One of the more disturbing trends in American society over the past several years has been the rise in mental health issues among the country’s youth and young adults. As a recruiter and employer of young Americans, the United States armed forces should not only pay close attention to this phenomenon, but start planning now for how to handle a force that is soon to be populated by an unprecedented number of individuals with mental health challenges.
While some officials believe that individuals with mental problems will simply be found to be ineligible through the military’s pre-entry screening process, this is unlikely: 80 percent of Americans age three to seventeen with “mental, emotional or behavioral disorders in a given year” go undiagnosed and untreated. That leaves 12 million young Americans who are never diagnosed or treated for their serious mental health challenges—12 million young Americans who will appear on paper and quite possibly upon examination as fully eligible for entry into military service.
Ironically, it is two of the military’s great strengths that make it uniquely exposed to this rapidly growing problem: it accepts individuals from a broad swath of society, and it accepts large numbers of young individuals directly into its ranks (an unusual characteristic for an established, professional organization). Some 84 percent of Marine recruits are under 20 years old, and more than 60 percent of the Corps is under 24 (40 percent of the Navy is under 24). Across the services, 45 percent of all members (and nearly 52 percent of enlisted members) are under 25. The American military is young, and its mental health statistics will skew toward the statistics of younger citizens.
What, then, can be done to prepare for the coming mental health challenges for the armed services? An update to screening standards with an eye to statistically indicated mental health issues would be the first step: the military should bolster the psychological components of pre-entry medical examinations. In addition, mechanisms for treating various mental health problems among already-serving individuals need to be improved—perhaps some of the programs introduced to deal with post-traumatic stress in recent years could be examined to be adjusted and applied to cases of individuals who entered the service with pre-existing issues.
Beyond these measures to address the needs and issues of individuals, the military must pay attention to overall force readiness. As anyone who has been a supervisor at a unit dealing with a difficult mental health case can attest, the medical bureaucracy and processes in place to support appropriate transfer of individuals to care and then on to reassignment (or discharge, as appropriate) are often burdensome. They require, too, the diversion of resources from pressing operational, training, or other unit tasks (all while leaving a billet encumbered by a non-performing individual). Moreover, mental health issues often manifest themselves in behavior.[1] While the military has well-established disciplinary processes to address unsatisfactory behavior, it also has justifiable prohibitions on punishing an individual for health problems. Without the support of a robust and dynamic mental health program within the armed forces, commanders can find themselves in a taxing and dangerous limbo: giving a non-performer a medical “out” is prejudicial to good order and discipline, just as disciplining someone for a genuine medical situation is unethical. Targeted improvements to personnel policies addressing individuals suffering from mental health issues are needed, and they must include expedited resolution of cases to allow operational commanders to move forward with their missions.
It is impossible to deny that the mental health problems of America’s youth are soon to be the mental health problems of the American military. It is incumbent upon responsible leaders and military medical professionals to act now to prepare for that reality.
Endnotes
[1] Mayo Clinic Staff, “Mental Illness,” The Mayo Clinic, updated 2019.
