Introduction

Chairman Filner, Representative Buyer, Distinguished Members of this Committee, thank you for the opportunity to appear before you on behalf of America’s Army.  Our greatest heroes are America’s most precious resource—our Soldiers and Veterans.  These Soldiers and Veterans represent the very best of America’s values and ideals and faithfully shoulder the load that our nation asks of them.  Their dedicated service and sacrifice are deserving of the very best services, programs, equipment, training, benefits, lifestyle, and leadership available.

Personality Disorder

The Army is dedicated to ensuring that all Soldiers with physical and mental conditions caused by wartime service receive the care they deserve.  The Army remains committed to tracking personality disorder separations for our Soldiers.  Our culture is shifting away from the stigma associated with having post traumatic stress disorder (PTSD) or traumatic brain injury (TBI) and ensuring Soldiers know that it is expected that they seek help for these hidden wounds to restore and maintain their health and readiness.

A personality disorder is a deeply ingrained maladaptive pattern of behavior of long duration that interferes with a Soldier's ability to perform duty.  The onset of a personality disorder is frequently manifested in the early adult years and may reflect an inability to adapt to the military environment as opposed to an inability to perform the requirements of specific jobs or tasks.  As such, observed behavior of specific deficiencies are documented in appropriate military counseling records to include history from sources such as supervisors, peers, and others, as necessary to establish that the behavior is persistent, interferes with assignment to or performance of duty, and has continued after the Service member has been counseled and afforded the opportunity to overcome the deficiencies.

In 2006 and 2007, public concern arose that some Soldiers returning from combat tours who were also suffering from PTSD or TBI as a result of their combat experiences had been discharged from the military for personality disorder.  To address these concerns, the Army’s Office of the Surgeon General issued policies in August 2007 and May 2008 requiring higher-level review of recommendations to administratively separate Soldiers for personality disorder and requiring screening for PTSD and TBI for administrative separation for personality disorder and other types of administrative separation.  In August 2008, the Department of Defense (DoD) mandated similar requirements across DoD including the requirement that the diagnosis of personality disorder for Service members who had served or were serving in imminent danger pay areas must be endorsed by the Military Department’s Surgeon General.

Army administrative separations policy was subsequently updated implementing the recommendations of the Government Accountability Office, the requirements of Department of Defense Instruction 1332.14 and the National Defense Authorization Act for Fiscal Year 2010.  Included were the requirements that a psychiatrist or PhD-level psychologist be the mental health professional diagnosing the personality disorder, that a Personality Disorder diagnosis be corroborated by a peer or higher-level mental health professional (Medical Treatment Facility Chief of Behavioral Health or equivalent official), that the Personality Disorder diagnosis be endorsed by the Director, Proponency of Behavioral Health, Office of The Surgeon General, and that the diagnosis address PTSD or other co-morbid mental illness, if present.  The Army also provided for the distinction between Soldiers who were separated for Personality Disorder who had less than 2 years time in service (Chapter 5-13/ Personality Disorder) with Soldiers with 2 or more years of service (Chapter 5-17/ Other Designated Physical or Mental Conditions).

Commanders make maximum use of counseling and rehabilitation before determining that a Soldier has limited potential for further military service and, therefore, should be separated.  When a Soldier’s conduct or performance becomes unacceptable, the commander will ensure that the Soldier is formally counseled on his or her deficiencies and given a reasonable opportunity to overcome or correct them.  If the commander believes a medical issue may be the basis of the misconduct or poor performance, the commander refers the Soldier for a medical evaluation.  Separation for personality disorder is authorized only if the diagnosis concludes that the disorder is so severe that the Soldier's ability to function effectively in the military environment is significantly impaired.  The Soldier is counseled that the diagnosis of a personality disorder does not qualify as a disability.  When it is determined that separation for personality disorder is appropriate, the unit commander takes action to notify the Soldier.  Separation authority for personality disorder for Soldiers who are or have been deployed to an area designated as an imminent danger pay area is the General Court Martial Convening Authority (General Officer-level commander).  In all other cases, the separation authority is the Special Court Martial Convening Authority (Colonel-level commander).

Separated Soldiers may request review and change of their discharge by petitioning the Army Review Boards Agency (ARBA).  ARBA’s case management division screening team hand carries these cases to the Army Discharge Review Board (ADRB), which prioritizes review and boarding of applications for upgrades or changes in discharges where either PTSD or TBI is diagnosed. ARBA's Medical Advisor serves as a voting board member when PTSD/TBI cases are boarded by the ADRB.

Army Career and Alumni Program

Soldiers who are separated from Active Duty prior to their actual separation date, also known as unanticipated losses, are fully eligible for all transition services provided by the Army Career and Alumni Program (ACAP).  Programs available for Soldiers within ACAP include pre-separation counseling, employment assistance, Veterans Benefits Briefing, and the Disabled Transition Assistance Program (DTAP).

Pre-separation counseling provides Soldiers information about services and benefits they have earned while on active duty.  The following areas are covered in this counseling:  effects of a career change, employment assistance, relocation assistance, education and training, health and life Insurance, finances, Reserve affiliation, Veterans benefits, Disabled Veterans benefits, post government service employment restriction and an Individual Transition Plan.  Each of these areas have several items that support the specific area.  This pre-separation counseling is mandatory for all separating Soldiers who have at least 180 days of active duty upon time of separation.

Employment assistance consists of individual one-on-one counseling, attending a Department of Labor two-and-a-half day long employment workshop, finalizing a resume, practice employment interviews, using various automated employment tools and using the internet to access job data banks.  This is strictly voluntary; Soldiers do not have to participate.

The Veterans Benefits Briefing is a four-hour long briefing provided by Veterans Affairs (VA) counselors covering all VA-controlled services and benefits that a Soldier can receive or may be eligible for after separation.  Transition counselors strongly encourage separating Soldiers to attend.

The Disabled Transition Assistance Program (DTAP) is a two-hour long briefing provided by VA counselors.  Soldiers who are separated due to medical or physical injuries, as well as Soldiers who believe that they will file a VA Disability Claim, are highly encouraged to attend this briefing.

Soldiers out-processing as an unanticipated loss normally have limited time remaining on active duty and will in almost all cases have insufficient time to take advantage of the above programs except for the legally-mandated pre-separation counseling.  However, these Soldiers are fully eligible to receive these services for up to 180 days after separation.  Additionally, they are referred by the transition counselor to go to the nearest Department of Labor Career One Stop after separation for assistance in obtaining employment and are instructed to use the VA E-benefits Web site to obtain information concerning their eligibility for VA benefits.

Congressional Assistance

The Army remains dedicated to making sure that all Soldiers with physical and mental conditions caused by wartime service receive the care they deserve.  The Army is grateful for the continued support of Congress for providing for the well-being of the best Army in the world.

Conclusion

The Army leadership has confidence in our behavioral health providers and the policies in place to ensure proper treatment for our Soldiers.  We continue to monitor these processes to ensure the accurate diagnosis of PTSD and TBI and to further corroborate each diagnosis of personality disorder.  Veterans who feel that they were discharged inappropriately are encouraged to seek a remedy through the Army Review Boards Agency (ARBA).

The mental and physical well-being of our Soldiers and Veterans depends on your tremendous support.  We must continue to maintain an appropriate level  of oversight on PTSD and TBI, wounds all too frequently associated with the signature weapon of this war, the improvised explosive device.  The men and women of our Army deserve this; we owe this to them.  The Army is committed to continuing to improve the accuracy and efficiency of these policies and their implementation.  Thank you for the opportunity to appear before you this morning.  I look forward to answering any questions you may have.