The Nature of
Personality
Disorder
Discharge Policy
In The United
States
Social Work Implications &
Recommendations
Introduction
 Amy
Hatcher (Leffingwell), MSW
 Background:
All of the service members inappropriately discharged
on the basis of Personality Disorder since 2001 remain
unable to access the disability benefits and free
health care they are due. (VVA, 2010)
 Statistics
The Problem
Because Personality Disorders (PD) are considered pre-existing conditions by the military, all
benefits are denied to the veteran based on this premise (Personnel Separations, 2003).

Personality Disorder: an “Enduring pattern of inner experiences and
behavior that deviates markedly from the expectations of the
individual’s culture, is pervasive and inflexible, has an onset in
adolescence or early adulthood, is stable over time, and leads to
distress or impairment” (APA, 2000 p. 685).
 Post-traumatic Stress Disorder: the “Development of characteristic
symptoms following exposure to an extreme traumatic stressor involving
direct personal experience of an event that involves actual or
threatened death or serious injury, or other threat to one’s physical
integrity; or witnessing an event that involves death, injury, or a threat to
the physical integrity of another person; or learning about unexpected
or violent death, serious harm, or threat of death or injury experienced
by a family member or other close associate” (APA, 2000 p. 463).
 Adjustment Disorder: a “psychological response to an identifiable
stressor or stressors that results in the development of clinically significant
emotional or behavioral symptoms. The symptoms must develop within 3
months after the onset of the stressor(s)” (APA, 2000 p. 679).
Military Culture
 What
is it? Does is perpetuate MH stigma?
 Weakness?? Stress/pressure/trauma=drug
abuse/DV/mental health etc…
 As strength?
Research Questions
 What
actions have been taken since the
last hearings held in 2010, to investigate all
PD discharges?
 What is the status of the PD discharge
policy at present.
 What outreach efforts are being made,
and by whom, to educate veterans of
their rights?
Methods

There were three methodological stages in
this study:


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(1) Identification of government documents
relevant to PD discharges, informed by
literature,
(2) Deductive analyses of key points/concepts
found within the documents, pooled into
summaries,
(3) Recommendations for advocacy and
empowerment to enhance professional’s
practice competency while working with
veterans.
Research Results
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1. Confusing eligibility and benefit procedures of
both the Department of Defense (DOD) and the
Veterans Administration (VA) are typical barriers
for veterans and service providers.
2. There is an apparent lack of cohesion and
cooperation attested to through poor
communication between the VA and DOD.
3. There is no uniform set of policies within the
DOD, nor are the required discharge regulations
for PD being followed in the military service
branches.
4. There is no evidence of further Congressional
oversight regarding PD discharge problems.
Implications
 Micro:
individual- Minority? On top of Vet
status, on top of MH status.
 Mezzo: families/community
 Macro: Policy
 Trickle down effect (where does MC play
a role?)
Education
Military Cultural Competence
Description
 This interactive online training course provides an
overview of military culture to include organizational
structure, rank, branches of service, core values, and
demographics as well as similarities and differences
between the Active and Reserve components. It is
intended to assist civilian mental health providers in
better understanding, communicating and
effectively interacting with Service members and
their families.
 http://deploymentpsych.org/training/trainingcatalog/military-cultural-competence
Education con’t…

2010 hearing on Personality Disorder
Congress:
http://archives.veterans.house.gov/hearings/hearing.aspx?NewsID=2266

Agency Involvement
Vietnam Veterans of America:
http://www.vva.org/ppd-faq.html
Future Areas of Study
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Where are the personality disorder
discharged veterans now?
What services are available in the regions
where they reside?
Are they getting needed services?
Do they know what services they can get?
What rates of servicemembers are still being
discharged with PDs?
Has the DOD complied with Congress to find
and update veterans regarding services?
References
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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders. (4th ed.). Washington DC: American Psychiatric Association.
Hsu, J. (2010). Overview of Military Culture [Powerpoint Slides]. Retreived from VA Palo Alto
Health Care System.
Kors, J. (2007, April 09). Thanks for nothing: How specialist town won a purple heart
and lost his benefits. The Nation, Retrieved from
http://www.joshuakors.com/part1.htm
Kors, J. (2010, October 15). Specialist town takes his case to Washington. The nation,
Retrieved from http://www.joshuakors.com/part2.htm
Larsson, H., Broman, L., & Harms-Ringdahl, K. (2009). Individual risk factors associated
with premature discharge from military service. Military Medicine, 174(1), 9-20.
O'Leary, M. E. (2012, March 22). U.s. military illegally discharging veterans with personality
disorder, report says. Denver Post. Retrieved from
http://www.denverpost.com/breakingnews/ci_20235680/u-s-military-illegallydischarging-veterans-diagnosed-personality
Personality Disorder Discharges: Impact on Veterans Benefits: Hearing before the
Committee on Veterans Affairs, 111th Cong. 97 (2010) (testimonies of: Berger, T.,
Buyer, S., Draper, D., Fairweather, A., Filner, B., Hebert, L., Kors, J., Luther, C., Sullivan,
P., Zeiss, A.)
Personnel Separations, Active Duty Enlisted Administrative Separations, (635-200),
Department of the Army (2003).
US Department of Commerce. (2013, June 27). State & county quickfacts. Retrieved from
http://quickfacts.census.gov/qfd/states/06000.html
Vietnam Veterans of America. (2010). Personality disorder discharges- faq. Retrieved from
http://www.vva.org/ppd-faq.html