Mental Health Screening and Coordination of Care for Soldiers Deployed to Iraq and Afghanistan

Mental health screening of soldiers prior to deployment to a theater of war was first attempted by the U.S. Army in World War I in the hope of avoiding the high rates of psychiatric casualties observed in British and French troops, but it did not prevent extensive disability from shell shock in American World War I veterans (1). In World War II, the U.S. military carried out mass neuropsychiatric screening with the aim of identifying individuals who might be psychologically vulnerable to later psychiatric breakdown in the combat environment because of, for example, neuroses or minor personality defects (1). In World War II, as in later wars, predeployment screening to predict the development of future mental disorders was a failure for a variety of reasons, including imprecise screening methods and instruments, poor interrater reliability, high false positive rates, low thresholds for caseness that did not discern significant severity, and low predictive power

Madelyn Hsiao-Rei Hicks, M.D., M.R.C.Psych.