Only 13 psychiatrists serve in the Polish Armed Forces, and one front-line psychologist is responsible on average for 825 soldiers, while NATO standards recommend no more than 300–500—according to a report prepared under the auspices of the Military Institute of Medicine – National Research Institute (WIM–PIB). Experts warn that such severe staffing gaps may weaken the army’s mental resilience. “Mental condition is sometimes a much more important factor than ammunition,” says Colonel Radosław Tworus, MD, PhD, of WIM–PIB.
“To talk about real mental health problems in the armed forces, we would need to conduct regular monitoring of the mental health of the Polish military—and that is not being done,” Colonel Tworus told Newseria. “We have had no studies that would assess the psychological condition of the Polish armed forces, including soldiers performing specific tasks in specific areas. This is a significant issue, because it would make both intervention and prevention much easier. You cannot draw conclusions from individual clinical cases, because they do not reflect the true nature of the problem,” emphasized Tworus, Head of the Clinic of Psychiatry, Combat Stress and Psychotraumatology at WIM–PIB.
The absence of population-wide research is one of the largest systemic gaps in the field of military mental health. It means the armed forces lack knowledge about the scale and structure of psychological problems, their dynamics, and risk factors—making it impossible to plan prevention and adequate system-wide measures.
“Within the Military Institute of Medicine, we would like to initiate research assessing the mental condition of the Polish armed forces. This need has been raised for a long time,” Tworus noted. “Already in 2012, during a meeting of the Sejm’s National Defence Committee, Professor Stanisław Ilnicki—now deceased, the founder and former head of our clinic—argued that such research was essential. For various reasons, however, it still has not happened.”
Unlike Poland, some NATO countries conduct regular monitoring of soldiers’ mental health. In the United Kingdom, the Ministry of Defence publishes the annual report UK Armed Forces Mental Health: Annual Statistics, which shows the share of personnel receiving medical support due to mental health issues. The latest 2024/2025 edition reports that 12.3% of UK armed forces personnel used such support, while 2% required specialist psychiatric or psychological care. The most common diagnoses were depression, anxiety disorders, and adjustment disorders. Canada also runs periodic epidemiological studies, enabling tracking of changes in soldiers’ mental health over time and planning appropriate preventive and therapeutic measures.
“The preparation of psychologists largely depends on whether we have research on the mental health of the Polish armed forces,” the WIM–PIB expert said. “If we had such data, we could work with psychologists to develop suitable prevention programs, as well as programs to counteract various events that occur more frequently within the soldier population.”
Severe medical staffing shortages
The report Restore Status, Retain Talent – A Strategy to Revitalize the Corps of Doctors in the Polish Armed Forces: Diagnosis of Staffing Deficits and a Structural Reform Program for the Military Health Service, prepared by a team of independent experts under WIM–PIB, states that although Poland has the third-largest army in NATO, it simultaneously faces one of the most serious medical staffing deficits among the alliance’s main contributors. With current force strength (about 216,000 personnel), one doctor in the Polish military provides medical coverage for an average of 260–270 soldiers. NATO standards assume a ratio of 1:100.
The situation is especially critical in psychiatric care. Across the Polish Armed Forces, there are only 13 active-duty military psychiatrists, and 20 doctors are currently specializing in psychiatry. With such numbers, it is difficult to ensure continuity of care, conduct preventive activities, and respond to rising needs resulting from the expanding size of the military.
“The issue of neglect in military mental health is very difficult, because we are dealing with a specific social group that is relatively small, yet highly prestigious,” Tworus said. “That puts the armed forces under intense public scrutiny. Any incident involving inappropriate behavior by a soldier linked to mental health is immediately widely discussed in the media. Poor care will lead to the same consequences as any inadequate supervision of a patient: starting with suicide, through incidents related to alcohol and drugs, to violence during service or outside it—including domestic violence.”
Psychologists overloaded as the “first and often only” line of support
One consequence of the deficit is systemic overload of psychological services, which have taken on the role of the first—and often the only—line of support for military personnel. Direct psychological support is currently provided by 255 specialists, which—given current force size—translates into 825 soldiers per psychologist. NATO-recommended standards assume one specialist for 300–500 soldiers.
“From a clinical perspective, the mental health problems of soldiers—looking at those who become patients—probably do not differ from those of Polish society,” Tworus explained. “Most often, these are emotional problems, adjustment disorders, and issues related to the use of psychoactive substances and alcohol. Contrary to appearances, it is not PTSD, because Polish soldiers are currently no longer actively participating in warfighting operations as they did during missions in Afghanistan and Iraq.”
Experience from modern conflicts—including the war in Ukraine—shows that prolonged psychological strain can affect soldiers’ decision-making, combat effectiveness, and unit cohesion. For this reason, NATO armies treat mental resilience as a component of operational readiness.
“I think mental condition is sometimes much more important than ammunition,” Tworus stressed. “If we know that soldiers are in a serious psychological crisis linked to a prolonged war, it doesn’t take much to tip the balance of victory to the other side. Knowing the mental condition of Ukrainian soldiers would give Russia complete information on what else it would need to do to defeat them.”
Mental resilience also matters for military doctors
The WIM–PIB report also highlights the need to prepare military doctors—who are also soldiers—for mental resilience. They must meet physical and psychological requirements associated with battlefield conditions. NATO emphasizes that the mental readiness of medical personnel is crucial: a doctor must remain functional in the face of traumatic scenes and intense emotions typical of modern warfare. That is why training increasingly includes mental resilience exercises, MASCAL (Mass Casualty Incident) scenarios, and elements of wartime medical ethics, including principles for making difficult decisions during triage.
