applicant’s 13th birthday. We recognize that the imprecision with which age cutoffs can accurately predict the likelihood of performance problems due to mental illness suggests that waivers may be commonly requested, and frequently granted, for illness occurring after age 13. However, using the 13th birthday as a cutoff allows sufficient time for clinical follow-up of a diagnosed mood or anxiety disorder to identify potential recruits with a risk of recurrence

Mental Health Screening

There is a single item on the self-report medical prescreen form completed at the recruiting station that is related to psychiatric disorders. Applicants are asked whether they have “seen a psychiatrist, psychologist, counselor or other professional for any reason (inpatient or outpatient) including counseling or treatment for school, adjustment, family, marriage or any other problem to include depression, or treatment for alcohol, drug or substance abuse.” Applicants responding “yes” are requested to explain the affirmative response, and all documentation relating to an affirmative response is to be sent directly from the treating clinician or hospital to the MEPS chief medical officer.

The committee concludes that the single item (2.a.(16), DD Form 2807-2) addressing psychiatric disorders on the medical prescreen form does not contain sufficient specificity for research and evaluation purposes.

Recommendation 6-2: Specific mental health disorders should be included on the medical prescreen report form. Recommended items include depression after the age of 13, bipolar disorder (manic depressive illness) after the age of 13, anxiety disorders after the age of 13, exposure to trauma, attention deficit hyperactivity disorder with medication treatment in the past year, schizophrenia and psychotic disorders, and hospitalization for mental illness care. A positive response to this screening question would require open-ended amplification regarding the specific diagnosis.

At the MEPS, the available information about the history of treatment for a mental condition depends solely on self-report. The committee concludes that the history questionnaire can usefully be augmented with a short set of questions regarding current symptoms and that a brief standardized mental status examination that addresses mood, anxiety, psychotic symptoms, and suicide would be important to include as a routine component of the medical evaluation.

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