Royal Naval Psychiatry : Organization , Methods and Outcomes , 1900 – 1945

In contrast to the Army and to a lesser extent the Royal Air Force, psychiatry in the Royal Navy has received scant coverage. In part, this neglect was a function of the smaller numbers involved but it also reflected a tacit view that as the ‘senior service’ with a long tradition of successful engagements, there were relatively few psychiatric casualties of battle. In 1924, for example, Surgeon Captain Meagher claimed that only 16 cases of shell shock were reported by the navy in the last year of the First World War, though he did concede that medical officers preferred to use the term ‘neurasthenia’ of which there had been at least 20,000 cases during the entire period of the conflict.1 ‘Anxiety neurosis’, suggested the official history of the Second World War, ‘was less common in the Navy than the other services’, a conclusion explained by the close-knit nature of ships’ crews, effective selection processes and pride in the performance of duties.2 More recently, on the basis of UK and US experience, Grossman argued that ‘in the twentieth century, psychiatric casualties during naval warfare have been nearly nonexistent’.3 The impersonal nature of naval combat and the fact that battles were often conducted at a great distance were cited as reasons why sailors rarely broke down on warships. Whilst no evidence has emerged during the period of this study to suggest that the Royal Navy suffered from a crisis of morale, psychological disorders were not negligible during the First and Second World Wars and their incidence cannot be explained solely by the dilution of the regular service by volunteers, reservists and conscripts. In this paper, using original and once classified sources, we chart the rise of the Royal Naval psychiatric service and identify issues unique to combat at sea. We ask to what extent was the organization itself, and the fact that psychiatrists rarely served on warships, responsible for the apparently low prevalence of psychological disorders.