The psychological toll of war is vast, and the social costs of war’s psychiatric casualties extend even further. Yet military mental health care suffers from extensive waiting lists, organizational scandals, spikes in veteran suicide, narcotic overprescription, shortages of mental health professionals, and inadequate treatment. The prevalence of conditions such as post–traumatic stress disorder is often underestimated, and there remains entrenched stigma and fear of being diagnosed. Even more alarming is how the military dismisses or conceals the significance and extent of the mental health crisis.

The trauma experts Mark C. Russell and Charles Figley offer an impassioned and meticulous critique of the systemic failures in military mental health care in the United States. They examine the persistent disconnect between war culture, which valorizes an appearance of strength and seeks to purge weakness, and the science and treatment of trauma. Instead of reckoning with the mental health crisis, the military has neglected the needs of service members. It has discharged, prosecuted, and incarcerated a large number of people struggling with the psychological realities of war, and it has inflicted humiliation, ridicule, and shame on many more. Through a far-reaching historical account, Russell and Figley detail how the military has perpetuated a self-inflicted crisis. The book concludes with actionable prescriptions for change and a comprehensive approach to significantly improving military mental health.