Mental health care in the Lebanon War, 1982.

Lessons in mental health care learned from the October 1973 War were applied in the Lebanon War 1982. A three-echelon system of management was followed according to the practices prevalent in Western armies. The clinical pictures were essentially similar to those observed in other wars. Combat stress reactions (CSR) comprised 15 to 20% of the total casualties during the active phase of the war; the rate of late reactions was 30 to 40% of the total CSR. Treatment on the battlefield was more effective than treatment following airlift to the rear, in returning soldiers to their units. The role of stress in causing CSR, and the importance of leadership and cohesion in its prevention were evident. The important lessons learned from the Lebanon War are discussed and include: 1) the need for a broad definition of CSR; 2) the importance of forward unit intervention; 3) the necessity of mobility and divisibility of mental health treatment units; 4) fighting units should not be dispersed immediately after combat; and 5) the management of stress reactions to be the responsibility not only of the mental health services, but of all sections of the medical corps, both in treatment and prevention.