Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future.
During the colonial period, mental health care policy in the Dutch East Indies was centred on the mental hospital, which provided custodial care. In 1949, independent Indonesia inherited four very large mental hospitals, about 10 acute-care clinics in the major cities, and an agricultural colony. During the 1950s, mental hospital care remained largely custodial. In 1966, the Directorate of Mental Health adopted the three-fold principles of prevention, treatment, and rehabilitation as the foundation of a comprehensive mental health care system. During the 1970s and 1980s, the number of mental hospitals in Indonesia doubled and a variety of treatment methods were introduced. Special attention was given to the care provided by dukuns, or indigenous healers.
This article analyzes the views of 3 Dutch physicians working in the former Dutch East Indies during the first part of the 20th century. These physicians based ideas about the nature of the normal indigenous psyche on both their analysis of Indonesian individuals suffering from mental illness and on casual observations that represented widely shared cultural stereotypes. On that basis, they advocated a psychological colonial policy, which was to be based on a scientific understanding of the psyche of the Indonesian people. Using these ideas, they advocated political repression, justified inequality and racism, and limited educational opportunities for Indonesians. Representatives of the Indonesian nationalist movement vigorously protested against these ideas.
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