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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
civilian to military life include changes in living arrangements, geographic locations, peer relationships, support systems, schedules, priorities, and control over one’s life, as well as separation from family and friends, difficulties in communication with home, and loss of privacy. Soldiers on wartime missions must deal effectively with the stress and anxiety associated with potential loss of their lives and their fellow soldiers.
About 20 percent of children ages 9-17 in the United States have a diagnosable mental or addictive disorder associated with at least minimum impairment, while 11 percent have a significant functional impairment. Common disorders are anxiety, depression, disruptive behavior disorders, and substance use disorder. Estimates of the prevalence of attention deficit hyperactivity disorder range from 7 to 16 percent of youth, and the rates are two to three times higher for boys than for girls. Recent evidence demonstrates that childhood attention deficit hyperactivity disorder (ADHD) is a predictor for adolescent substance use; stimulant therapy for childhood ADHD has been shown to reduce the risk of subsequent adolescent drug and alcohol use disorders. Growing numbers of youth receive outpatient treatment or are hospitalized for mental health disorders. There has been a substantial increase in the use of psychotropic medications, particularly antidepressants and stimulants, for children and adolescents with psychiatric disorders.
Psychiatric disorders account for 6 percent of the disqualifications at the military entrance processing stations; of these, almost half apply for and receive a waiver from one of the Services. It is important to note that many with mild conditions may be discouraged from applying on the basis of questioning at the beginning of the recruiting process; the medical prescreening tool does not differentiate among minor and major psychiatric conditions, and all require the provision of some medical follow-up information. Data from the medical prescreen are not included in any database.
Current enlistment standards reflect the reality that some consumption of alcohol is commonplace among youth, despite the fact that in most states it is illegal to consume any alcoholic beverage under age 21. Occasional or “recreational” use of marijuana is also fairly common among youth, and as a result the military decided during the early 1990s that such use would not be disqualifying under its moral character standards. Supply constraints are therefore more focused on heavy or chronic use of illicit drugs or alcohol, especially when they indicate drug dependence.
Alcohol consumption in the population of high school age youth dropped significantly between 1980 and 1993, from a high of more than 70