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I thought it would be interesting to hear others' thoughts on this topic.  The Iraq and Afghanistan Wars have brought issues of military service and mental illness to the fore, with high rates of post-enlistment diagnosis.  

About five years into the Iraq War, I looked into the possibility of serving (in the U.S. Navy).  I was asked what medications I was taking (no questions about diagnoses, though I was BPII).  I said I was on Paxil , and was told that I would need to be off that medication a full year before I could enlist.  Later, after my medication regime had changed, this time to Lithium, I thought I would check again, less because I thought Lithium would be more acceptable and more because I wondered if perhaps the policy had changed--for want of troops and because that policy seemed to incentivize untreated mental illness in  a war zone.  The policy had not changed.

Some thoughts for discussion with anyone who cares to discuss them:

 

I believe that the military has a responsibility to protect its soldiers and noncombatants.  I believe the consensus of the mental health profession is that serious mental illnesses are not temporary diagnoses, which would seem to make electing to forgo life-saving medication medically unsound.  The U.S. military might be said to economically incentivize this course of action.  Furthermore, although many mentally ill soldiers are not a risk to others, some are.  Knowingly putting persons less-well-equipped to handle stress into situations of high-stress seems irresponsible.  And then we have situations where soldiers are known to be mentally ill, don't receive proper treatment, and go on to commit crimes.  They are punished as though the factor of mental illness has no mitigating power, and as though the U.S. military has no culpability in employing mentally ill soldiers and in not doing enough to remove them from combat situations.  And then there's my friend, who served two tours of duty in Iraq, was awarded the purple heart, and has had great difficulty in getting mental health assistance through the VA.  These are all instances in which the military might be said to be failing our (mentally ill) people. (I can hunt down specific sources for you if you'd like them.)  

Are their still ways for our people to serve?   I'm good at languages, for example, and at medical things.  And aside from my mental illness, I'm a rather athletic person.  I'm a good team player--able to give orders and to take them, able to get results.  My medication makes me better able to do these things.  Why would I want to leave them at home?  We best know our own diseases.  We don't want to hurt others.  We best know how to protect others from our own diseases.  I don't like guns.  They're loud and they hurt my shoulder.  Maybe if these were saber days we'd be having a different conversation.  I don't understand why, when I can go out my door right now and run five miles, do "boy" push-ups, have the respect of men when I speak, and have a decent stack of letters and "W's" and "sportsmanship" awards from high school, that when I say "put me in, coach," I can't even get an audition for a theater from which it seems like everyone is walking away.  What do you think?  Should our people be given an audition?  Do our illnesses necessarily make us a military liability?  And how is targeting mental illness medications in war zones not a terrible, terrible idea?     

Edited by Inanlae
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There are all sorts of medical issues that disqualify one from service, not just mental illness issues. Since you mentioned lithium - you need regular blood tests, something that cannot be guaranteed, even if you are able to get the meds.

Recruiters who tell people if they're off their meds for x time frame they'll be able to join are a problem. It is often disingenuous and can cause harm. I totally agree with that.

The bottom line is there's no way to guarantee one will be able to get their meds and the price of running the risk of deploying an individual who has a greater chance of needing a medevac can put an entire crew at risk. There are other issues that cone into play as well - in some countries that you might deploy to your psych meds (or various other meds) are illegal. In some cases, having a mental illness dx prevents you from obtaining a security clearance classification. Or with weapons handling.

In my opinion, joining the military isn't really about how many push ups you can do, how far you can run, how smart you are, how much you love your country, or even your ability to follow orders. It is how well you can survive the process of being broken down and remade. Breaking down someone already fragile usually has the potential for a lot of bad outcomes.

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I was medically discharged from the Navy in my early 20s.  I can assure you that getting any kind of meds ANYWHERE is not an issue.  The United States Military has a logistics capability that would blow your mind. Seriously.

 

The Navy said that allthough my reviews were top-notch I could no longer serve.  Its not the medecine, its the fact that even under peace time service (the persian gulf has been a combat zone since 1991.  FYI ) I could be a danger to my self and my entire crew.  What would happen if a critical piece of equipment failed on my watch?  Like the steering gear, or emergency compressed air, etc..

 

My ship carried 2000 marines and 1200 sailors.  Would you risk all those lives so one sailor could serve?

 

 

You can PM me with any questions.  I have lots of sea stories. :)

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I absolutely think the military is justified to reject mentally ill people from service. Apart from the issue that military service, even in a translator role, can mean being left in situations where there is no access to medical care (as others have brought up) there are countless other issues. You are on Lithium, so dehydration is a major danger for you, I don't think the military could guarantee access to enough water in every situations. And then there is the issue of what military service entails: lack of sleep, high-stress situations, no possibility to withdraw to a calm environment, basically all the things (apart from a good routine) that we as mentally ill people need to avoid to function. From what I understand, military service is so stressful that many previously not mentally ill people develop problems, I highly doubt it will be suitable for chronically mentally ill people (as in, those suffering from BP, schizophrenia, maybe MDD).

 

I don't think this is primarily about mentally ill people being dangerous, as in uncontrollably violent, because the vast majority clearly are not, it is about the fact that some conditions make people unsuitable for certain jobs.

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There are a lot of jobs that are at heart service to the people of one's country without as many of the potential hazards that people have outlined here.  Maybe something else could be a possible alternative means of supporting, protecting, promoting the well being of fellow Americans even if it's not possible to do it by way of the Navy?

 

For example, off the top of my head -  

 

* paramedic

* police officer (although not liking guns might be an issue with that)

* AmeriCorps volunteer

* firefighter

* court interpreter or language line interpreter

* civilian employee of the Department of Defense

* 911 operator

 

I don't know whether having a mental illness disqualifies a person from any of the above jobs, but it seems less likely, and they are all important roles in serving the American people.

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My husband can't be in the military because he has epilepsy. He never has been that put out by it. Relieved is more like it.

 

I don't want to be included in your sobriquet "our people." We aren't an ethnic group or religious organization. It implies a uniformity that is absolutely not there.

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Thanks for the thoughtful feedback, guys.  I agree that not enlisting soldiers with mental illness is prudent.  Helloheartbreak, I think your rendering is especially poetic:  "It is how well you can survive the process of being broken down and remade. Breaking down someone already fragile usually has the potential for a lot of bad outcomes."  I'm inclined to agree to in general, and that erring on the side of not breaking is best.  But what if I know my strength?  I think sometimes in being broken there is also strength--like being refined in a crucible.  It's a bit hard to explain, but there are ways in which I have been broken such that I know some pains can never touch me now, and I know that some fears could never daunt me in the doing what I believe to be right.  Revolution724, you're right about there being non-military jobs for people with MI.  I'm pursuing medical studies now, though when it comes to healthcare the team is bigger than the U.S., the team is humanity.  And though, VelvetElvis, helloheartbreak, and rachael, the prospect of going through withdrawal in some outposty place is terrifying, I hope it won't keep me from serving somewhere if I'm needed.  I see the days I've survived with my disease as a gift.  If I can't spend them serving my country, then even better to spend them in fighting disease.

Destro, my uncle served in the Gulf and my one of Grandpas was in the Navy during Korea.  He could do a swan dive from the mainmast into the ocean.  He was responsible for something to do with a testy missile-launcher.  I know I would space out with something like that.  Definitely not the place for me.  Sea stories welcome.  Haul away, Joe!  : )

Queen of Ergots, I'm glad your husband didn't have didn't have to be in the military, though sorry he had to have epilepsy for it to be so.  I don't believe anyone should have to be in the military without their consent.  

Apologies for roping you into "our people."  I know very few MI people, especially in "real life."  This site gives me a sense of community that I don't have in real life.  I believe that many aspects of public life are inherently discriminatory against persons with mental illness--i.e., "Please account for all of the periods in your C.V. in which you were unemployed for more than two months."  I answered that question honestly once and I'll never do it again.  You can't get healthcare because you have gaps in your resume from when you were symptomatic.  You can't get Medicaid because you've worked since your initial diagnosis.  Ditto, disability.  Good luck getting and holding a job unmedicated long enough to get healthcare, let alone FMLA.  I know it isn't just me.  As a healthcare worker, when I can work, I have had patients sit across from me, through the HIPAA screen, who don't know my diagnosis, but I can see that they and their families are struggling through the same things too.  The relationship between mental illness and poverty, and the relationship between mental illness incarceration, are too cozy.  Those people do I call my people.  And I will forever call them my people until they can take their fight for life into the light and not keep it the furtive fight in the shadows that it is now.  I do feel a certain protectiveness towards all persons with diagnoses in this constellation.  I am sorry if I offended you.  I certainly did not mean to imply homogeneity among persons with MI, or that a diagnosis in any way defines the person who bears it.  I know for me it's bit more than tinsel.  It cuts more to the core of me.  I hope this is not the case for most.

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I can assure you that getting any kind of meds ANYWHERE is not an issue. The United States Military has a logistics capability that would blow your mind. Seriously.

I get what you're saying, but there are also a lot of special circumstances - my husband is an active duty submariner - sometimes things happen, they get their mission unexpectedly extended due to whatever is happening in the world, and when that happens they're underwater with whatever they have - they're not going to surface to get a drop for someone's xyz med. Half the time they're not even going to be able to send out a message saying hey we've been extended. It's that kind of unpredictability that I think is one major reason why they have to actively try to screen out for so many conditions. It's a hard reality sometimes, I've known people who had to get medically discharged for various things and it wasn't what they wanted but they understood the reasoning and they'd never want to be the one to put others in jeopardy. It's an interesting topic, because it is sometimes so difficult to find where the line should be.

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I personally think mental illness and military just don't mix. For so many reasons, many of which have already been discussed. I have a brother in the infantry in the army. He's been to Iraq (one of the first in as a matter of fact) and did like 3 or 4 consecutive tours in Iraq. He received no break really. He's not mentally ill and it seriously messed with him mentally. I could get no help for him. His CO wouldn't do anything, the army in general wouldn't do anything and he just got worse and worse. The army's general response was "suck it up and move on, it's part of war".

 

For me, I don't do well with stress. I can handle small doses for short amount of times, but anything major or extended will send me straight into an episode. Even during peace times, the military is HIGH stress. I'd be sick more than I was well.

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  • 2 weeks later...

I have been dx'd with bipolar I disorder since I was 5 and I was told I couldn't go.  I would have loved to go over and fight when I was manic.  Most people come back with bad PTSD and it is a different world, culture and the norms are different in that situation and I can handle that part of things because I am fluent in 3 languages and culture and norms are part of knowing languages and cultures so I can adapt easy like that but I was denied.  

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I have been dx'd with bipolar I disorder since I was 5 and I was told I couldn't go.  I would have loved to go over and fight when I was manic.  Most people come back with bad PTSD and it is a different world, culture and the norms are different in that situation and I can handle that part of things because I am fluent in 3 languages and culture and norms are part of knowing languages and cultures so I can adapt easy like that but I was denied.  

 

Part of the deal with signing up for the armed forces is that no matter what they say you're going to do and what you train for, if shit hits the fan they expect you to be able to pick up a gun and fight.  You might be great with languages and cultures when you're manic, but could you really deal with firing a rifle at living targets on full auto for days while you're under fire yourself?  Mania + machine gun is not a good combination.  

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