point at which
they were effective leaders. Studies of soldiers have shown that
rank is a protector against psychological disorders. However, for
the navy this was not necessarily true. As a general rule the higher
the rank in the army, the further the soldier found himself from the
front-line. Hazards were shared more equitably on warships, while
senior officers also carried the heaviest burden of responsibility.
Mid-way through the conflict, the navy accepted that even
experienced sailors had a breaking point and introduced the term
‘fatigue’ for those who earlier in the war might have been diagnosed
as suffering from an anxiety state. This was designed to avoid any
stigmatizing label and to encourage natural recovery...
....The
apparently low rate of breakdown aboard warships during the First
and Second World Wars may conceal more than it revealed. First, the
sailor who feared for his life had no safe escape route, while
adopting the sick role conferred no obvious benefit. In fact, if he
had a vital task to perform, such as closing a watertight door or
securing a magazine, deserting his post may have increased the risk
that the ship could be damaged or sunk. Naval personnel were well
aware that the sea, irrespective of war, was a hostile environment.
The closed space of a warship may be analogous to some aspects of
modern combat where there is no clear front-line and hence no
obvious escape route. A further reason for the low rate of breakdown
at sea was the decision to deploy psychiatrists to shore
establishments. Doctors on board ships may have not detected
psychological disorders as long as a sailor continued to perform his
duties. Not labelling someone who somatized their distress, whether
as a deliberate policy or by chance, may have allowed them to
continue at duty and, in turn, prevent the emergence of recalcitrant
psychological symptoms...
