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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
underuse by blacks and Hispanic groups have been reported (Zahner and Daskalakis, 1997).
In summary, of those adolescents with a psychiatric disorder, roughly 5 to 10 percent will have received inpatient treatment services.
When the above studies of prevalence, psychotropic medication use, and hospitalization are synthesized, the following picture emerges. Of a population of 10,000 older adolescents from which the military draws its enlistees, roughly 2,500 will experience symptoms of a psychiatric disorder other than attention deficit hyperactivity disorder, of whom roughly 1,000 to 1,200 will suffer severe functional impairment from their psychiatric disorder. Of these, roughly 400 to 600 will be prescribed psychotropic medication, and 20 to 60 will be hospitalized as part of their treatment program. Of the same 10,000 adolescents, roughly 800 will have attempted suicide and 300 will have made a serious suicide attempt. Also, of the same 10,000 adolescents, roughly 750 to 1,500 will be diagnosed with attention deficit hyperactivity disorder, and, of those, about 250 to 500 will be receiving treatment with stimulant or antidepressant medication.
MENTAL HEALTH OF THE MILITARY POPULATION
Lifetime prevalence rates of mental disorders were determined for the total active-duty U.S. Army population from 2000 using a logistic regression projection (Messer et al., 2004). This method was used because no observations were available and sociodemographic differences were prominent. The predicted prevalence rates for the Army population were as follows: any mental disorder (37.5 percent), depressive disorders (6 percent), anxiety disorders (16.6 percent), antisocial personality disorder (8.3 percent), and schizophrenia (1 percent).
Mental disorders among U.S. military personnel were investigated using an analysis of hospitalizations among all active-duty military personnel from 1990 to 1999 and ambulatory visits from 1996 to 1999 (Hoge et al., 2002). The category of mental disorders was the leading discharge diagnosis among men and second leading diagnosis among women. Mental disorders accounted for 13 percent of all hospitalizations and 23 percent of all inpatient bed days. A total of 47 percent of individuals hospitalized for the first time for a mental disorder left military service within six months. The rate of attrition was significantly higher than the 12 percent rate of attrition after hospitalization for other disease categories. In 1998 and 1999, 6 percent of the military population received ambulatory mental health services. The researchers concluded that mental disorders are the most important source of medical and occupational morbidity among active-duty U.S. military personnel.