Which Troops Were Most Likely to Suffer Shell Shock?—Battle of Messines Case Study

Aid Station at the Battle of Messines

An examination of the admission and discharge books of No. 4 Stationary Hospital, the "Not Yet Diagnosed Nervous Centre" (NYDN) for the First and Second Armies, is instructive. Set up in December 1916 at Arques, France, about miles from Messines Ridge, it was designed to treat psychiatric casualties quickly with the expectation that the soldier would return to active service.  This facility would receive the bulk of possible shell shock cases, leading up to and including the Battle of Messines (7–14 June 1917).

Observations of shell shock cases at base hospitals, both on the French coast and in the UK, had suggested that symptoms tended to multiply the longer a man was an in-patient. During the first three months of its operation, a period of routine trench warfare, admissions to the shell shock unit were steady and at a relatively low level with 107 new cases in January, 80 in February, and 110 in March. These have been analysed by unit to show whether they were in frontline units or combat support roles (Table 1). 

Virtually all admissions to the shell-shock division were from units directly engaged in combat, the majority being infantrymen. Combat support troops (Army Service Corps and Labour battalions) and non-combatant medics were scarcely represented. 

The attack on Messines Ridge brought a rapid increase in the incidence of shell shock. The detonation of 19 mines on 7 June led to initial gains, though the attempt to advance further was responsible for most of the 25,000 casualties. Admissions for shell shock escalated. On 7 June alone, over 50 cases were referred followed by 100 the next day. Ten days later there were 1,011 cases of shell shock in No. 4 Stationary Hospital, and one month after the first attack 1,800 psychiatric casualties had been admitted.  To some extent, the dramatic rise in the number of admissions reflected the increased number of troops deployed for the attack. 

The pattern of admissions to No. 4 Stationary Hospital (Table 1) reflected the offensive nature of warfare. The attack was preceded and accompanied by artillery barrages, which in turn inspired counter-barrage from German gunners. As a result, the percentage of gunner patients rose dramatically from 9.1 percent in March to 21.8 percent in June. Royal Engineers in combat roles were needed in greater numbers to maintain communications and the flow of munitions, though their admission rates did not rise significantly. The number and proportion of combat-support troops rose but represented only 7.7 per cent of all admissions. 

These figures suggest, therefore, that frontline combat troops, those most exposed to danger and those best placed to kill the enemy, were the most likely to break down.

Source: "The Psychology of Killing: The Combat Experience of British Soldiers During the First World War," Edgar Jones, Journal of Contemporary History, Vol. 4, 2006