While it's been a problem for more than a decade, a very small section of the 2014 NDAA seeks to address the issue of military members being discharged wrongfully for personality disorders or adjustment disorders. Many have alleged that this practice is used to sweep problems under the rug and now Congress wants some answers. However, what they will do with those answers is a mystery.
To be clear, these are very real disorders, characterized by severely dysfunctional behavior, but veterans and veteran service organizations contend that these diagnoses are being used to discharge members improperly in order to save money and get rid of problem troops.
The NDAA states in section 530H;
"Not later than 180 days after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report evaluating— (1) the use by the Secretaries of the military departments, since January 1, 2007, of the authority to separate members of the Armed Forces from the Armed Forces due of unfitness for duty because of a mental condition not amounting to disability, including separation on the basis of a personality disorder or adjustment disorder and the total number of members separated on such basis; (2) the extent to which the Secretaries failed to comply with regulatory requirements in separating members of the Armed Forces on the basis of a personality or adjustment disorder; and (3) the impact of such a separation on the ability of veterans so separated to access service-connected disability compensation, disability severance pay, and disability retirement pay."
Since 2001, there have been more than 31,000 service members discharged and labeled as having a personality disorder or adjustment disorder. Particularly troubling is evidence that shows the 'diagnose and discharge' practice isn't stopping and may be increasing.
The problem of personality disorder discharges in the military has existed since at least 2008, when the Government Accountability Office found that the services were improperly discharging members for personality disorders, but veteran advocacy groups and veterans say the problem existed long before this.What makes these discharges improper is that they violate the Department of Defense's own regulations on discharging members for unfitness for duty based on mental health problems. According to
Vietnam Veterans of America (VVA), DoD regulations require that service members be diagnosed by a psychiatrist or psychologist as having a personality or adjustment disorder that impedes their ability to serve in the military and then be given formal counseling before separated. But according to the Government Accountability Office (GAO), that occurs less than half of the time.
In 2008, the GAO issued a report stating that the "DoD does not have reasonable assurance that its key personality disorder separation requirements have been followed."
In September 2010, the GAO reported that the Army, Marine Corps, and Navy still had not come into compliance with updated Defense Department Personality Disorder discharge regulations.
In several cases, evidence was found that suggests commanding officers are simply asking mental health providers to enter the diagnosis in the member's permanent record in order to discharge troops with minor problems or those who cause the chain of command embarrassment quickly and with no benefits -- embarrassment such as reporting a sexual assault.
Many victims of MST report being discharged for a personality disorder or adjustment disorder after attempting to report the incident.
"It's convenient to sweep this under the rug. It's also extremely convenient to slap a false diagnosis on a young woman ... and then just get rid of them so you don't have to deal with that problem in your unit," Service Women's Action Network founder Anu Bhagwati said in an interview with CNN. "And, unfortunately, a lot of sexual assault survivors are considered problems."The problem with these diagnoses is that in order to apply them to a service member correctly, the service member would have to display a long-standing pattern of maladaptive behavior and inflexibility beginning in adolescence, behavior that would likely preclude someone from being accepted to serve in the first place.
For decades, veteran groups have asserted that the Pentagon uses personality disorder diagnoses to get rid of troops they find troublesome or to avoid paying benefits for service-connected injuries. Because the military considers these disorders a pre-existing condition, those given the diagnosis are discharged without military retirement pay or even VA medical care. In some cases, members have even been required to repay enlistment bonuses.
Post-traumatic stress disorder, for sake of comparison, is usually linked to military service, meaning that a medical discharge is accompanied by benefits. PTSD is also very common after sexual assault. The VVA estimates that the DoD has saved $8 billion in disability compensation and $4.5 billion in medical care costs by discharging members with different disorders.
Questions about the Army manipulating psychiatric diagnoses to save money have been raised at Joint Base Lewis-McChord. Soldiers undergoing treatment complained that their psychiatrists rescinded their PTSD diagnosis, leaving these soldiers with a personality disorder or adjustment disorder diagnosis that did not qualify them for medical discharges and the subsequent benefits they were due.
Memos have circulated advising mental health providers that a diagnosis of PTSD can cost $1.5 million over a service member's lifetime, and warned doctors to be careful about "rubber-stamping" the diagnosis in the interest of saving taxpayer dollars. As a result of complaints, the Army suspended some of the doctors at Joint Base Lewis-McChord and reviewed a small handful of cases, reinstating a PTSD diagnosis for 6 service members receiving treatment.
While some of the military's top brass have voiced concerns about the over-diagnosis of PTSD, the DoD denies using psychiatric diagnoses to get rid of injured or troublesome troops or to save money. However, section 530H of the 2014 NDAA gives the impression that the opposite is true and that the DoD is now trying to find out how far reaching the problem is.
Currently, service members who have been wrongfully discharged have an uphill battle to get their status changed and have their benefits restored. While the NDAA gives the services and the DoD 180 days to report to Congress about the problem, what remains unclear is what Congress will do for those who have already been wronged.