Military Medical Standards For Enlistment And Commission

Mental Health Conditions

Capt Tara Neeley explains how she became a Clinical Psychiatrist in the U.S. Air Force
AF Psychiatry. airforce.com

Mental health in the military is taken very seriously for obvious reasons not just for the admission into the services, but also staying in the services as well. There are many disqualifying medical conditions to entry and continued service into the military, but none are quite as challenging as the subjective nature of mental health and illness.

The disqualifying medical conditions are listed below.

The International Classification of Disease (ICD) codes are listed in parentheses following each standard.

The causes for rejection for appointment, enlistment, and induction (without an approved waiver) are an authenticated history of:

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder , or Perceptual/Learning Disorder(s) (315) is disqualifying, unless applicant can demonstrate passing academic performance and there has been no use of medication(s) in the previous 12 months.

Current or history of academic skills or perceptual defects secondary to organic or functional mental disorders, including, but not limited to dyslexia, that interfere with school or employment, are disqualifying. Applicants demonstrating passing academic and employment performance without utilization or recommendation of academic and/ or work accommodations at any time in the previous 12 months may be qualified.

Current or history of disorders with psychotic features such as schizophrenia (295), paranoid disorder (297), and other unspecified psychosis (298) is disqualifying.

Mood Disorders

Mood disorders such as depression, bipolar disorder, psychoses, and other unspecified depressive issues are disqualifying.

 Any history of mood disorders requiring medication and/or outpatient care for longer than six months by a mental health professional is also disqualifying. Also any symptoms of mood and mental issues that affect social ability, school and learning, or work efficiency is disqualifying.

Current or history of adjustment disorders within the previous 3 months is disqualifying.

Behavioral Disorders

Behavioral disorders history in school and with law enforcement agencies having to get involved due to dangerous behavior to self or others is disqualifying. Antisocial attitudes or behaviors are disqualifying as people who exhibit these symptoms are typically not adaptive to military service. 

Any history of personality disorder that is demonstrated by documented and recurring inability to remain in a school environment, work with employers or fellow employees, social groups is disqualifying. Any psychological testing that reveals a high degree of immaturity, instability, personality issues, impulsiveness, or dependency will also interfere with the ability to conform to the rules and regulations of the Armed Forces is disqualifying. 

If a person has a current or history of behavior disorders that include but not limited to the following conditions:

1 - Enuresis or encopresis after the 13th birthday is disqualifying.

2 - Sleepwalking after 13th birthday is disqualifying. 

3 - Eating disorders such as anorexia, bulimia, or other unspecified eating disorders lasting longer than three months and occurring after the 14th birthday is also disqualifying. 

Speech Affected Disorders

Any speech impediment, stammering, stuttering or other receptive or expressive language disorder to such a degree as to significantly interfere with productions of speed or to repeat commands is disqualifying. 

Other History of Medical Disorders That Are Disqualifying

Any history of suicidal behavior, that includes discussions, gestures, or the actual attempt is disqualifying. A history of self-mutilation is also disqualifying.

Anxiety issues, either current or historical, or panic, agoraphobia, social phobia, simple phobias, obsessive-compulsive disorders, other acute reactions to stress, and posttraumatic stress are disqualifying for entry into the service.

Any history or current disorder of being dissociative, bouts of hysteria, or de-personalization are disqualifying.

Any history or current somatoform disorders, including, but not limited to hypochondriasis or chronic pain disorder, are disqualifying.

Any history or current psychosexual conditions, including, but not limited to transsexualism, exhibitionism, transvestism, voyeurism, and other paraphilias, are disqualifying.

Any history or current issue with alcohol dependence, drug dependence , alcohol abuse, or other drug abuse is disqualifying.

Of all the medical issues that disqualify a person from being in the service, the mental health side is rigid in its stance, even if some diagnoses can be highly subjective. However, over the past decade, there has been a relaxing of some previous conditions such as ADD / ADHD.  Over-diagnosed or misdiagnosed children that exhibited such symptoms when younger may not longer have those same symptoms and may be perfectly functioning for military service.  Since 2014, Department of Defense has softened their stance on childhood Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). The rule is now, children with a history of ADD/ADHD under the age of 13 are now waiverable on a case by case basis. Future waivers may allow older applicants to enter the military as long as they have been off any medication for a year of high school, college education, or work experience. 

Many of these diagnoses are marked with historical data as well as the opinion of the civilian or military provider as to if the ailment or history of mental illness and medications will interfere with, or prevent satisfactory performance of military duty.

Derived from Department of Defense (DOD) Directive 6130.3, "Physical Standards for Appointment, Enlistment, and Induction," and DOD Instruction 6130.4, "Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces."