Is the U.S. military using dubious personality disorder diagnoses to kick out troubled soldiers out of the military without health benefits? James Dao of the New York Times found one clear example of this kind of treatment and unearthed evidence of a larger pattern.
Capt. Susan Carlson was kicked out of the military after being diagnosed with a personality disorder not otherwise specified. Carlson enlisted late in life and thrived as a military behavioral scientist in the U.S., but her career imploded when she deployed to Afghanistan with the Colorado National Guard.
She disputed the diagnosis, but it was not until months later that she found what seemed powerful ammunition buried in her medical file, portions of which she provided to The New York Times. “Her command specifically asks for a diagnosis of a personality disorder,” a document signed by the psychiatrist said.
Veterans’ advocates say Captain Carlson stumbled upon evidence of something they had long suspected but had struggled to prove: that military commanders pressure clinicians to issue unwarranted psychiatric diagnoses to get rid of troops.
“Her records suggest an attempt by her commander to influence medical professionals,” said Michael J. Wishnie, a professor at Yale Law School and director of its Veterans Legal Services Clinic. [NYT, emphasis added.]
Since 2001, 31,000 troops have been discharged for personality disorders.
A personality disorder diagnosis is useful for military bureaucrats because these disorders are, by definition, preexisting conditions that emerged in childhood. Therefore, if a soldier is diagnosed with a personality disorder, she can be administratively discharged and lose her retirement pay and medical benefits.
Veterans’ advocates note that the symptoms of PTSD and traumatic brain injury can overlap with the symptoms of some personality disorders.
Recently, soldiers at a base in Washington State complained that doctors were reversing their PTSD diagnoses and branding them as personality disordered. A doctor at the Madigan Army Medical Center warned his colleagues that a PTSD diagnosis can cost the taxpayer $1.5 million over a soldier’s lifetime, so they’d better not “rubber stamp” PTSD diagnoses.
The Army has since reviewed 14 cases and reinstated the PTSD diagnosis in 6 of them. The head of Madigan has been removed and two forensic psychiatrists have been suspended.
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