Mental Health Standards for Combat Deployment: In Reply

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Back to table of contents Previous article Next article LettersFull AccessMental Health Standards for Combat Deployment: In ReplyGerald E. Larson, Ph.D., and Emily A. Schmied, M.P.H.Gerald E. LarsonSearch for more papers by this author, Ph.D., and Emily A. SchmiedSearch for more papers by this author, M.P.H.Published Online:1 Jul 2011AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail We thank Dr. Nevin for facilitating additional discussion of appropriate psychiatric screening practices for U.S. military personnel deploying to combat zones. He provides evidence that predeployment psychiatric screening practices have been, and may still be, suboptimal in identifying personnel with a history of mental disorders (1,2). Moreover, Dr. Nevin cites an example of an enhanced predeployment program developed by Warner and colleagues (3) that increased the rigor of predeployment screening without causing substantial numbers of personnel to be disqualified for deployment. In light of possible deficiencies in current screening practices and evidence of potentially better screening paradigms, Dr. Nevin challenges our apparent reluctance to change the status quo.However, we believe that the recommendations in our article have been misconstrued. We stated, “Any attempt to further restrict deployability of service members with psychiatric diagnoses might lead to greater avoidance of care. Therefore, tightening of current deployment policy might have severe and unintended negative consequences.” Thus we have no opposition to more rigorous screening; rather, our concern lies with subsequent decisions that overly restrict deployment. We applaud the work of Warner and colleagues because it has improved the accuracy of screening without substantially restricting deployability. The latter is key, because military surveys indicate that service members worry that receipt of mental health care may limit their deployability.References1 Nevin RL : Low validity of self-report in identifying recent mental health diagnosis among US service members completing Pre-Deployment Health Assessment (PreDHA) and deployed to Afghanistan, 2007: a retrospective cohort study. BMC Public Health 9:376, 2009. DOI 10.1186/1471-2458-9-376 Crossref, Medline, Google Scholar2 Nevin RL : Mefloquine prescriptions in the presence of contraindications: prevalence among US military personnel deployed to Afghanistan, 2007. Pharmacoepidemiology and Drug Safety 19:206–210, 2010 Crossref, Medline, Google Scholar3 Warner CH , Appenzeller GN , Parker JR , et al.: Effectiveness of mental health screening and coordination of in-theater care prior to deployment to Iraq: a cohort study. American Journal of Psychiatry 168:378–385, 2011 Link, Google Scholar FiguresReferencesCited byDetailsCited byNone Volume 62Issue 7 July 2011Pages 805-806 Metrics PDF download History Published online 1 July 2011 Published in print 1 July 2011