Defense Health Care: Additional Efforts Needed to Ensure Compliance with Personality Disorder Separation Requirements
GAO-09-31
Published: Oct 31, 2008. Publicly Released: Oct 31, 2008.
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Highlights
At DOD, a personality disorder can render a servicemember unsuitable for service. GAO was required to report on personality disorder separations and examined (1) the extent that selected military installations complied with DOD's separation requirements and (2) how DOD ensures compliance with these requirements. GAO reviewed a sample of 312 servicemembers' records from four installations, representing the Army, Air Force, and Marine Corps, that had the highest or second highest number of Operation Enduring Freedom or Operation Iraqi Freedom servicemembers separated because of a personality disorder. The review is generalizable to the installations, but not to the services. GAO also reviewed 59 Navy servicemembers' records, but this review is not generalizable to the installation or the Navy because parts of the separation process could have been completed at multiple locations.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | To help ensure that DOD's requirements for personality disorder separations are met and to help increase assurance that these separations are appropriate, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to direct the Secretaries of the Army, the Air Force, and the Navy and the Commandant of the Marine Corps to develop a system to ensure that personality disorder separations are conducted in accordance with DOD's requirements. | In its comments to this report, the Department of Defense (DOD) concurred with this recommendation. In a January 2009 memo, the Under Secretary of Defense directed the military services to provide a report on their compliance with DOD's personality disorder separation guidance for fiscal years 2008 and 2009. Specifically, the compliance reports were to be based on, at minimum, a random sampling of at least 10 percent of all personality disorder separations for the respective service for the designated fiscal year and each case file sampled was to be checked for compliance with DOD's personality disorder separation requirements. Additionally the compliance reports should include the total... number of personality disorder separations for the applicable fiscal year, and the total number of personality disorder separations that were for servicemembers who had served in immanent danger pay areas since September 11, 2011. Overall, the fiscal year 2008 compliance reports showed that three out of the four services were not in compliance with any personality disorder separation requirements. Each military service reported its findings of compliance based on its review of a sample of personality disorder separations; the sample size for each service ranged from 10 to 35 percent of the respective service's total personality disorder separations for fiscal year 2008. In addition, in a summary of the services' compliance reports, the Office of the Under Secretary of Defense stated that the military services' compliance with the additional personality disorder separation requirements that DOD added in 2008 was generally well below 90 percent. The Office of the Under Secretary attributed this level of compliance to the services not revising their own requirements to reflect DOD's changes until after fiscal year 2008 was complete. DOD's revisions to its personality disorder separation requirements became effective August 28, 2008. For fiscal year 2009, the military services improved their compliance with DOD's personality disorder separation requirements with sample sizes ranging from 10 to 45 percent. Specifically, in fiscal year 2009, only one of the military services was compliant with less than four of DOD's personality disorder separation requirements. The military services also stated that they expected their compliance with DOD's requirements to increase after fiscal year 2009, as all of the military services revised their own requirements to match those of DOD by August 2009.
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| Department of Defense | To help ensure that DOD's requirements for personality disorder separations are met and to help increase assurance that these separations are appropriate, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to ensure that DOD monitors the military services' compliance with DOD's personality disorder separation requirements. | In its comments to this report, the Department of Defense (DOD) partially concurred with this recommendation. In the January 2009 memo, DOD required the military services to provide a plan for correcting compliance deficiencies if the services found that their compliance with any DOD personality disorder separation requirement was less than 90 percent. According to their fiscal year 2008 reports, each service has planned or taken corrective actions to improve compliance. For example, the Army's report stated that as of March 13, 2009, the Army's Office of the Surgeon General will review all personality disorder separation cases to ensure that each contains the required documentation....
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