In June 2007, pursuant to Congressional order, a Department of Defense Mental Health Task Force issued a report entitled, "An  Achievable Vision," assessing the mental health needs of the Armed Forces and the ability of DoD to meet those needs.  It came as no surprise to veterans advocates when the Task Force reported that "occupational exposure" in military service can cause hidden injuries for which DoD is responsible for diagnosing correctly and treating appropriately, such as Post Traumatic Stress Disorder and non-penetrating Traumatic Brain Injuries.

Because these injuries are not outwardly visible ("to the naked eye"), they have to be identified by how they manifest themselves in post-deployment behavior.  Essentially, according to DoD, symptoms of PTSD and mild to severe TBI make it difficult for affected servicemembers to comply with and conform to the military's strict code of conduct.  The Task Force called this "disinhibitory" behavior and gave examples such as:  a) difficulty controlling one's emotions; b) problems completing complex tasks and managing complex stimuli; c) self-medicating with drugs and alcohol; d) engaging in thrill-seeking/reckless/high-risk behavior; and, e) disruptions in sleeping that further causes a decline in job performance.

As a result, the DoD Mental Health Task Force recommended (Recommendation 5.1.4.3) that servicemembers who are engaging in a pattern of misconduct (i.e., "disinhibitory" behavior) and who have been exposed to conditions that could cause PTSD and/or TBI (such as combat), should be referred to a Medical Evaluation Board (if at all possible) as opposed to being involuntary and administratively discharged from the military.

DoD stated that in these cases the servicemember could be suffering from a service-connected disability (PTSD, TBI) and thus the military had a responsibility to ensure that this disability was treated, from DoD to the Department of Veterans Affairs.  Without a medical evaluation board (and subsequent medical discharge from DoD), there is no way to ensure continued treatment  for the servicemembers combat injuries by the DVA--especially for a pattern of misconduct discharge.  Meanwhile, veterans advocates know that undiagnosed or untreated PTSD and/or TBI puts veterans at an increased risk of suicide, unemployment, drug and alcohol abuse, partner violence, and homelessness.

What's the point of DoD recognizing that PTSD/TBI causes misconduct when it doesn't do anything to stop "pattern of misconduct" discharges for soldiers with PTSD/TBI?  How can it say this is evidence of a service-related disability only to use this evidence to deny servicemembers access to benefits for that disability?  I like to call this the Military Misconduct Catch-22.

Recently the Army Times covered the discharge of Sgt. Adam Boyle.  Boyle served in the Army for eight years, including two tours in Iraq.  After his second combat tour, he returned to Ft. Bragg in the middle of 2007 and began self-medicating with alcohol.  Shortly thereafter, he realized that he had PTSD and he began seeking treatment for it.

Predictably, Sgt. Boyle was having problems "complying" with the "military's strict code of conduct."  After a series of disciplinary actions for mostly alcohol-related incidents, Sgt. Boyle was diagnosed with chronic PTSD by a medical evaluation board.

One month later, Sgt. Boyle was kicked out of the Army with a "pattern of misconduct" discharge by the commanding General, the singular deciding authority on his case.  Now Sgt. Boyle has to pay back an $18,000 re-enlistment bonus and fight for VA benefits (which he won't likely receive with a pattern of misconduct discharge).  Most importantly to his family, however, is continuing his mental health care and psychiatric medications (of which he is on several).  How can he do that without an honorable discharge?

Lest you think this is an isolated incident, Fort Hood is currently discharging a soldier, Spc. Muff, for his post-deployment "pattern of misconduct."  Unlike Boyle, however, Spc. Muff has been diagnosed with a TBI as well as PTSD.

Am I the only person who read "An Achievable Vision?"  I am not advocating for the lack of disciplinary action altogether, but certainly if the DoD and the Department of the Army are going to recognize PTSD as a combat injury, then it needs to treat it accordingly.

 Consider all the hoopla about the DoD increasing the disability rating for PTSD.  I am unimpressed.  Odds are, if you have PTSD, they are probably going to kick you out for a pattern of misconduct so you won't be getting paid disability anyway.