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.
Conclusion: 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, recruits complete a medical history questionnaire. The available information about the history of treatment for a mental condition depends solely on this self-report. Although recruits undergo a medical evaluation at the MEPS, there is no formal psychiatric assessment.
Conclusion: The history questionnaire can usefully be augmented with a short set of questions regarding current symptoms and a brief standardized mental status examination that addresses mood, anxiety, psychotic symptoms, and suicide. This would be important to include as a routine component of the medical evaluation.
Recommendation 6-3: A brief self-report questionnaire regarding current symptoms of mental health conditions should be administrated at the military entrance processing station.
Recommendation 6-4: A brief mental status examination should be conducted by the medical officer at the MEPS.