Thursday, May 18, 2017

GAO Report Raises Questions About Mental Health of Discharged U.S. Servicemembers

More than 60% of U.S. servicemembers separated for misconduct from fiscal years 2011 through 2015 were diagnosed with mental illness or substance use disorders within two years before their separation, according to a report released yesterday by the Government Accountability Office (GAO).

GAO's analysis of Department of Defense (DOD) data found that of the 57,141 servicemembers separated for misconduct between 2011 and 2015, 16% (9,142) had been diagnosed with posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI), and 23% (13,283) received an “other than honorable” characterization for their service, leaving them “potentially ineligible” for health benefits from the Department of Veterans Affairs (VA), the analysis said.

“As a result of policy inconsistencies and limited monitoring, DOD has little assurance that certain servicemembers diagnosed with PTSD or TBI receive the required screening and counseling prior to being separated for misconduct and that all servicemembers, including officers, have been trained on how to identify symptoms of mild TBI in the deployed setting,” the report stated.

To ensure PTSD and TBI are appropriately considered prior to separating servicemembers from the military for misconduct, GAO recommended the Secretary of Defense take several actions, including directing the Air Force and Navy to address inconsistencies with DOD policy related to PTSD and TBI screening; training servicemembers, including officers, on how to identify mild TBI in the deployed setting; and ensuring that the military services monitor adherence to their screening, training, and counseling policies.

“PTSD and TBI can be difficult entities to diagnose because they are based on self-report and history,” said psychiatrist Elspeth Cameron Ritchie, M.D., M.P.H., a retired Army colonel, in response to the analysis. As psychiatry consultant to the Army Surgeon General from 2004 through 2008, she helped developed policies regarding PTSD and TBI. “Sorting through whether misconduct is actually related to PTSD and TBI can be challenging.”

For related information, see the Psychiatric Services article “Barriers to Engaging Service Members in Mental Health Care Within the U.S. Military Health System.”

(Image: iStock/MTMCOINS)


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