Reflections of a Military Psychiatrist by Robert Marietta is a powerful and deeply insightful memoir that offers readers a rare glimpse into the intersection of mental health care and military service. Marietta draws on his extensive experience as a psychiatrist serving those in uniform, crafting a narrative that is both compassionate and thought-provoking. What makes this book truly stand out is its honesty and humanity. Marietta doesn’t shy away from the challenges of providing mental health care in the military—where stigma, high stakes, and unique stressors often collide—but he approaches each story with empathy and respect. His reflections highlight not only the resilience of service members but also the profound emotional toll that combat and service-related trauma can have on individuals and their families.

Thank you to NetGalley and the publisher for this ARC!

The military industrial complex is certainly a strange beast. I think most have long expected that there is a propensity for them to preference people who are both absolutely flawless in nature and design, whilst also understanding that humanity is an essential element in making difficult decisions.

I will preface this review by saying that this is a very good book in terms of the substance. It puts across a very important point, and it makes it with grace. There is definitely an inclination to speak more to points than is necessary sometimes, but that makes for a slightly longer read more than anything else.

I think the break for me is that I don’t feel like the audience for this book. I anticipated individual case studies, detailed in chapters, which are then pulled apart and examined. This feels more so like an essay than anything else, and that’s of benefit if you are involved in the military yourself. I didn’t need to hear about specific, unit targeted solutions- I wanted to hear the substance of people’s stories instead.

All in all, I think this is a really important book, and one that needed to be written. I just wish it scratched more than the surface on some issues, and I wish it were a little more interpersonal with the stories it tries to tell.

Reflections of a Military Psychiatrist by Robert Marietta is a staggering exposé of the deeply fractured mental health system within our military. While the quality of care may vary across branches, it deteriorates even further from base to base, ship to ship, and squadron to squadron. The inconsistency is maddening—and heartbreaking.

Despite the selfless oath our service members take to protect and serve, they are often met with a system that fails to protect them in return. The cases highlighted in this book are not just tragic—they're infuriating. One truth rings loud and clear: the toxicity is internal. Soldiers are not emotionless machines. They break, they hurt, they feel. To ignore the very things that make us human is not only cruel—it’s inhumane.

From a purely operational standpoint, neglecting the mental health of those you've invested in is a disastrous business model. I’ve witnessed firsthand the damaging message that seeking mental health support could jeopardize one’s clearance or career. That fear keeps too many silent, and this book shines a necessary light on that broken narrative.

To be clear, this is not a collection of sensationalized stories. While it includes real cases, its purpose is to examine and critique the system itself. If you're looking for graphic, detailed accounts, this isn't that book—and rating it poorly for that reason would be a disservice to its mission.

This is an urgent and important read. I’m grateful to Robert Marietta for his courage in confronting this failure head-on. Thank you to Köehler Books and NetGalley for the ARC.

This was an unbelievably eye-opening read about the abysmal state of mental health healthcare in branches of the military. Most people would think the military is doing a fine providing mental health services to service members, but this book demonstrates that is not the case. Unfortunately, it seems as if how things 'look' to military leadership are prioritized over actual assistance.

Our servicemembers should be provided top of the line mental health services as they are dealing with some of the hardest things people deal with and we are failing. This book shows the rotten underbelly of how bad things have gotten in nearly all branches and provides ways to fix these issues as well.

Military leadership needs to read this book and then do something about it. Once you have seen and read about how bad it is, it is hard to look away. The author provides superb direction and should be followed up. I would recommend this to all Americans to see how bad things have gotten for our service members, an absolute shame that needs to be corrected!

Military personnel face unique psychological stressors that civilian populations rarely encounter, yet institutional culture has historically stigmatized mental health support as incompatible with military professionalism and character. This creates a dangerous paradox where those most in need of mental health services are least likely to seek them.

The Author's Approach
The author draws from extensive cross-branch military health service experience to present both insider perspective and professional analysis, combining personal memoir with policy critique to reach broader audiences.

Strengths
1. Multi-Branch Credibility. Unique perspective spanning multiple military branches. Provides comprehensive view of systemic issues across services. Builds author credibility through diverse experience,

2. Dual-Audience Appeal. Memoir format makes complex military culture accessible to civilians Personal narratives humanize institutional problems Professional insights satisfy military audience expectations
3. Evidence-Based Foundation. Extensively researched using DoD reports, Government documentation supports personal observations, Balances anecdotal evidence with official data

Areas for Improvement
1. Methodological Concerns. Reliance on discredited research (Stanford Prison Experiment) Limited fact-checking of popular psychological studies.
2. Narrow Geographic Scope. Absence of international military mental health approaches. Limited comparative analysis with allied nations. Missed lessons from successful international programs
3. Repetitive Examples. Overuse of certain case studies weakens impact Could benefit from broader range of illustrative material Risk of reader fatigue with familiar examples

Positive Outcomes
Cultural Conversation: Successfully bridges military-civilian understanding gap

Accessibility: Makes institutional critique approachable for general audiences

Advocacy Platform: Provides clear framework for policy discussions

Personal Validation: Offers recognition and support for struggling service members

Reflections of a Military Psychiatrist presents a profound examination of military mental health through the lens of an experienced military psychiatrist. The author, Marietta, recounts his diverse experiences across multiple branches, including the Navy, Marine Corps, Air Force, Coast Guard, and Veterans Affairs. It addresses significant mental health challenges prevalent within the military and their implications for service members and the institution as a whole. His candid narrative offers an unvarnished examination of the inefficiencies and shortcomings within the military healthcare system. The theme of this book is that reform is needed within the military healthcare system, with a more empathetic approach required. This novel was interesting, but at times, I found the emphasis on bureaucracy to be excessive and would have preferred just more case studies. While the red tape and the difficulty accessing services is an important part of the story, it is overwhelming at times and distracts from the stories of the individuals- which I found to be the most interesting part. This book is a good resource for individuals interested in military mental health and it offers great suggestions and recommendations for reducing the stigma. Thank you to the publisher and NetGalley for the advance review copy in exchange for my review.

One of the things that I, as a psychologist, consider key to being a good mental health care provider, is the ability to listen to more experienced colleagues whose career looks different from mine. Despite the fact that psychiatrists graduate in Medicine then specialise in Psychiatry, whereas us therapists study Psychology and go on to specialise in clinical intervention (and may choose to focus on specific populations / disorders / age groups), we both work towards the same endgoal, which is providing those who seek our help with tools and strategies with which their suffering can be relieved.

Throughout this book, Marietta offers an unsweetened and raw account of his time in the different units and divisons of the US Military, where he had the chance to stay with most - if not all - corps and learn how each one does things. Despite not quite grasping some of the implications tied to the US Military's hierarchy, since I am not from the States, what I found and definitely value is a sincere look at how the system fails those who protect it when they need help the most. Without any harsh words or bile, yet also without euphemisms or sugarcoating, Marietta examines the different causes of the flaws in the military healthcare system.

In particular, it was quite interesting to learn about different cases in which the unhealthy environment was clearly the root issue, since Marietta accounts for the ways in which the context can either heal or break a person. Although psychiatrists are more so in charge of medication and diagnoses, whereas it's psychologists who can do therapy, Marietta clearly developed therapeutic skills and helped enormously with primary and secondary prevention of severe mental health issues amongst military personnel who were largely forgotten and mistreated by the system. Reading about the beliefs and moral codes of conduct that are taught in the US Military (which is not all too different from what happens in other countries, I reckon) was enlightening to me, since it helped me understand how they think and why their values are these or those.

Overall I would recommend it to anyone who is interested in the mental health of the military and their loved ones. This book will be an excellent read for anyone who works in the mental health care field, military specialty or not, through its thorough review of the environmental faactors that can cause a person to spiral in highly demanding environments.

Repetitive and dull. Too much complaining about bureaucracy, not enough about practicing psychiatry. I thought it would be more like case studies but most of the actual patient descriptions are vague and generic.

This was a wonderful book. It was easy to read and understand. I might be a little more familiar with the talk as an Air Force brat, but it was still very informative. I would love to interview the good doctor about his work and the subject in a broader context. There seems to be a lot of talk about mental health in the services nowadays.