During the Second World War, many aircrew fell victim to what medical personnel termed ‘flying neurosis,’ a psychological/emotional reaction to stress analogous to ‘battle exhaustion’ suffered by ground troops. Today, this is referred to as an Operational Stress Injury (OSI).
In 1945, the Operational Research Section of the Mediterranean Allied Air Forces issued A Statistical Analysis of Neurosis Precipitated by Flying Duties Among Operational Aircrew Under the Control of the R.AF. in M.A.A.F. during 1944. The study aimed to compile information on the incidence of neurotic breakdown ‘in an operational command overseas’ for comparison with rates in home (ie UK) commands, identify factors that contributed to breakdown such as squadron losses or periods of intense operational stress, and study the influence of flying experience generally on incidences of neurotic breakdown.
Statistics were compiled from patient case notes of the Command Medical Board with broader information on aircrews from the Senior Personnel Staff Officer, Mediterranean Allied Air Forces. Information on neurosis in Home Commands was drawn from reports by the Flying Personnel Research Committee and Medical Directorate, RAF. In order to facilitate “useful comparisons [between] crews on widely different types of operations,” especially the difference between six-month tours in the Mediterranean Theatre and ‘full-time’ operations in home commands, the study measured neurosis in number of cases ‘per 100 man-years.’
Researchers found that the proclivity of aircrew towards neurosis depended primarily on their role in the aircraft and operational strain, as measured by effort and unit casualties. For some roles, number of operational flying hours was also a factor.
Not surprisingly, air gunners and those on night operations suffered the most. Incidences of neurosis among bomber crews did not increase with operational flying time as was the case with fighter crews, crews on special duties or in a general reconnaissance role. Rather, bomber crews were more susceptible to increases in operational strain, while air gunners showed a tendency towards decreased rates of neurosis as their operational flying hours increased.
In sum, the 282 patients designated as unfit for flying duties due to neurosis in 1944 accounted for 5.4% of the average aircrew strength in the Mediterranean Theatre, or 8.5 cases per 100 man-years. This rate was far higher than in the only comparable set of data: home commands in 1942. The authors speculated that the difference could be due to a number of factors, including theatres of war; differences in aircrew quality two years on; a change in attitude among aircrews with the war’s end in sight; variances in medical standards between home and overseas commands; or a change in the outlook of medical authorities after two additional years of war.
Few studies like this were conducted during the war, and the report offers insight into the strain on aircrews and how medical officers approached the issue.