The Management of Fitness for Duty in the United States Military

This chapter explains how unfitness for duty and impairments from mental disorders are handled in the U.S. military. It focuses on behavior consistent with antisocial personality disorder or adult antisocial behavior as defined in the Diagnostic and Statistical Manual, Fifth Edition. All branches of the U.S. military screen candidates in order to prevent those individuals with major physical and mental health conditions from joining. Each basic trainee undergoes a criminal background check. The results of these investigations tend to become known while the member is in basic training. Each branch of the armed forces uses guidelines to manage members with major psychiatric illness. The guidelines for the army, navy, and air force are, respectively, Army Regulation 40‐501, Manual of the Medical Department Chapter 15‐6, and Air Force Instruction 48‐123. Personality disorders begin in adolescence or early adulthood and are considered by the military to have Existing Prior to Service.