Over fifty years ago, it was the American involvement in Vietnam that most awakened us to the severe psychological problems that wars can bring to those that fight them. The US military planners had taken into account the possibility of psychiatric casualties, so combatants were sent to the war zone for a set period – one year for most soldiers and 13 months for the Marines. And each man knew he would leave after this period, which had a ‘holding-on’ effect, to keep going and see it out.

Consequently, in Vietnam, the percentage of US combatants who had to be evacuated because of psychiatric breakdown was low. And the US military planners thought they had reduced this problem to an almost irrelevant level, but after many of the troops had returned to America problems began to surface. Back home, many Vietnam veterans felt alienated and isolated and had difficulty settling down.

Their combat training and tours-of-duty had moulded them into effective soldiers, but was now causing them to be troubled and ineffective civilians. Back in America, a few Vietnam veterans flew into rages with little or no provocation, some using violence against their partners, or others they came into contact with. A few chose to live a solitary life, usually armed to the teeth, in the National Parks or other wild countryside.

The ‘Viet Vet Survival Guide’ starts its section on Psychological Readjustment like this:

“Most people think the Vietnam war was over in 1975. A lot of Viet Vets know they’re wrong. For hundreds of thousands of vets – and their loved ones – the psychological effects of the war are a part of everyday life. Most of these vets suffer from Post-Traumatic Stress Disorder (PTSD). Some have other war-related psychological problems or a war-related dependence on drugs or alcohol … For most Viet Vets, the adjustment back to civilian life posed few or no major problems. But for others – perhaps as many as 40% of vets who served in Vietnam – things haven’t gone well. In fact, sometimes things seem to be getting progressively worse. These and other complaints are often heard:

• “I can’t keep a job.”
• “I have no skills or training that will get me a decent job.”
• “I feel my life is going nowhere.”
• “I can’t stay in a relationship. I’ve been married and divorced [once or several times] and the same thing keeps happening over and over again – I go so far and that’s it.”
• “I just can’t get close to anybody. I don’t trust anybody.”
• “Sometimes I have nightmares about the ’Nam or I wake up in a cold sweat, trembling.”
• “I’m always tense, wired for something to happen, can’t relax.”
• “I thought when I left Vietnam I left all that behind me, but things keep coming back – memories, thoughts, feelings, for no apparent reason.”
• “I feel so dead [or empty] inside, just numb to people and things that happen.”
• “I started drinking [or taking drugs] over there and now I’ve started again.”
• “I just don’t fit in anywhere in society.”
• “I look around, and I seem to be the only one who is having these emotional problems.”
• “During certain times of the year I just seem to lose it, and that’s not normal.”
• “I feel so alone.”
• “I don’t know what’s happening to me.”
• “At times I think I must be going crazy.”
• “How can something that happened ten, fifteen, twenty years ago still be influencing my life?”

The feelings expressed in the quotations just given can be a normal reaction to an abnormal situation, such as war. But when the normal healing process of adjusting to terrible experiences becomes disrupted, a normal stress reaction can worsen, becoming a ‘stress disorder’.”

[The Viet Vet Survival Guide, Ballantine Books, New York 1985].

Soldiers, who had seen their combat period through, sometimes after treatment for psychiatric problems, found their memories of the war, combined with the gap between their expectations and the reality of their situation on their return, overwhelming. Back in the US there were high levels of suicide amongst Vietnam veterans. One veteran stated after his tour-of-duty in Vietnam:

“They gave me a Bronze Star … and they put me up for a Silver Star. But I said you can shove it up your ass. … I threw all the others away. The only thing I kept was the Purple Heart because I still think I was wounded.”

In 1980, five years after the ending of the Vietnam war, Post-Traumatic Stress Disorder was officially recognised as a condition. It was then included in DSM111 (the Third Edition of the Diagnostic and Statistical Manual of the American Psychiatric Association). It had taken a lengthy campaign by the Vietnam veterans and their friends to force the US Government to admit that some returning soldiers were suffering from PTSD and other rehabilitation problems.

In 1990, fifteen years after the ending of the Vietnam War, a study in the US found that over fifteen-per-cent of Vietnam veterans were still suffering from PTSD. Many with this condition were unemployed and liable to abuse alcohol or drugs, seventy-per-cent had failed marriages and almost half had served terms in prison. Four years later, in 1994, a study in the UK by the homeless charity Crisis into rough sleepers in London found that: “Around one-quarter of all single homeless people have served in the forces.”

Twenty-nine per-cent of the homeless ex-service people interviewed by Crisis said they were suffering from nerves, depression and stress and forty-one per-cent of them had spent time in prison. These were mainly veterans of Northern Ireland and the Falklands, with a few from WW2, Malaya, Korea, Kenya, Cyprus and Aden. After this, they were joined by veterans from the Gulf War, Bosnia, Iraq and Afghanistan.

One distinct legacy of the USA’s involvement in Vietnam was the psychological problems that afflicted many of their GIs after they had returned home. In Britain, the early years of the conflict in Northern Ireland coincided with the latter years of the Vietnam War. And we in the UK found that the same problems were happening to our returning veterans too, with the numbers of ex-forces personnel serving sentences within the UK prison system starting to rise dramatically.

The US country and folk songwriter and performer John Prime (1946-2020) wrote ‘Sam Stone’ after leaving the US Army. Many Vietnam veterans had turned to alcohol, or drugs, to relieve their suffering and Prime’s song depicts a veteran who has become hooked on drugs:

https://www.youtube.com/watch?v=z1TmNNZJ2HI

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Article by Aly Renwick, who co-founded Veterans In Prison with Jimmy Johnson. Aly served for 8 years in the British Army (1960-8).