This article uses the closed patient medical files from two large Sydney psychiatric hospitals to discuss ways in which the return of soldiers suffering mental illness, both during and after the First World War, impacted on Australian society. It argues that despite the intention of a ‘two tiered’ system designed to separate war trauma cases from a civilian insane population, this was not always adhered to and the results were often ad hoc. It further looks at resistance to, or acceptance of, medical diagnoses and treatment as well as issues that plagued some returned men well into the interwar years—violence, alcoholism, shame, and self-harm. While service in the war was deemed the cause of mental illness for some ex-soldiers, in many cases it was impossible to state with certainty that the war was the only cause.
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