Apr 8, 2010
2
0
0
Status
Pre-Medical
I am a junior in HS, and this time last year, I OD'd on a suicide attempt and was diagnosed with depression while at the hospital. In March 2010, I was taken off of my medication after my current outpatient mental health physician noted that it seemed to be a 'one-time isolated event'.The 'depression' has not hindered me in any way, including high school performance as I am in the top 10% of my class of ~350 w/ a GPA of 4.5. My physician has said that he supports me 100%, and will do whatever necessary to help me in regards to HPSP or the USUHS.

Seeing that this is behind me and I have ~5 years before I apply for HPSP or USUHS, what are the chances of a waiver if I continue with no more 'black marks' on my record and have a formidable GPA/MCAT score in college?

Thanks :)
 

DrMetal

To shred or not shred?
Lifetime Donor
10+ Year Member
Sep 16, 2008
1,473
193
281
Status
Resident [Any Field]
I am a junior in HS, and this time last year, I OD'd on a suicide attempt and was diagnosed with depression while at the hospital. In March 2010, I was taken off of my medication after my current outpatient mental health physician noted that it seemed to be a 'one-time isolated event'.The 'depression' has not hindered me in any way, including high school performance as I am in the top 10% of my class of ~350 w/ a GPA of 4.5. My physician has said that he supports me 100%, and will do whatever necessary to help me in regards to HPSP or the USUHS.

Seeing that this is behind me and I have ~5 years before I apply for HPSP or USUHS, what are the chances of a waiver if I continue with no more 'black marks' on my record and have a formidable GPA/MCAT score in college?

Thanks :)
If it truly was a one time event, if something like that never happens again and if you're all clear of meds (both the Rx and recreational kinds) . . . then you should be fine. There's plenty of people currently in the military that had such one-time episodes in their past.

Now, if it happens again, thus establishing a habitual pattern, then your situation might be a show-stopper as far as the military route is concerned.

Just take care of yourself in college. It can be a tough time, especially if you're a premed. But it can be a fun time too if you relax and unwind every once in a while. And if you catch yourself craving 'old habits' or feeling depressed, get yourself help right away (it can be as easy as just talking to a mental health counselor, probably wont get noted on your medical record . . .nobody has to know about it if its just a brief counseling session, and better to nip the problem in the bud). Good luck . . .
 
Apr 8, 2010
2
0
0
Status
Pre-Medical
Would this (suicide attmpt. / relatively short diagnosis of depression) prevent me from obtaining the security clearance required for military officers?
 

DrMetal

To shred or not shred?
Lifetime Donor
10+ Year Member
Sep 16, 2008
1,473
193
281
Status
Resident [Any Field]
Would this (suicide attmpt. / relatively short diagnosis of depression) prevent me from obtaining the security clearance required for military officers?
No, again if it's just a one time thing. When the time comes, just be honest and truthful about what happened.
 

The White Coat Investor

Practicing Doc and Blogger
Partner Organization
15+ Year Member
Nov 18, 2002
5,166
2,280
381
www.whitecoatinvestor.com
Status
Attending Physician
You're in high school and thinking about signing away 15 years of your life? Are you even 15?

Give it a few years before you starting worrying about stuff like this, it'll make you depressed.

The most likely thing is you'll decide you don't want to be a doctor your freshman year in college.
 

AF M4

Junior Member
10+ Year Member
7+ Year Member
Jul 6, 2006
884
4
141
Status
I am a junior in HS, and this time last year, I OD'd on a suicide attempt and was diagnosed with depression while at the hospital. In March 2010, I was taken off of my medication after my current outpatient mental health physician noted that it seemed to be a 'one-time isolated event'.The 'depression' has not hindered me in any way, including high school performance as I am in the top 10% of my class of ~350 w/ a GPA of 4.5. My physician has said that he supports me 100%, and will do whatever necessary to help me in regards to HPSP or the USUHS.

Seeing that this is behind me and I have ~5 years before I apply for HPSP or USUHS, what are the chances of a waiver if I continue with no more 'black marks' on my record and have a formidable GPA/MCAT score in college?

Thanks :)
Hmm. Please follow below step-by-step instructions for ultimate happiness:

1. Chill.
2. Acquire prom date.
3. Acquire large supply of hard liquor from whichever of your friends' parents is most liberal.
4. Use protection.

....


15. Arrive at college.
16. Rush.
17. Join frat.
18. Drink heavily.
19. Acquire significant other(s)
20. Use protection.
21. Drama.
22. Break up.
23. Repeat steps 18-22 until "you're tired of the games."


...


56. Take MCAT
57. Receive poor score due to hangover.
58. Repeat MCAT
59. Receive poor score, resolve to study/sleep/not spend night before at sorority house
60. Repeat MCAT
61. Success!


....


125. Arrive at med school
126. Realize that you should have gone to law school, but you still have a soul so you carry on.
127. ?????
128. Profit.



Do not even consider HPSP/USHUS until at least Step 83. Good luck.
 
  • Like
Reactions: peanutsss

61November

Ex-Flight Surgeon
10+ Year Member
Jan 29, 2009
698
496
281
Back Stateside
Status
Attending Physician
Greetings from Afghanistan!

Here's my take as a Flight Surgeon who has dealt with a disproportionate amount of mental health issues in my unit.

This may sound harsh... but there is absolutely no way you should be eligible to serve the U.S. Military, in any capacity. I hope that should you make the mistake of applying for HPSP/USUHS in the DISTANT future you will be completely honest about your hx of depression and suicide attempt. If I was a MEPS doc, I would permanently disqualify from service anyone with hx of a suicide attempt. On my bad days, I wish the military would disqualify permanently anyone with a hx of depression. No waivers, either.

I am so sick of dealing with the mentally broken people who find their way into AD units. They create so many headaches for docs, their comrades and commanders. The MilMed bureaucracy has clamped down hard on suicide and mental health with a vast array of clinically non-validated and tiresome screens/protocols that serve to make the average GMO/FS's life miserable.

And God help you if someone under your care does commit suicide- better make sure your documentation was good, because the witch hunt will be on!


The military is incredibly stressful. Deployments are even moreso.

Do everyone a favor and do not even think about trying to join the U.S military.

-61N
 

notdeadyet

Still in California
Moderator
10+ Year Member
Jul 23, 2004
11,694
1,849
381
Status
Attending Physician
The MilMed bureaucracy has clamped down hard on suicide and mental health with a vast array of clinically non-validated and tiresome screens/protocols that serve to make the average GMO/FS's life miserable.
More soldiers are dying from suicide than from combat. Literally.

Suicide screening and prevention isn't as sexy as trauma, but your average GMO has the potential to save more lives by preventing suicide than patching up bullet-holes.
 
  • Like
Reactions: VanEman

dru2002

10+ Year Member
Dec 23, 2008
591
0
0
Status
Pre-Medical
More soldiers are dying from suicide than from combat. Literally.

Suicide screening and prevention isn't as sexy as trauma, but your average GMO has the potential to save more lives by preventing suicide than patching up bullet-holes.
I was about to bash PDHA/PDHRA and then found this:

http://jama.ama-assn.org/cgi/content/full/298/18/2141

There is apparently some data to support the continued use of PDHA/PDHRA although it is intersting that most seeking care weren't doing so as the result of a referral. If anyone else has good information on how to properly screen and treat ptsd and the like I'd love to see it. Thanks.
 

AF M4

Junior Member
10+ Year Member
7+ Year Member
Jul 6, 2006
884
4
141
Status
I was about to bash PDHA/PDHRA and then found this:

http://jama.ama-assn.org/cgi/content/full/298/18/2141

There is apparently some data to support the continued use of PDHA/PDHRA although it is intersting that most seeking care weren't doing so as the result of a referral. If anyone else has good information on how to properly screen and treat ptsd and the like I'd love to see it. Thanks.
Interesting study.

One possible reason not mentioned is that since the PDHA is taken immediately after deployment - this is sometimes the last thing standing between the guy and 2 weeks of time off with their family - it is often pencil-whipped through with the member simply checking "no" to everything so they can get home. The PDHRA, done months after they're already home, can show increased problems simply because the member no longer has the incentive to burn through the questionnaire.

The alcohol portion is somewhat misleading. The questionnaire is designed to err on the side of false positives of alcohol abuse rather than false negatives, and so someone who had 4 beers on Super Bowl Sunday gets tagged for evaluation along with someone who drinks a couple of six packs every night. Many times when the clinician sees the patient the question of alcohol use turns out not to be a significant issue; therefore the positive screening results are often not referred for further treatment simply because this is not indicated.

+1 on the "existing DoD mental health system is overburdened, understaffed, and underresourced" portion. I've got some great MH people at my base, but there's only so much a few people can do.

+1 on the "family–member mental health care is generally only available through the civilian TRICARE insurance network, a system that has been documented to be inadequately resourced, inconvenient, and cumbersome." I've got some more words for it, but they all have four letters.
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
11,890
7,405
481
Home Again
Status
Attending Physician
On my bad days, I wish the military would disqualify permanently anyone with a hx of depression. No waivers, either.
Amen.

pgg deployment #1 - I passively agreed with the BN CO who didn't want to "lose bodies" to division psych. Looked for reasons to justify taking questionable Marines. Hellish experience in theater with those guys.

pgg deployment #2 - I aggressively pursued admin seps for anyone with a hint of a cluster B personality disorder. Don't remember how many I cut loose but it was maybe 15 or so. Only real problem on the deployment was a Marine who arrived as a combat replacement after I'd deliberately sent left him home with Regiment because of mental health issues.


GMOs do (did, at least) have some ability to use Divison Psych as a blunt instrument to thin the herd, and they should. :)
 

BubblesnBugsDoc

7+ Year Member
May 27, 2009
15
0
141
Status
Resident [Any Field]
Interesting study.

One possible reason not mentioned is that since the PDHA is taken immediately after deployment - this is sometimes the last thing standing between the guy and 2 weeks of time off with their family - it is often pencil-whipped through with the member simply checking "no" to everything so they can get home. The PDHRA, done months after they're already home, can show increased problems simply because the member no longer has the incentive to burn through the questionnaire.

The alcohol portion is somewhat misleading. The questionnaire is designed to err on the side of false positives of alcohol abuse rather than false negatives, and so someone who had 4 beers on Super Bowl Sunday gets tagged for evaluation along with someone who drinks a couple of six packs every night. Many times when the clinician sees the patient the question of alcohol use turns out not to be a significant issue; therefore the positive screening results are often not referred for further treatment simply because this is not indicated.

+1 on the "existing DoD mental health system is overburdened, understaffed, and underresourced" portion. I've got some great MH people at my base, but there's only so much a few people can do.

+1 on the "family–member mental health care is generally only available through the civilian TRICARE insurance network, a system that has been documented to be inadequately resourced, inconvenient, and cumbersome." I've got some more words for it, but they all have four letters.
I always wonder how many guys answer "no" to avoid security clearance and access to weapons issues. It is a sad reality, but it has to be addressed I suppose, especially from a defensive medicine perspective, not to mention just preventive med. Unfortunately, it seems many cases present themselves in the form of ETOH abuse and some commands have a bad habit of circumventing medical with the misconception that it is strictly an administrative issue, not recognizing it as a medical problem.
 

a1qwerty55

Attending
10+ Year Member
Aug 16, 2006
708
32
261
Status
Attending Physician
More soldiers are dying from suicide than from combat. Literally.

Suicide screening and prevention isn't as sexy as trauma, but your average GMO has the potential to save more lives by preventing suicide than patching up bullet-holes.
Amen -

When you read "noncombat related death" in an obit - think suicide - not always but usually.

There have been physician suicides in theater so this is a real issue and I agree with the former comments urging the OP to rethink joining.
 

AF M4

Junior Member
10+ Year Member
7+ Year Member
Jul 6, 2006
884
4
141
Status
I always wonder how many guys answer "no" to avoid security clearance and access to weapons issues. It is a sad reality, but it has to be addressed I suppose, especially from a defensive medicine perspective, not to mention just preventive med. Unfortunately, it seems many cases present themselves in the form of ETOH abuse and some commands have a bad habit of circumventing medical with the misconception that it is strictly an administrative issue, not recognizing it as a medical problem.
A good point. These guys aren't dumb; they know that answers involving high levels of EtOH are bad and so they sometimes minimize even more than the usual civilian does.

EtOH abuse is one of those issues that requires a good relationship between the line and medical to deal with properly. I've seen guys get away with way too much because they've played the "I have a disease" card, and this led to some order and discipline problems in their squadron because the perception became that one could escape punishment for misdeeds simply by being drunk at the time.

As one commander who handled it better said: Making sure that they get taken care of medically is one thing; allowing them to keep their job at the same time is another issue.
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
11,890
7,405
481
Home Again
Status
Attending Physician
Amen -

When you read "noncombat related death" in an obit - think suicide -
Or MVA. LOTs of deaths from Humvee rollovers.

They drive in darkness without lights +/- night vision that has depth perception problems, the roads are poor or unknown, road hazards from potholes to chunks of concrete to just missing pavement or bits of bridges are common, speed is often viewed as a security measure, and they don't have airbags or even decent seatbelts. All being driven by young males who - let's be honest - aren't always the safest drivers back home, and they don't magically become better drivers when they know a speeding ticket isn't a possibility.

I saw a lot more noncombat deaths from MVAs than from suicide.
 

IgD

The Lorax
10+ Year Member
Jul 5, 2005
1,901
6
251
Status
Greetings from Afghanistan!

Here's my take as a Flight Surgeon who has dealt with a disproportionate amount of mental health issues in my unit.

This may sound harsh... but there is absolutely no way you should be eligible to serve the U.S. Military, in any capacity. I hope that should you make the mistake of applying for HPSP/USUHS in the DISTANT future you will be completely honest about your hx of depression and suicide attempt. If I was a MEPS doc, I would permanently disqualify from service anyone with hx of a suicide attempt. On my bad days, I wish the military would disqualify permanently anyone with a hx of depression. No waivers, either.

I am so sick of dealing with the mentally broken people who find their way into AD units. They create so many headaches for docs, their comrades and commanders. The MilMed bureaucracy has clamped down hard on suicide and mental health with a vast array of clinically non-validated and tiresome screens/protocols that serve to make the average GMO/FS's life miserable.

And God help you if someone under your care does commit suicide- better make sure your documentation was good, because the witch hunt will be on!


The military is incredibly stressful. Deployments are even moreso.

Do everyone a favor and do not even think about trying to join the U.S military.

-61N
The problem is that a majority of mental health problems can't be screened out. Any attempt to do so fails. Vigorous screening results in a high number of false positives, increases stigma and drains critical medical resources that could be used to restore people to health.
 

Apollyon

Screw the GST
Lifetime Donor
15+ Year Member
Nov 24, 2002
19,886
4,590
381
SCREW IT!
I thought a history of depression was permanently disqualifying and non-waiverable (or maybe that's what it was when I looked at the Navy). This would be different, of course, for undiagnosed by a health professional before being in theatre.
 

dru2002

10+ Year Member
Dec 23, 2008
591
0
0
Status
Pre-Medical
I thought a history of depression was permanently disqualifying and non-waiverable (or maybe that's what it was when I looked at the Navy). This would be different, of course, for undiagnosed by a health professional before being in theatre.
Major depression is disqualifying. As far as I understood everything is waiverable, some are just more likely to be approved than others. If the military is hurting for docs when s/he applies then it is probably more likely that the waiver will be approved. If the military is fat and happy with physician it becomes less likely.

Also there is the issue of whether or not he discloses the issue. We had a marine instructed by his recruiter to not disclose is hx of mental illness to MEPS. He made it through boot camp and SoI to reach our battalion and have a breakdown complete with suicidal acts. Upon probing it was discovered he had spent a month in a mental hospital just two days before he was contacted by the recruiter. He was subsequently admin sep'ed. The idea of this is true but a few details have been modified to protect patient privacy. So MEPS can only make decisions based on the information they have available, which unfortunately is only what the patient provides.
 

IceScrewball

Soon to be in PharmD!
Jul 22, 2009
49
0
0
Southeast Connecticut
Status
Pre-Pharmacy
Also there is the issue of whether or not he discloses the issue. We had a marine instructed by his recruiter to not disclose is hx of mental illness to MEPS. He made it through boot camp and SoI to reach our battalion and have a breakdown complete with suicidal acts. Upon probing it was discovered he had spent a month in a mental hospital just two days before he was contacted by the recruiter. He was subsequently admin sep'ed. The idea of this is true but a few details have been modified to protect patient privacy. So MEPS can only make decisions based on the information they have available, which unfortunately is only what the patient provides.
The way to solve this problem has more to do with the recruiting process than with screening at MEPS. I don’t think that recruiters should get “credit” for a recruit until that person successfully completes initial training and six months on board his/her first duty station. This would disincentivize the used-car salesmen recruiters from encouraging lying or hiding information, and would lead recruiters to be more selective in their choices. I know not every recruiter acts like this (mine was great, honest, and straightforward), but it would greatly reduce the number of kids that get kicked out at a training command due to anxiety/adjustment or other MH disorder.

To the OP, yes, there are people who have happy and healthy tours in the military with hidden disqualifying conditions, but why would you do this? Suicide is a selfish act, and it is even more selfish to put your teammates at potential risk because you have a breakdown at a critical moment. Sorry, but you are not removed enough from the event (only a year ago!) to realize that joining the military is probably not a good idea.
 

libo1369

mmm beer
10+ Year Member
Aug 4, 2005
123
0
241
40
Jacksonville FL
Status
Resident [Any Field]
Sorry to drag up an old thread but I am an OMS-III and just got a letter from the navy saying that because I am on citalopram and fluctiasone for Single Episode Major Depression and a seasonal allergic rhinitis. The Navy says I may be DQ'd.

I was a Marine Infantrymen and never had problem with deployments or training. It was recently when I was in medical school and quit dipping that I started getting all out of whack. The meds seemed to help calm me down and make me less "explosive" My PCP prescribed it to me and I am wondering if I should "quit" the meds after talking with him. Would this take care of the problem?

Really my question is what the hell do I do to take care of this easily and efficiently? Any help would be great Thanks.
 

IgD

The Lorax
10+ Year Member
Jul 5, 2005
1,901
6
251
Status
Sorry to drag up an old thread but I am an OMS-III and just got a letter from the navy saying that because I am on citalopram and fluctiasone for Single Episode Major Depression and a seasonal allergic rhinitis. The Navy says I may be DQ'd.
Who exactly is the communication coming from? Is it coming from the Navy? I would ask what the process is for requesting a waiver.
 

notdeadyet

Still in California
Moderator
10+ Year Member
Jul 23, 2004
11,694
1,849
381
Status
Attending Physician
Sorry to drag up an old thread but I am an OMS-III and just got a letter from the navy saying that because I am on citalopram and fluctiasone for Single Episode Major Depression and a seasonal allergic rhinitis. The Navy says I may be DQ'd.
Apologies, but I'm confused. Are you a third year medical student currently in the Navy under HPSP worried about being kicked out for being on antidepressants? Or you're a third year medical student currently applying to the Navy worried about being DQ'd from starting HPSP due to the antidepressants?

If you're the former, there are plenty of physicians on SSRIs. I wouldn't see a problem unless you withheld the information during your application cycle.

If you're the latter, most services consider current mood disorders disqualifying. Whether a history of mood disorder is waiverable is going to depend on how long you were on psych meds, if you received inpatient treatment, etc. How long you need to be off psych meds is going to be service-dependent and might be a subjective call.

Also, you might look at what you're trying to do. If you're about to start your third year, I'd be very careful about stopping SSRIs right now. It's a very stressful year in its own right. If you're about to start fourth year, do you really want to take HPSP for one year and incur the obligation? Holding off and taking FAP might make more sense, no?
 

Gastrapathy

no longer apathetic
Lifetime Donor
10+ Year Member
Feb 27, 2007
4,868
3,964
281
Status
Attending Physician
One major problem with suicide prevention is the total lack of evidence that prevention programs have any benefit. Just because the PDHA identifies "at risk" people doesn't mean we are preventing suicides.
 

former military

Member
10+ Year Member
Jun 12, 2006
359
6
0
Status
Attending Physician
When I was an AF resident, two fellow residents who I knew extremely well killed themselves and a whole bunch more medical personnel at my hospital It really was an eye opening experience to life....

1) The AF never takes any accountability and nobody in the AF even feels bad. Many of the times the person is showing signs of extreme stress or substance abuse... rather than put them in rehab... they typically get fired from the residency and sent unchaperoned as a GMO of flight surgeon. They get rid of the bad apple... that unstable guy gets to go take care of people unsupervised. Nobody thought that was odd.

2) The AF immediately speculates the reason in the individual killed themselves because they had a secret, sin-filled gay lifestyle which they recognized as incompatible with life and did the right thing by offing themselves. This sounds crazy but it seems standard explanation.

3) Somebody cleans out their office, their patients get reassigned, and life marches on. You see instantly you are very dispensible.

Suicide prevention lectures in the AF consisted of a staff seargent giving us a lecture. I always wondered why a psychiatrist wasn't conducting the briefing. The ssgt giving one of my briefings was actually telling jokes throughout the briefing.

4) I think the Army SG approach to depression and suicide prevention was to simply give everyone prozac. like a tetanus shot.

I realized early that nobody cared at all. I am suprised the suicide rates aren't higher.