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    Many US soldiers turn to alcohol or drugs, but when they seek help from the Army’s substance-abuse program they are often turned away.

    Psychiatrist: US Doesn't Need People 'Hearing Voices' Leading Troops Into Battle

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    The US army has expanded its waivers for recruits with a history of particular mental health issues. People with a history of self-injuring, bipolar disorder, depression and addiction are now free to sign up. Dr. Elspeth Ritchie, a former chief psychiatrist in the army explained why such a decision has been made and what the risks of it are.

    Sputnik: What’s your general take on the reports? Is there any reason for concern or is it rather a victory for people who have had historical mental disorders?

    Dr. Elspeth Ritchie: When times are tough for the military, and that’s usually in the time of war, they tend to take people more readily. When the economy is strong, people are less likely to join the military. On the other hand, when the military is having a hard time getting recruits, they are more likely to offer more waivers. So, with that as the background, it is neither a victory nor a defeat. I would say more a historical and current reaction to: “It’s harder for us to get recruits, therefore we need to grant more waivers.”

    Sputnik: So, more of an emphasis on the economics rather than on anything else?

    Dr. Elspeth Ritchie: Yes, economics, and we have now been at war for 16 years, since 9/11, so this, I believe is an effort to widen the pool of recruits.

    READ MORE: US Army Lifts Ban on Recruits With Mental Health History

    Sputnik: What risks can recruits with mental disorders pose? You've obviously got embedded knowledge and history, being a colonel in the army until 2010. What are the historic issues you had with people with mental disorders from life before the army?

    Dr. Elspeth Ritchie: Let me break out mental disorders for you because not all mental disorders are the same. Schizophrenia and bipolar disorder are clearly disqualified. On the other hand, many people who are in the military have, for example, a history of post-traumatic stress disorder or of depression. Having said that, the risk of letting somebody in when you know that they have a mental disorder makes higher the risk that the disorder will recur and may impair their ability to do their job.

    READ MORE: Mandatory Mental Health Screenings For US Armed Forces Take Effect

    Sputnik: How can a poor mental state affect a soldier’s performance in conditions of war? Does it increase risks of such a person committing a crime against soldiers or civilians, for example?

    Dr. Elspeth Ritchie: It does. Most often, what we see is suicide attempts or completed suicides, and it is something that the military has been wrestling with. But certainly, if someone is "hearing voices", you don't want them leading the troops into battle. And two very publically known examples of that are Sergeant Bowe Bergdahl –  I have not examined him personally but by all accounts he had a history of "hearing voices," he wandered off the base and was held by the Taliban for five years and many of his fellows were injured while they were looking for him – and the other dramatic case is that of Staff Sergeant Bales who shot up the villagers in Afghanistan and appears to have been suffering from at least temporary mental illnesses and psychotic episodes.

    Sputnik: How can serving with mentally ill people affect the morale of mentally healthy soldiers?

    Dr. Elspeth Ritchie: Many soldiers have post-traumatic stress disorder and can continue to serve. So I would not lump all disorders together. But on the other hand, if someone is caught "acting crazy," if they are bizarre, nobody wants to follow that person into a battle.

    Another question which you have not asked but I will speak briefly about is what will it cost to a taxpayer, because if someone comes on an active duty and then needs to be medically discharged for mental illness, that is usually expensive for the taxpayer. That is perhaps a small consideration, but certainly you don't want to bring in people with any kind of pre-existing severe illness, whether it is physical or mental. And that is part of the reason that we have accession standards, the standards you have to meet implying the question of granting a waiver to somebody who does not meet the accession standards is such a critical one.

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    army recruits, mental disorders, US Armed Forces, US Army, Elspeth Ritchie, United States
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