coded: neurotic disorders (1.4 percent, N = 918 people) and depressive disorders (0.4 percent, N = 271 people).

  • Waivers at MEPS: Data are available for the top 10 DoD diagnoses of waivers considered and granted for active-duty enlisted applicants in 1997-2001 and 2002 for the Army, Navy, Marines, and Air Force. Diagnoses of physiological malfunction arising from mental factors; neurotic, mood, somatoform, dissociative or factious disorders; attention deficit hyperactivity disorder; and major depression accounted for the mental health disorders that resulted in granting of a waiver (see Table 6-1).

  • Hospitalization: Hospitalization data are available for Army active enlistees for the period 1997-2002. The category of neurotic and personality disorders and the category of other psychoses accounted for all mental health hospitalizations (see Table 6-2).

  • Existing prior to service discharges: Existing prior to service (EPTS) discharges of enlistees occur < 180 or fewer days after beginning military service. Data on EPTS discharges for active-duty enlistees are available for the period 1997-2002. Psychiatric conditions were the most common cause of EPTS discharges reported for the Navy and the Marines (47 and 36 percent, respectively) and the second leading cause of discharge in the Army (15 percent) (see Table 6-3). In 2001, according to data from the Army, the Marines, and the Navy, there were 207 EPTS discharges for depression. No Air Force records were reviewed because of a policy of administratively discharging recruits with mental illness. The percentage of EPTS discharge/accessions were as follows: Marines 0.22; Army 0.16; Navy 0.08; total 0.15.

A study conducted at Fort Leonard Wood, Missouri, from September 2002 to March 2003 found that reliance on EPTS coding alone underestimated the number of mental health conditions that contributed to discharge. Psychiatric conditions were also coded under non-EPTS codes (i.e., other mental and physical conditions and entry-level separation).

CURRENT SCREENING PROCESS

Psychiatric Exclusion Criteria

There is increased recognition of depression in children and a concomitant increase in the use of mental health treatment for this disorder in youth. The typical duration of treatment is approximately one year for a single episode of depression. The current DoD fitness standards exclude any individual who has a history of a mood disorder for which outpatient treatment has been rendered for longer than six months by a physician or mental health professional. In effect, that criterion eliminates any appli-



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement