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Military and Mental Health: The Strong Silent Soldier

I think often in Asian cultures we emphasise strength, hard-work and toughness. Our men, especially, are expected to bear the brunt; to never cry; to never talk about their feelings; to never suffer. When a young boy goes to war, we don’t say ‘poor thing’, we say ‘that is where he will become a man’. The ideal man, in many Asian cultures, is the Strong Silent Soldier.

But what do we sacrifice to reach this ideal? What effects do the expectations of strength and silence have on the soldier?

Conversations around mental health and service in the military have only recently been brought into the spotlight, despite the fact there has been evidence of the effects of war on mental health for over a century (Zillmer & Kennedy, 2012). During the US Civil War, for example, soldiers were reported to experience “acute and chronic mania, alcoholism, suicidal behaviour…and substance abuse” yet formal treatment for these symptoms were rare and practically non-existent. Later, in World War I, symptoms such as memory deficits, decision-making difficulties, and speech problems were called “shell-shock”, as it was proposed that when a soldier was exposed to a bomb, it damaged their brain and caused such changes (Bhattacharjee, 2008). Now, we know these to be symptoms of Post-Traumatic Stress Disorder (PTSD). Even a hundred years ago, it was easier and less ‘weak’ to attribute psychological symptoms to a physical cause.

Today, it is understood that exposure to the horrors of war are linked to major depression, PTSD, substance abuse, and increased suicidal behaviour (for further information on these topics, head over to Seribu Tujuan). Approximately 20-30% of soldiers in active duty report experiencing symptoms of one of the above-mentioned disorders (Hoge, Auchterlonie & Milliken, 2006; Greene-Shortridge, Britt & Castro, 2007). In the US and most other Western countries, mental health services are offered to veterans during and after their service, to aid them in their journey of re-entering society. Yet, many Eastern countries have yet to adopt this practice. Today in Indonesia, the common use of pasung and the lack of government acknowledgement of mental health issues has meant that such services are still a long way away.

However, arguably, a bigger problem than the lack of formal and governmental support is the cultural stigma associated with psychological disorders, which is prevalent all over the world. A study in 2004 (Hoge et al., 2004) found that only 38-45% of soldiers with mental health disorders in the US indicated willingness to seek professional help; even less (23-40%) actually sought such help in the following year. The root cause of this is identified to be the social stigma of mental illness, which is thought to affect soldiers’ willingness to treat the problem as seriously as they would a physical condition (Greene-Shortridge, Britt & Castro, 2007). One could argue that in countries where mental illnesses are still a taboo topic, soldiers would be unlikely to seek help even if there were services in place, for the fear that it will make them look weak.

This notion begs the question: is our ideal of the Strong Silent Soldier worth the lives of our actual soldiers?