Mental health and turnover following an initial term of military service.
OBJECTIVE
This study compared the rates of mental disorders between Marines who re-enlisted and Marines who separated after 1 term, distinguishing between Marines who were and were not recommended for re-enlistment.


METHODS
Participants included 28,693 male Marines enlisting for 4-year terms between 2002 and 2003, including 9,338 who re-enlisted after 1 term, 18,177 who voluntarily separated after 1 term, and 1,184 who were not recommended for re-enlistment and separated after 1 term.


RESULTS
Analysis revealed disproportionately high rates of mental disorders among Marines not recommended for re-enlistment (Odds Ratio = 8.5, 95% Confidence Interval 7.5-9.8) compared with Marines who re-enlisted. Mental disorder prevalence was also elevated among service members who voluntarily separated after 1 term (Odds Ratio = 1.2, 95% Confidence Interval 1.1-1.3). Several specific categories of disorders, including personality disorders, substance use disorders, and post-traumatic stress disorder, predicted re-enlistment status.


CONCLUSIONS
These results suggest that mental disorders influence personnel retention in diverse ways, including heightened turnover, which could have a substantial impact on military manpower costs.
Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA.
Emily A
EA
Schmied
Robyn M
RM
Highfill-McRoy
Gerald E
GE
Larson
D000328:Adult; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008889:Military Personnel / Q000523:psychology*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010554:Personality Disorders / Q000453:epidemiology; D010560:Personnel Selection / Q000706:statistics & numerical data*; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult