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July 6, 2005

Screening for Psychological Illness in the Military

JAMA. 2005;294(1):42-43. doi:10.1001/jama.294.1.42-b

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.

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