Generational Wartime Behavioral Health Crises: Part One of a Preliminary Analysis

As the USA enters into its 12th year of war, the persistent drum beat of negative news headlines of unmet mental health and social needs of veterans fuels public perception of a twenty-first century military behavioral health crisis. For many Americans, the status quo harkens back to previous wartime crises. Wartime mental health crises continue to happen, despite the personal and financial consequences. This paper address this crisis by carefully tracking the critical decisions that lead to the current situation. This is the first of a two-part preliminary analysis of generational wartime behavioral health crises. We first define wartime mental health crises and how current and past conditions qualify as such a crisis. Next, we point out that there is a continual underestimate of war and post-wartime behavioral health needs. We then provide an extensive review of official military records, government investigations, and news media reports; a compelling evidence of a major crisis in the twenty-first century. In the final section of the paper, we discuss the themes that emerged from the review that both confirm the generational failure to learn fundamental war trauma lessons.     

Investigating Recurrent Generational Wartime Behavioral Health Crises: Part 2 of a Preliminary Analysis

This is the second of a two-part analysis of generational wartime mental health crises. Wartime mental health crisis has been defined as a sentinel public health event whereby mental health demand of the military population demonstrably exceeds the mental health system’s capacity to provide adequate access to timely, effective mental health and social support services during and/or after a period of war. The present study extends an analysis that substantiated a twenty-first century wartime crisis by investigating the hypothesis of repetitive mental health crises following every major American war since the 20th century. Compelling evidence of recurring generational crises is established by citing first-hand primary sources from wartime cohorts. A clear trend emerged, possibly linking the pattern of wartime crises with generations of self-reported failure to learn well-documented war trauma lessons (e.g., the need to adequately plan, prepare, and train for inevitable war stress casualties). The authors discuss the need for further research that would elucidate so-called “psychiatric lessons of war” and contribute to the prevention of cyclic crises.     

Class, Status, and the Punishment of White-Collar Criminals

The treatment of white-collar offenders by the criminal justice system has been a central concern since the concept of white-collar crime was first introduced In general, it has been assumed that those higher up the social hierarchy have an advantage in every part of the legal process, including the punishment they receive as white-collar criminals. In a controversial study of white-collar crime sentencing in the federal district courts, Wheeler, Weisburd, and Bode contradicted this assumption when they found that those of higher status were more likely to be imprisoned and, when sentenced to prison, were likely to receive longer prison terms than comparable offenders of lower status. While they argued that results were consistent with "what those who do the sentencing often say about it," their analyses failed to control for the role of social class in the sentencing process. In this article we reanalyze the Wheeler et al sentencing data, including both measures of socioeconomic status and class position. Our findings show that class position does have an independent influence on judicial sentencing behavior. But this effect does not demand revision in the major findings reported in the earlier study.     

Books in review

has taught at the universities of London and York. He is author of The Making of Sociology, The Shaking of the Foundations: Family and Society,and The Abolitionists—The Family and Marriage under Attack.Fletcher’s own book on Burt, Science, Ideology, and the Media,will be issued by Transaction in 1991.     

Big Windows and Little Windows: Implementation in the 'Congested State'

This paper argues for the need to re-assess models of policy implementation in the 'congested state'. This re-appraisal focuses on two main directions. The first involves locating implementation in the context of wider models of the policy process. We fuse three models, those of Kingdon, Wolman, and Challis et al ., to form a new 'policy streams' approach. The second examines implementation in multi-level governance. In the UK and elsewhere, much of the focus of traditional implementation studies has been on the link between one central government department and a local agency. However, this vertical (central-local) dimension fails to give sufficient stress to the other horizontal dimensions of 'central-central' and 'local-local'. Paraphrasing Kingdon's terms, implementation models also need to incorporate the 'little windows' at local level as well as the 'big' windows at national level. Using evidence relating to the implementation of UK policy towards health inequalities, this paper argues successful implementation is more likely when the three policy streams are linked across the three dimensions. The model is thought to be applicable to other areas of the public sectors and complex issues facing all governments.