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ARLINGTON, Va. — Servicemembers who are discharged from the military because of personality disorders are entitled to medical care, according to senior Pentagon health officials.

“If we let them in, we can’t just cut them loose and throw them out,” Ward Casscells, the Pentagon’s assistant secretary of Defense for health affairs, said Thursday.

“I feel our responsibility is to not blame them for the fact that they wanted to serve, and the military didn’t bring out the best of them like it does for most people,” Casscells said during a two-hour roundtable in the Pentagon with senior mental health officials.

Since October 2001, more than 22,500 servicemembers from all branches of the military have been discharged under Chapter 5-13 of the Army’s separations manual — “separation because of personality disorder.”

A 5-13 discharge may leave a veteran ineligible for disability pay and benefits. Some may also be required to return some or all of their re-enlistment bonuses.

Veteran’s advocacy groups and members of Congress have alleged that the services are misusing the personality disorder diagnosis to avoid paying for long-term health care for combat veterans.

Casscells said he began to look into personality disorder discharges in July, when news reports began spotlighting such discharges, and members of Congress began asking him if the services are misusing the diagnosis to avoid paying for long-term health care for combat veterans.

Casscells said that he directed a department review of 22,500 cases, and an early sampling showed that while 85 percent of the diagnoses were correct, 15 percent “needed more work.”

“Where there are mistakes, we will fix them” he said.

Army Col. Joyce Adkins, director of psychological health and strategic operations, said Thursday “we are still plowing through [all 22,500] cases” to review each.

Overall, the military services are a long way from having an ideal way to screen for personality disorders, according to Air Force Lt. Col. Michael Jaffe, National Director for the Defense and Veteran’s Brain Injury Center.

The problem is that such disorders can cross symptoms with, mimic, or be exacerbated by depression, traumatic brain injuries and post-traumatic stress disorder suffered in combat, Jaffe said.

The services have a number of pilot pre- and post-deployment screening programs under way — such as the 101st Airborne’s mental health assessment at Fort Campbell — that should help provide helpful baselines in separating personality disorders from combat-related issues, Jaffe said.

“But all of those [pilot] programs still haven’t come up with a definitive answer that this is a better way to go forward,” Jaffe said.


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