Defense officials step up ‘personality disorder’ ID system

Under pressure from Congress and following the Army’s lead, the Department of Defense has imposed a more rigorous screening process on the services for separating troubled members because of personality disorder.

The intent is to ensure that, in the future, no members who suffer from wartime stress get tagged with having a pre-existing personality disorder which leaves them ineligible for service disability compensation.

Since the attacks of Sept. 11, more than 22,600 service members have been discharged for personality disorder. Nearly 3,400 of them, or 15 percent, had served in combat or imminent danger zones.

Advocates for these veterans contend that at least some of them were suffering from Post-Traumatic Stress Disorder (PTSD) or traumatic brain injury but it was easier and less costly to separate them for personality disorder. By definition, personality disorders existed before a member entered service so they do not deemed a service-related disability rating. A disability rating of 30 percent or higher, which most traumatic stress sufferers receive, can mean lifelong access to military health care and on-base shopping.

Over the last 18 months, lawmakers and advocates for veterans have criticized Defense and service officials for relying too often on personality disorder separations to release members who deployed to Iraq, Afghanistan or other another areas of tension in the Global War on Terrorism.

A revised instruction, which took effect without public announcement Aug. 28, responds to that criticism. It allows separation for personality disorder for members deployed to an imminent danger area only if:

The diagnosis by a psychiatrist or a Ph.D.-level psychologist is corroborated by a peer or higher-level mental health professional.

It’s endorsed by the surgeon general of the service.

And it takes into account a possible tie with symptoms of stress disorder or war-related mental injury or illness.

Sam Retherford, director of officer and enlisted personnel management in the Office of the Secretary of Defense, said adding rigor and discipline to the process when separating deployed members for personality disorder is “very important,” considering what’s at stake.

Last year, several congressional hearings focused on overuse of personality disorder separation after The Nation magazine exposed apparent abuses in a March 2007 article. It described the experience of Army Specialist Jon Town. In October 2004, while Town stood in the doorway of his battalion’s headquarters in Ramadi, Iraq, an enemy rocket exploded into the wall above his head, knocking him unconscious.

When he came to, Town was numb all over, bleeding from his ears and had shrapnel wounds in his neck. For two years he struggled with deafness, loss of memory and depression before the Army, in September 2006, separated Town after seven years’ service. He was separated for a pre-existing personality disorder and without disability benefits. Writer Joshua Kors suggested there might be thousands of veterans like Town, separated administratively to save the services billions of dollars in benefits.

In June, the Defense Department reported to Congress that it would add “rigor” to its personality disorder separation policy, previewing the changes implemented in late August. The Navy strongly had opposed the changes because it frequently uses personality disorder separations to remove sailors found too immature or undisciplined to cope with life at sea.

Requiring their surgeon general to review every personality disorder separation from ships deployed in combat theaters would be too burdensome, the Navy argued. But Defense officials insisted on the changes.

The DoD report in June showed the Navy led all services in personality disorder separations. For fiscal years 2002 through 2007, the Navy total was 7,554 versus 5,923 for the Air Force; 5,652 for the Army and 3,527 for the Marine Corps. The Army led in personality disorder separations to members who had wartime deployments, with a total of 1,480 over six years. The Navy’s total was 1,155, the Marine Corps 455 and the Air Force 282.

DoD said it found no indication that personality disorder diagnoses of deployed members “were prone to systematic or widespread error.”

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