These are fairly loose measurements, and the regulations are designed to allow some medical discretion in disability decisions. Servicemembers are frequently given medication not always accompanied by therapy in an effort to stabilize or improve the condition and permit retention in the service. Refusing psychiatric medication can be very difficult, as a practical matter. While members are entitled to refuse medical treatment, in some cases it may affect entitlement to disability benefits or even the reason for discharge.
Under current wartime conditions, monitoring of medication use is often sporadic, making it difficult to determine whether there is really sufficient improvement to retain a servicemember, or whether side-effects may exacerbate the psychiatric condition or create other medical problems.
When medical problems are noticed within the first few months of service, soldiers and sailors are sometimes discharged with abbreviated medical proceedings under the medical standards for enlistment or procurement.
See, for example, AR , Chapter 2. These are generally stricter than retention standards, so that members with less serious disorders may obtain discharge much more easily at the beginning of their enlistment.
In the very old days, prior to , less serious psychiatric conditions could lead to discharge for Unsuitability, a catch-all which included personality disorders, inability to adapt to military life, performance problems, etc. In , DoD overhauled its administrative discharge system and added, under Convenience of the Government discharges, the new category of Other Designated Physical and Mental Conditions later changed to Conditions and Circumstances Not Constituting a Disability.
Along with Unsatisfactory Performance and Entry Level Performance and Conduct discharges, this replaced the old category of Unsuitability in all of the services. DoD Instruction With the change, DoD While the service regulations initially followed this general language, they have more recently expanded the list of conditions significantly.
Most have designated personality disorder as a separate discharge category and all have added various other grounds for this discharge. DoD A diagnosis by an authorized mental health provider as defined in DoDI Thus, as with disability discharge or retirement, the existence of a psychiatric condition alone is theoretically insufficient to warrant discharge. A psychiatrist or psychologist must make a determination not only of severity, but of impairment of functioning in the military. In some services, the command must also conclude that performance is impaired.
The DoD Instruction and the services require that members be formally counseled, in writing, about performance deficiencies, and given an opportunity to overcome these deficiencies, before discharge may be initiated.
Command failure to do so is common, and may be used to challenge involuntary administrative discharges under these regulations.
For many years, personality disorders were a common reason for both voluntary and involuntary discharge. In many cases, servicemembers with PTSD, depression, anxiety or other serious disorders were under-diagnosed with personality disorders and so administratively discharged rather than medically retired with benefits. In other cases, the diagnosis was given on the basis of non-conformist behavior, whistleblowing, or other actions disliked by commands. To make matters worse, personality disorders were and are the only psychiatric-related discharge in which the diagnosis is listed on DD discharge documents, rather than general language such as Conditions and Circumstances Not Constituting a Disability or Other Designated Physical and Mental Conditions.
After significant attention to these problems by national media and then by Congress, the military was forced to revise its policies. This was, however, matched by a significant increase in discharges based on the relatively mild psychiatric diagnosis of adjustment disorder see below. Nevertheless, some servicemembers are still discharged on the basis of personality disorders, and the category deserves attention from attorneys and counselors. Personality disorders are considered conditions of character or personality rather than mood or cognition, extremely resistant to treatment, and likely to cause difficulties in occupational.
A diagnosis of personality disorder is insufficient without the specific type. Under the DoD and service regulations, an opinion about severity and interference with duties must be made by a military psychiatrist or psychologist. At the same time, it should be supported by command documentation of actual performance problems. These points are sometimes lost on military psychiatrists and commands. The Army has placed personality disorders in a separate Convenience of the Government discharge section, AR , Chapter 5, Section The requirement of a psychiatric opinion on severity and interference with duty parallels the DoD language.
The regulation states that evidence of actual performance problems should be documented. Unlike the other services, the Army discharges soldiers for personality disorders only if they have served less than 24 months when discharge proceedings are initiated; those who have served longer may be discharged under Section , which technically does not include personality disorders. This section does not follow the DoD Instruction carefully on the requirement of severity.
Section , Para. Subsection 2 does not make any reference to severity at all. The Air Force has come up with its own grouping of discharge categories. AFI , Section 5. Subsection 5. The Air Force makes the need for a psychiatric finding on severity quite clear for personality disorders and the other mental disorders in 5.
This report may not be used as, or substituted for, the explanation of the adverse effect of the condition on assignment or duty performance. The Air Force stands alone in requiring some oversight where commands fail to act on appropriate psychiatric findings about personality disorders or other mental disorders: When a psychiatrist or psychologist confirms a diagnosis of a mental disorder, under paragraph 5.
Section 5. For servicemembers seeking discharge, this may sometimes be a convenient option, often requiring less time and documentation than, for example, conscientious objection or family hardship. At the same time, counselors and attorneys should ensure clients are comfortable with the presence of a psychiatric diagnosis on their DDs, the possible effects on employment, and the absence of medical benefits for the condition.
As noted above, the constraints placed on personality disorder discharges led to a sharp decrease in these discharges and an equally sharp increase in administrative discharges based on adjustment disorders, as medical personnel and commands looked for other methods to discharge unwanted members who had previously been separated for personality disorders.
Here, too, the discharge has often been an under-diagnosis of PTSD or other more serious conditions, or a diagnosis for members whose problems were not psychiatric, but rather issues of conformity to military culture, whistleblowing, dissent and the like.
You can be open and honest about your symptoms, while being careful not to violate regulations in the process. For example:. Refer to specific Service regulations for a detailed description of the criteria for discharge and use these as guidelines for documenting each claim. People who do not want to have psychiatric problems on their record which may be requested by future potential employers may prefer another discharge.
The following are some symptoms which may indicate personality disorders. Members of the military may be referred to a mental health professional as part of an evaluation for discharge. For many servicemembers, this may be the first time they have visited a mental health professional or been asked direct questions about personal matters.
It helps to know what to expect at the interview and to be prepared to talk about conditions and feelings which people often hide. Members can share personal thoughts and feelings and also be honest. There are some things that could be used against a military member if they share the information with a mental health professional:.
Members can share their feelings, rather than simply list their complaints. The member can talk about why military service is difficult for them rather than why they want to get out. They can emphasize the problem and how it interferes with performance of duties, not a desire for discharge. Mental health tests can seem strange. Members may want to answer all questions and be as cooperative as possible. If there is a particular problem a member is having, they can be prepared to talk about it even if the interviewer does not ask specific questions about it.
Mental health professionals have been known to test patients. If this happens, the member can keep telling the interviewer about the problem and why they are serious.
Walking out usually isn't helpful. Talk to a counselor in advance about how to respond to such questions. Sometimes the psychiatrist will ask a member what they want, or if they want out. A member might say they do not know what alternative there is to a discharge, since they can not go on the way they are. They can make it clear that the problems are really bothersome and are the reason a discharge is appropriate. Jump to content. Mono Bar U.
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