U.S. Military Enlisted Accession Mental Health Screening: History and Current Practice

Cardona, Robert Andrew; Ritchie, Elspeth Cameron

doi:10.7205/milmed.172.1.31

Cited by 30 publications

(20 citation statements)

References 13 publications

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“…Although historically pre-enlistment screening of military personnel for mental health issues has not demonstrated utility [12], the current system of pre-deployment criteria appears to demonstrate retrospective utility and potential to decrease combat theater attrition. Should these criteria be adequately applied, there is potential for the DoD to reduce the numbers of theater evacuations and the disruption caused by medical evacuation.…”

Section: Resultsmentioning

confidence: 99%

“…Cardona and Ritchie [12] reviewed the history of military enlistment screening for mental health issues and describe a history that betrays the value of detailed psychological screening for enlistment. However, their work suggested that longitudinal functional histories and assessment of capacity under realistic conditions were considered more reliable.…”

Section: Discussionmentioning

confidence: 99%

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Untitled

2015

JPCPY

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Objective: Military sponsored personnel deploying to combat theaters undergo medical and behavioral health screening prior to deployment, ensuring a healthy fighting force is deployed. Methods:Retrospective review of combat theater deployed personnel presenting in theater for mental health treatment were screened for the presence theater limiting mental health conditions that were present prior to combat deployment. Rates were retrospectively established for patients who could be treated in theater (N=511) compared to those that necessitated theater medical evacuation (N=123) due to psychiatric decompensation.Findings: 50.1 percent of those medically evacuated had a previously identified theater limiting mental health condition, statistically different than those with a newly identified mental health condition treated in theater (P<.0001). Those with retrospectively determined medical screening failures were 52 times more likely to evacuated (OR 52.61, 95% CI 25-108) than those without. This study demonstrates potential support of the utilization of existing pre-deployment medical screening procedures.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Untitled

2015

JPCPY

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Section: Understanding Personality Disordersmentioning

confidence: 99%

“…Screening efforts were further refined during World War II and this period marked a shift in reliance on intelligence testing in identifying psychological abnormalities (Cardona and Ritchie 2007). Even during World War II, however, there was a divergent opinion as to whether service members with pre-existing personality abnormalities could adequately serve in a military setting and perform their duties accordingly (Cardona and Ritchie 2007). Today's military screening utilizes three components to identify psychological abnormalities-the Armed Services Vocational Aptitude Battery (ASVAB) which was introduced in 1968, the attainment of a high school diploma (significant predictor for finishing an enlistment term), and a general psychological evaluation in the Military Entrance Processing Station (MEPS) (Cardona and Ritchie 2007).…”

Section: Understanding Personality Disordersmentioning

confidence: 99%

U.S. Military Discharges and Pre-existing Personality Disorders: A Health Policy Review

Leroux

2014

Adm Policy Ment Health

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The Department of Defense (DoD) is facing allegations service members were wrongfully discharged for pre-existing personality disorders. From 2001 to 2007, 26,000 enlisted service members were discharged for a pre-existing personality disorder (2.6 % of total discharges). With national media attention of the issue, personality disorder discharges were reduced by 31 % in 2008 with new discharge procedures issued by the DoD. Even with the reduction, a government review found the DoD did not adhere to its discharge protocols. The objective of this paper is to explore personality disorders in the military, analyze various costs to stakeholders, and identify potential policy alternatives.

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“…The analysis mainly relied on conceptual scientific literature and reports (e.g., Cardona and Ritchie 2007;Sharpley et al 2008;Mulligan et al 2012) and to a lesser extent on program materials (e.g., WRAIR Land Combat Study Team 2006; MGGZ 2008). Each of these sources concerns the US, UK, and/or Dutch armed forces.…”

Section: Literature Analysismentioning

confidence: 99%

Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness

Molendijk

Kramer

Verweij

2015

Cult Med Psychiatry

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Research indicates that soldiers struggling with PTSD under-utilize mental health care. Quantitative studies of barriers to care point to the importance of soldiers' beliefs about mental health and mental health interventions in their care-seeking behavior, yet these studies still struggle to understand the particular beliefs involved and the ways they impact care-seeking behavior. This preliminary study makes a start in examining these questions through qualitative literature analysis. It maps out dominant messages surrounding PTSD in military mental health interventions, and explores how they can both shape and conflict with soldiers' personal notions. It does so by analyzing these messages and notions as institutional and personal (illness) narratives. Institutional military PTSD-narratives, which draw on mainstream scientific and clinical models, appear to communicate contradictory notions on the meanings of violence and its psychological consequences, often without acknowledging these contradictions. As such, these narratives seem to shape struggles of soldiers, both within themselves and with the military institution. The identified conflicts indicate, contrary to the individualizing and decontextualizing focus of dominant PTSD-understandings, that soldiers' struggles also have social and moral dimensions. This has important implications for both research into PTSD-interventions and understandings of PTSD as such.

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U.S. Military Enlisted Accession Mental Health Screening: History and Current Practice

Cited by 30 publications

References 13 publications

Untitled

Untitled

U.S. Military Discharges and Pre-existing Personality Disorders: A Health Policy Review

Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness

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