Across the military, service members can get a one-on-one session with a psychologist by four different paths. Ideally, they voluntarily seek treatment through a confidential appointment. Service members can also be referred by a primary-care provider or receive a mandatory evaluation as part of a routine screening for certain specialized jobs, such as drill sergeant or recruiter. And in some cases, a commander may ask a psychologist to perform a fitness-for-duty evaluation on a service member that may pose a danger to self or others.
“That’s the way you don’t want to be referred,” says Capt. Carrie Kennedy, PhD, division chief of the Psychological Health Center of Excellence and the clinical psychology specialty leader for the Navy. “Typically, someone has behaved in a way—usually involving safety and judgment—which alarmed the command sufficiently that they’ve asked a mental health provider to decide whether or not they are fit for duty.”
The clinician then conducts a comprehensive mental health evaluation and provides feedback to the service member and commanding officers, which may include a recommended treatment plan, a limitation of duties or a permanent medical discharge from the military. Kennedy says that service members who refer themselves for care early, when symptoms are mild and haven’t caused safety concerns, are much less likely to have duty-limiting recommendations compared with those who are referred by a commander.
