WASHINGTON – The Army issued waivers over 13 months to more than 1,000 recruits who had been diagnosed and treated for mood disorders and 95 more with a history of self-mutilation, according to data obtained by USA TODAY.
The acceptance of new soldiers with a history of serious behavioral health issues, some of which can be lifelong challenges, came as the Army struggled to meet its recruiting goals. The time period ran from Oct. 1, 2016, through Oct. 31, 2017.
Last week, Army Secretary Mark Esper indicated that the Army issues waivers only for mental health issues that have been resolved or upon further review were misdiagnosed. There were no waivers issued for a history of drug overdoses or suicide attempts.
“As the stigma of seeking therapy or counseling becomes less of an issue than when I grew up, you’ll see probably more cause for waivers,” Esper said. “But again, the waiver is only for an historical condition that we look at and assess. We do not allow anybody in who is undergoing therapy, who is a cutter or was a cutter, identified clearly as a cutter or is using drugs. They are not allowed into the service. And I will not accept them. Quality trumps quantity every single day of the week.”
Mood disorders include conditions such as bipolar disorder and severe depression. Self-mutilation can indicate deep psychological problems.
“Bipolar in most cases is a lifelong challenge,” said Elspeth Cameron Ritchie, a psychiatrist who retired from the Army as a colonel in 2010 and is an expert on waivers for military service. “It is more of a challenge when you’re younger and is not something you can simply be clear of. You’re often on medication for life.”
A history of severe depression raises the risk of suicide, a problem the military sought to minimize in part by eliminating waivers for many behavioral health issues in 2009, Ritchie said.
Last fall, USA TODAY reported on Army documents that showed the service tried to ease the waiver process for recruits with a history of self-mutilation, bipolar disorder and depression. The Army encountered challenging recruiting goals, including adding more than 76,000 soldiers this year. In 2017, it accepted more recruits who had fared poorly on aptitude tests, and it increased the number of waivers for marijuana use.
Sen. John McCain criticized the service for accepting recruits who mutilated themselves.
McCain, R-Ariz., chairman of the Armed Services Committee, was outraged by the story and threatened in November to hold up nominations for Pentagon posts unless the Army axed the waiver practice. The next day, Gen. Mark Milley, the Army chief of staff, announced that he had rescinded a memo on mental health waivers but insisted that the document never had the effect of policy. The only change, he said, was that the Army allowed a lower-ranking general officer to approve the waivers.
McCain blasted Army witnesses at a committee hearing, saying none of the panel’s members favored granting waivers for serious mental health conditions.
Figures obtained through a Freedom of Information Act request show that from Oct. 1, 2016, through Oct. 31, 2017, the active-duty Army issued waivers to 738 recruits with a history of mood disorders and 49 more with a history of self-mutilation. The Army Reserve and National Guard accepted the rest of the recruits with behavioral health issues.
Soldiers with bipolar disorder often require medication such as lithium, Ritchie said. That medication must be monitored carefully, a task that may be impossible in austere combat environments far from laboratories.
Manic episodes of bipolar disorder can be triggered by sleep deprivation, a common occurrence in the military, she said. She recalled treating an Army major who scrawled graffiti on walls during a “classic bipolar episode” while deployed to South Korea.
“When you’re manic, your judgment isn’t good,” Ritchie said. “You shouldn’t be driving a tank when you’re manic. You shouldn’t have a rifle if you’re manic.”
Accepting recruits with a history of behavioral health issues is risky — for the Army and the soldier, Ritchie said.
“It is concerning,” she said. “It can be very problematic. And we may be setting them up to fail.”
The Army is about 1,000 recruits behind its goal of recruits for this year.
