title: Mental health diagnoses and attrition in Air Force recruits.
abstract: BACKGROUND
  Mental disorders effect military readiness. Evaluating the frequency and impact of mental health diagnoses (MHD) in recruits, the source of the military workforce, is key to identifying opportunities for screening and prevention.
  
  
  OBJECTIVE
  This study assessed the relationship between MHD in the Air Force recruit population and time to discharge.
  
  
  METHODS
  A recruit cohort at Lackland Air Force Base was followed through Basic Military Training, technical school, and 14 months of service using data from Trainee Health Online Reporting System. Incidence rate of MHD was calculated. A risk ratio and attributable fraction were calculated for attrition comparing recruits with MHD to recruits receiving other diagnoses (non-MHD). A survival analysis was performed on recruits with MHD compared to those with non-MHD.
  
  
  RESULTS
  Incidence of MHD was 7.9%. A recruit with a MHD was 4.28 (95% CI = 4.04-4.54) times more likely to separate in the first 14 months of service as compared to a recruit with a non-MHD.
  
  
  CONCLUSIONS
  Recruits with MHD were separated faster and more often when compared to non-MHD. This study increases visibility of mental health disorders in recruits as a step toward better identifying those at higher risk of attrition.
authors.affiliation: Department of Preventive Medicine and Biometrics, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Shawn M S
authors.initials: SM
authors.lastname: Garcia
authors.affiliation: Public Health Flight, 633 AMDS/SGPM, 45 Nealy Avenue, Langley AFB, VA 23665.
authors.forename: Brian V
authors.initials: BV
authors.lastname: Ortman
authors.affiliation: Department of Preventive Medicine and Biometrics, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Burnett
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D001523:Mental Disorders / Q000453:epidemiology*; D008889:Military Personnel / Q000523:psychology*; D010560:Personnel Selection / Q000706:statistics & numerical data*; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology