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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
knowable prior to enlistment is needed for the application of cost-benefit analysis.
Conclusion: In light of current data, the existing standard and waiver process regarding asthma is appropriate. Research on the cost-benefit consequences of enlisting individuals with more severe asthma would be needed prior to recommending any change in enlistment policy regarding asthma.
Psychological adaptation to military service is critical for successful completion of a tour of duty. Stressors associated with transition from civilian to military life include changes in living arrangements, geographic locations, peer relationships, support systems, schedules, priorities and control over one’s life, separation from family and friends, difficulties in communication with home, and loss of privacy. Soldiers in wartime missions must deal effectively with the stress and anxiety associated with potential loss of their lives and their fellow soldiers. Stressors associated with peacekeeping missions include isolation, a sense of powerlessness, boredom, coping with unpredictability of the mission, dealing with shifting rules of engagement, struggling with conflicting personal views, being unable to identify a clear enemy, and questioning the lasting impact of the mission. All of these features highlight the importance of mental health.
Lifetime prevalence rates of mental disorders for the total active duty U.S. Army population were projected at 37.5 percent for any mental disorder, 5.8 percent for depressive disorders, 16.6 percent for anxiety disorders, 8.3 percent for antisocial personality disorders, and 1.1 percent for schizophrenia. Those hospitalized for a mental disorder have a higher subsequent rate of attrition (45 percent) than those hospitalized for other reasons (11 percent).
Mental Health Enlistment Standards
DoD has recently revised the mental health disorders that are causes for rejection for enlistment into the military service. 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 and/or work accommodations or medications in the previous 12 months.
An age cutoff (the 13th birthday) is used for some standards, including those for enuresis, encopresis, sleepwalking, and eating disorders.