What is Mental Health Stigma?

The U.S. Army leadership initially requested a change in terminology stating that the word “disorder” is stigmatizing and that removing it would encourage more individuals suffering from symptoms to access care. However, the American Psychiatric Association (APA) board of trustees recently voted on changes to the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Among the decisions was one to retain the word “disorder” in the term “posttraumatic stress disorder”. Although the APA has issued its ruling, the term “posttraumatic stress” is being used informally by many individuals within the military communities. It is unclear whether informal use of the term will continue, or whether military leaders will continue to advocate future changes to the DSM. The tenth district of the American Legion has a committee, the ‘posttraumatic stress committee”. It refuses to use the term “disorder.”

Unfortunately psychiatrists do not understand the differences are very different in each of the different wars. For example, they state that the systems of PTSD have been documented as far back as the Civil War. Though the name has experienced a few changes, from soldier’s heart, shell shock, battle fatigue, PTSD and now more recently post-traumatic stress, the definition for the condition remains relatively the same.

However, the symptoms and causes very different in the different for each of the wars.

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In the Civil War Americans of North and South shooting and killing each other. This led to the highest number of suicides and mental problem in our history. This caused our country to build many mental asylums. Most of which were converted to VA hospitals post World War I. With World Wars I & II the battle lines were drawn. They were far from each other so in most cases the soldier did not see the enemy getting shot. However, both sides wore the uniforms of their country. They witnessed fellow troops getting killed in the trench of battle lines. Their biggest fear was being killed. The Vietnam War and the Afghanistan Wars were mostly guerilla fighting at very close range. The enemy not only wore civilian clothes, but included women and children. The women were used to refill the sniper’s rifles and to get close to our troops where they were carrying loaded bombs. The children were also used to carry loaded bombs into our camps. This forced our troops not only to shoot civilians, but also women and children. There was no way that our troops could have been trained to kill women and children so those killings caused the troops to suffer guilt and shame and Moral Injury. That guilt and shame led to them committing suicide at a rate of 20 or more veterans per day. This problem is increased because of the fact that before entering the service they were taught the commandment “Thou Shall not Kill.” Whereas, the commandment is “thou shall not Murder.” How would you react to killing a women or child?

It is also important to understand how hard it is for veterans to tell anyone what they did. It is also very important to realize that shame and guilt grows stronger the longer someone suffers from them. However, we in Suffolk County were able to stop 11 veterans from committing suicide that were labeled PTSD, but were suffering from Moral Injury.