Suicide following Medical/Physical Evaluation Boards: a complication unique to military psychiatry

Psychiatrically hospitalized military members are at risk for suicide during Medical/Physical Evaluation Board processing. Following initial hospitalization and treatment, usually for major depression, members are entered into medical administrative channels. During this period they are often returned to duty, placed on "casual" status in a holding company, or moved to a "transition unit" within the hospital, often under the care of other than mental health personnel. It is in this situation that they must face the reality of the loss of their military identity and career. This stressor may occasion a reoccurrence of the presenting illness which may be missed by medical personnel because the member is viewed by them as treated, or no longer actually a patient, but rather in the process of leaving. Medical personnel are reminded that ongoing or de novo psychiatric illness, including the risk of suicide, can and does occur on the occasion of separation from the military as stressor-independent from the reason for admission.