Brain injury or mental health behind most military misconduct discharges – govt watchdog

Brain injury or mental health behind most military misconduct discharges – govt watchdog
More than six in 10 service members who were discharged for misconduct had a brain injury or mental health condition, and many of them are potentially ineligible to receive health benefits from the Department of Veterans Affairs, a new report has found.

The US Government Accountability Office (GAO), an independent government watchdog agency, reported that 57,141 of the 91,764 service members who were separated or discharged for misconduct from fiscal years 2011 through 2015 had been diagnosed with post-traumatic stress disorder (PTSD), a traumatic brain injury (TBI), or another mental health condition at least two years before their separation.

Using data from the Department of Defense’s Defense Manpower Data Center (DMDC), the DOD’s Defense Health Agency (DHA), and the Veterans Benefits Administration, the report found that 16 percent of troops discharged for misconduct had been diagnosed with TBI or PTSD. The remaining 46 percent had been diagnosed with some other condition, mostly adjustment disorders and disorders relating to alcohol and substance abuse.  

Only 38 percent of troops discharged for misconduct had not been diagnosed with any conditions, the GAO found.

Nearly a quarter (23 percent) of those discharged with a diagnosis had an “other than honorable” characterization of service, making them potentially ineligible for health benefits from the Department of Veterans Affairs (VA).

The watchdog agency reported that the military policies for addressing brain injuries and mental health conditions are inconsistent with policies from the Pentagon.

The DOD requires a medical screening to assess whether PTSD or TBI were mitigating factors in misconduct charges against service members. The DOD also requires the military to adhere to certain training and counseling policies before discharging a service member.

The Navy and Air Force were not adhering to DOD policies on screening service members prior to their separation or policies relating to training service members how to identify mild TBI symptoms, GAO found.

The Army and Marine Corps may not have even adhered to their own policies regarding PTSD and TBI, the report said. Interviews conducted by the GAO revealed that Army officers may not have been trained to identify mild TBI symptoms. They also discovered that the Army and Marine Corps were not adhering to their own policies on counseling, which requires them to inform service members about their potential ineligibility for VA benefits and services.

Finally, the GAO found that while the Army and Marine Corps record data on their screenings, training and counseling, they do not use the data to monitor if they are adhering to the policies.

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

Unless the policy inconsistencies are resolved and routine monitoring is undertaken to ensure adherence, the risk increases that service members may be inappropriately separated for misconduct without adequate consideration of these conditions’ effects on behavior, separation characterization, or eligibility for VA benefits and services,” the study continued.

The GAO made five recommendations to ensure that service members with PTSD and TBI are appropriately considered prior to their separation.

The agency suggests the defense secretary should direct the Air Force and Navy to adhere to DOD policies relating to training and screening. They also suggested the secretary should ensure that the military is monitoring its adherence to DOD policies relating to screening, training and counseling.

The Pentagon agreed with most of the recommendations, and claims that the policies are currently in the process of being implemented. However, a letter included with the report from David Smith, the acting assistant defense secretary for health affairs, said that the DOD took issue with the “accuracy and clarity” of the findings presented in the report.

The number of service members in the GAO report were “inflated” due to certain service members who are diagnosed with more than one condition, Smith wrote.

The inflated figures “create the false impression that the majority of service members administratively separated for misconduct had psychological health conditions that would explain their misconduct,” he wrote.

The GAO disputed Smith’s claims but stated in the report that parts were rewritten to address any concerns that the Pentagon raised.

On Tuesday, the agency wrote a letter to Senator John McCain (R-Arizona) and other lawmakers, outlining how PTSD and TBI have become the “signature wounds of the conflicts in Afghanistan and Iraq.”

These conditions can adversely affect service members’ moods, thoughts and behavior, they may lead to disciplinary infractions and subsequent separations for misconduct from the military,” the GAO wrote.