Association between mental health conditions diagnosed during initial eligibility for military health care benefits and subsequent deployment, attrition, and death by suicide among active duty service members.

OBJECTIVE: To examine incidence of mental health diagnoses during initial service of U.S. active duty military members and identify associations with deployment, attrition, and suicide. METHODS: A retrospective cohort of 576,502 service members (SMs) newly enlisted between 2003 and 2006 was identified. Data included medical encounter, deployment and attrition, and suicide. Multivariable logistic regression models examine the association between mental health diagnoses coded within the SMs' first 6 months of eligibility for health care benefits and deployment. Multivariable Cox proportional hazards models quantify the association between mental health diagnoses and attrition and suicide. RESULTS: The cumulative incidence of mental health diagnoses was approximately 9% at 6 months of service. Adjustment, depressive, and anxiety disorders were most common. Those with any mental health diagnosis during initial eligibility had increased risk of early attrition and were 77% less likely to deploy. Early mental health diagnoses were not statistically significantly associated with death by suicide. CONCLUSION: Mental health diagnoses during initial eligibility are common and associated with reduced odds of deployment and increased risk of early attrition. Policies designed to either retain or discharge SMs with a mental health diagnosis identified during initial training merit close examination in light of these findings.

Unplanned pregnancy among active duty servicewomen, U.S. Air Force, 2001.

Unplanned pregnancy is a major public health problem in the United States. Although the U.S. Air Force has the highest proportion of active duty women of any of the U.S. military services, there are no published data on the occurrence of unplanned pregnancy among active duty Air Force (ADAF) women. Civilian female interviewers conducted telephone interviews with a random sample of 2,348 ADAF women during early 2002, using questions that were closely based on the 1995 National Survey of Family Growth. During 2001, approximately 12% of ADAF women had one or more pregnancies. By National Survey of Family Growth criteria, approximately 54% of these pregnancies were unplanned. Thus, approximately 7% of ADAF women had one or more unplanned pregnancies during 2001. Roughly one-half of unplanned pregnancies represented contraceptive nonuse and the other half represented contraceptive failure or misuse. Unplanned pregnancy is a serious and frequently occurring problem among ADAF women, with many opportunities for prevention.