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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
There is minimal systematic data collected by the Services regarding individuals with mental health conditions. The prevalence and impact of specific mental health conditions on military performance or attrition rates require further careful study. Mental illness is often coded in vague terms (e.g., adjustment disorder) or is handled administratively without attaching a diagnostic category.
Conclusion: Some elements of a complete database describing the impact of mental illness on military personnel exist, and the committee has reason to think that other data elements could be developed through appropriate linkage of existing databases.
Recommendation 6-5: Data about mental health disorders from recruitment through active duty should be collected and maintained so that informed decisions can be made regarding recruitment and retention of applicants with mental illness. These data should be obtained for all Services and should create an accurate picture of the impact of mental illness on military personnel from recruitment through separation, with a particular focus on the outcome of recruits who request and receive mental illness waivers for specific diagnoses, as well as the rates and diagnoses leading to attrition during training and active duty. Further studies using complete data sets should be designed to determine whether there are any differences in retention and performance between recruits with and without a history of psychiatric disorders, such as depression and anxiety disorders.
SUBSTANCE ABUSE AND TOBACCO USE
Alcohol and Drug Abuse
The general DoD requirements relating to moral character are quite general, stating only that individuals should be disqualified “who have exhibited antisocial behavior or other traits of character that would render them unfit to associate with military personnel.” Military leaders generally agree that individual performance and unit morale would suffer greatly if individuals were allowed to be drunk or be high on drugs while on duty.
The specific standards for alcohol and drug abuse are set by each Service, although there are some broad similarities across them. Generally, a history of more severe types of alcohol and drug abuse or dependence is disqualifying, while limited “recreational” use of marijuana does not now require a waiver. Alcohol use does not require a waiver unless the recruit tests positive at the physical. Between these two extremes, the