building a complete picture of prevalence, treatment, and consequences of mental illness in military populations. In general, of 10,000 active-duty military personnel, perhaps 3,000 to 3,500 will experience some form of mental illness or psychiatric symptoms during their military career, with roughly similar short-term risk in the period following deployment to combat duty, such as in Iraq or Afghanistan. Of these, perhaps only 750 to 1,400 will seek care for their mental illness, which is similar to the roughly 600 such personnel who seek mental illness care in general in any single year. Mental disorders are the leading cause of medical and occupational morbidity, hospitalization, and separation for a medical reason, but population-based risk and prevalence data for such outcomes are not available.

MILITARY STANDARDS

In 2005 the Department of Defense (DoD) revised the list of mental health disorders that are causes for rejection for appointment, enlistment, or induction into military service. The disorders included are categorized as learning, psychiatric, and behavioral (E1.25):

  • For learning disorders and attention deficit hyperactivity disorder, the criteria have been changed to allow eligibility for individuals who can demonstrate passing academic performance without the use of academic or work accommodations or medications in the previous 12 months.

  • Any individual with current or a history of psychotic disorders, such as schizophrenia, paranoid disorder, or other unspecified psychosis, is disqualified.

  • Current mood disorders, such as major depression, bipolar disorder, or depressive disorder not otherwise specified, are disqualifying. In addition, a history of mood disorders requiring outpatient care for longer than six months by a physician or other mental health professional, or inpatient treatment in a hospital or residential facility, is disqualifying. A history of symptoms consistent with a mood disorder of repeated nature that impairs school, social, or work efficiency is also disqualifying.

  • Current or a history of anxiety disorders, including panic disorder, agoraphobia, social phobia, simple phobias, obsessive-compulsive disorder, acute reactions to stress, and posttraumatic disorder are disqualifying conditions.

  • Any individual with current or a history of adjustment disorder within the previous three months is disqualified.

  • A history of suicidal behavior, including gesture or attempts or a history of self-mutilation, is disqualifying.

  • Current or a history of conduct or behavioral disorders is disqualifying due to concerns about the ability to adapt to military service.



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