To the Editor: In their Commentary on screening
for psychological illness in military personnel,1 Dr
Rona and colleagues proposed 6 criteria for implementing a psychological screening
program in the military. In supporting these criteria, the authors misinterpreted
data cited from several of our studies.
The US military psychological screening program is based on the premises
that screening should target significant mental health problems and should
use simple and validated procedures.2,3 In
discussing the first of these criteria, the authors described data from 2
of our studies2,4 as reporting
a “low yield” for important health problems. However, the referral
rate of 0.5% reflected only emergency cases requiring same-day care. The actual
percentage of soldiers referred for follow-up services after clinical interview
was a clinically important 8%. In the study by Bliese et al,4 redeployment
rates of mental health problems were low; however, rates significantly increased
in a follow-up 120 days later.3 This finding
reflects the importance of timing of screening.
Wright KM, Bliese PD, Adler AB, Hoge CW, Castro CA, Thomas JL. Screening for Psychological Illness in the Military. JAMA. 2005;294(1):42–43. doi:10.1001/jama.294.1.42-b
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