Thank you Chairman Filner, Congressman Buyer and the members of the House Veterans Affairs Committee for the opportunity to submit testimony on this important topic; Personality Disorder discharges and their impact on our veterans. 

Founded in 1974, Swords to Plowshares is a community-based not-for-profit organization that provides counseling and case management, employment and training, housing and legal assistance to homeless and low-income veterans in the San Francisco Bay Area. We promote and protect the rights of veterans through advocacy, public education, and partnerships with local, state and national entities. Swords to Plowshares is a Congressionally recognized Veteran Service Organization which represents veterans in VA Compensation and Pension claims as well as discharge review matters.  As such we have represented many veterans who have unjustly received inappropriate personality disorder (PD), adjustment disorder (AD) and pattern of misconduct discharges and been denied treatment for their PTSD. 

The purpose of this testimony is to emphasize how the inappropriate use of personality disorder, adjustment disorder and pattern of misconduct impact our veteran clients on the ground. Such discharges have a tremendously negative impact on our veteran clients. We will not go into data on a broader scale as our colleagues at Veterans for Common Sense have done an excellent job framing the issues.  Instead, we can tell you that client after client with PTSD and traumatic brain injury and inappropriate PD discharges come to us feeling that they have been branded as damaged goods, their combat service has been invalidated, and their identity and self worth as once proud warriors destroyed.  The fallout can be tragic, this practice exacerbates PTSD, depression, homelessness and suicidality, and creates obstacles to employment, and access to healthcare and benefits.

At Swords to Plowshares we have 35 years experience in picking up the pieces and pulling our Vietnam era clients out of poverty, and chronic homelessness, mental health need and substance abuse stemming from their military service. We hope that we have learned lessons and may be proactive, prevent future homelessness and suffering by ensuring that this generation of combat veterans are afforded the honor, care and support they need for successful outcomes.

The following are some of our observations regarding personality disorder, adjustment disorder and pattern of misconduct discharges for veterans with PTSD, TBI and other mental health needs.   

The Impact of Misdiagnosis 

Many of our clients served honorably and without any disciplinary or mental health concerns for several years prior to receiving a personality disorder or adjustment disorder discharge. Unlike PTSD, schizophrenia and psychosis, personality disorder does not develop following a traumatic stressor or deployment. It does not manifest suddenly.  Instead it is a pre-existing condition and was allegedly present at the time the service member joined the military. If the service member had a pre-existing personality disorder which led to such a discharge it should have been identifiable in the preceding years of service. Indeed, it should be identified in boot camp or A school.  We are seeing and hearing from veterans who have been diagnosed with personality disorder after multiple deployments.  The military is simply not following the diagnostic criteria set forth in the DSM-IV, and its failure to do so should not forever punish former service members.     

The DoD is shirking their responsibility to treat PTSD to the VA and the community-based system of care.  If these service members were properly and legally discharged they should receive medical retirement, an honorable discharge, a 50 percent disability rating and medical care.  Instead they are kicked out of the military with a less than honorable discharge status with no readily available means of support or healthcare.  Veterans come to Swords to Plowshares in financial and psychological crisis, many believe that they are not eligible for VA care and benefits because personality disorder, as a pre-existing condition is not service connectable.  Even with the help of our legal and social services staff, this status causes significant delays in care, causing unnecessary exacerbation of their symptoms.  The cost of care should never have been externalized to our communities. Further the cost in suffering, poverty, and the shame inflicted on warriors is immeasurable. 

The DoD is taking advantage of vulnerable disabled service members.  Many of our clients have signed away their right to a just and proper discharge because they are suffering from PTSD or TBI and cannot bear remaining in the military environment.  Some because their PTSD and depression are too acute, others because of the stigma and mistreatment they receive in seeking care.  In other cases, their symptoms have led to some diminished capacity which interferes with performance or have engaged in some degree of misconduct symptomatic of their true diagnosis and are being met with discipline rather than care.  These service members will sign anything to escape a hostile environment and do not have the capacity for informed consent in signing away their right to a proper medical discharge.

Personality, adjustment and pattern of misconduct discharges can unjustly strip veterans of their GI Bill benefits.  A personality disorder discharge in itself is not a bar to benefits however, in our experience; they often arise in the context of a pattern of misconduct and disciplinary action. If the veteran received an other than honorable discharge they are barred from the GI Bill benefits.  This unjustly throws more obstacles in their path to healing, employment, housing and economic stability.  

To assign a PD, AD or BCD discharge to a mentally ill warrior is a devastating betrayal.  It is a cruel injustice to service members who have served their country for some years, deployed to combat, been exposed to trauma and injury, witnessed the deaths of friends, and struggled with the demons of PTSD.  Rather than honoring their service and healing their wounds, the military with which they have identified and sacrificed for has labeled them 'crazy' and sent them packing.  This overwhelming psychic blow to our clients cannot be overstated.  The military is a not just a job, it is an all-encompassing culture of its own, and these injured veterans are in essence banished from society.

There is virtually no access to justice for disabled veterans who have illegally and unjustly received PD, AD and BCD discharge.  There are very very few attorneys who specialize in discharge upgrades and corrections. And only a handful in the country that provide this service free of charge. Our own funding for discharge review has been cut back and we have had to severely restrict our client representation in these matters. Without competent affordable representation too many combat veterans will fall into a life of chronic mental illness, poverty and homelessness due to the military’s illegal and inexcusable mistreatment of wounded service members.

In closing, we urge the HVAC committee will ensure that service members with mental health needs receive appropriate discharges and streamlined access to all the benefits and care they have earned. To that end, we fully concur with the recommendations of Veterans for Common Sense.