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While combat readiness is a top priority for the U.S. Army, there is concern that behavioral health (BH) return to duty (RTD) practices may under-represent the number of soldiers available for deployment. Profiling, the official administrative process by which medical duty limitations are communicated to commanders, was recently found to be significantly under-reporting BH readiness levels in one Army Division. This is a safety issue in addition to a readiness problem, and underscores the importance of better understanding RTD practices in order to offer solutions. This study sought to categorize the information and tools used by Army BH providers in garrison to make decisions about duty limitations that can affect BH readiness.

ABSTRACTSymptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) have a negative effect on occupational, social, and marital/intimate partner functioning. Other problem emotions or behaviors, such as sleep troubles, irritation, or agitation, could also have a similar relationship to a variety of functional impairments. The current study sought to (a) replicate findings supporting a relationship between symptoms of psychopathology and a variety of functional impairments; (b) examine the relationship between sleep disturbances, agitation, and irritation on the same functional impairments; and (c) examine the differences in the strength of the relationships described in (a) and (b). Military providers completed a survey indicating clinical perceptions of the variables of interest for one service member from their clinical caseload. Higher levels of depression, anxiety, and PTSD symptomatology were related to all domains of functional impairment, as were reported levels of sleep disturbances, agitation, and irritation. Few differences were found in the strength of the correlations established for depression/anxiety/PTSD and sleep problems/irritation/agitation. Given the potential hesitation of service members to report symptoms of psychopathology, reports of sleep problems, irritation, and agitation may present unique clinical benefits by providing an additional health touch point for education on behavioral health and available services.