Military changes course on psychiatric discharge for sexual assault survivor

In recent years, women who have been sexually assaulted while serving in the United States military have testified to Congress and have organized campaigns to address the devastating consequences of those assaults and the equally or more devastating consequences of reporting the attacks and seeking justice. One of the most alarming and intractable forms of harm has been that military therapists often erroneously label these victims’ anguish about the attacks as psychiatric disorders rather than as deeply human reactions; then, the military often discharges them because they are allegedly mentally ill.

Veterans’ advocate and filmmaker Patricia Lee Stotter has called this use of psychiatric labels “weaponized diagnosis,” and until recently, there has been little reason to hope it would cease. For servicewomen, as for civilian sexual assault victims, probably the most damaging psychiatric label has been “borderline personality disorder” (BPD), because a personality disorder is considered a lifelong, intractable, maladaptive organization of the entire personality, and those with this label are commonly assumed to be seriously emotionally damaged. This label has variously led to loss of employment, child custody, and other human rights, and women are far more likely than men to be given this diagnosis.

It is impossible to determine how many sexual assault victims in or out of the military have had their normal reactions classified either as any psychiatric disorder or specifically as BPD. Outside of the military, there is no central system of such records. Between 2001 and 2010, the military discharged more than 31,000 servicemembers on the basis of their having been diagnosed with personality disorders of various kinds, but the military has refused to release information about the “scope and nature” of these cases.

On the website of the U.S. Army Board of Appeal for Correction of Military Records (ABCMR), 13 cases were located of women sexual assault victims who had been diagnosed with BPD and discharged on that ground, and who requested removal of that reason for discharge. For only two has that request been granted. The request of the more recent of those two, Katie Leigh Patterson, was initially refused in 2013, when she filed it on her own, but in 2014, her second request was filed by a team of attorneys provided by Protect Our Defenders (POD)—which advocates for and supports victims of sexual assault in the military—and it was granted this spring. A similar ABCMR decision changing personality disorder to Secretarial Authority as the reason for discharge of a sexual assault victim was made less than one month after the Board’s 2013 rejection of Patterson’s first appeal.

Commenting on the outcome of the Patterson case, Nancy Parrish, founder of POD, said, “The military's misuse of personality disorders as a tool for silencing victims of sexual assault is all too common. As Representative [Jackie] Speier has often said, it is a life-altering form of retaliation that kicks victims out with no benefits. While we are thrilled with Katie’s hard-fought victory, this case demonstrates the extraordinary lengths that survivors are required to go through to receive any type of relief.”

Patterson has bravely gone public with her story, saying, “We hope this is the beginning of a new chapter of treating victims with the respect and dignity they need and deserve after suffering sexual trauma while fighting for their country's freedom.” This decision paves the way for a sorely needed look at the use of psychiatric labels—including but not limited to personality disorders—to harm people in both military and civilian spheres.

When she was a private first class in 2005, Patterson says, a sergeant sexually assaulted her on their base. She reported this to another sergeant in her chain of command, and the report proceeded higher up, eventually reaching the Judge Advocate General (JAG), who issued a restraining order for the perpetrator to stay away from her. According to Patterson, a later assault sent her into a tailspin of fear and despair that led to confinement in a mental hospital. She was told she would be discharged from the Army and was ordered to see an Army therapist, who after one 30-minute meeting assigned her the psychiatric diagnosis of “personality disorder with borderline features.” Patterson reports that this therapist had expressed uncertainty whether she should be discharged on the basis of the personality disorder, because she also had serious physical injuries that could warrant discharge, so he recommended a medical examination before the reason was decided. However, nothing in the records indicates that the Army followed that recommendation.

Patterson had assumed that she would be granted medical retirement because of traumatic brain injuries and multiple leg injuries she had sustained in an incident that was unrelated to the assaults but occurred during her Army service. These would have qualified her for assistance to veterans for “service-connected” problems, but lifelong disorders by definition are not considered service-connected. Patterson had no history of emotional problems and had a sterling performance record in the Army.

In 2013, Patterson on her own appealed the personality disorder basis for discharge, providing documentation to the ABCMR that she had no history of emotional difficulties before the assaults. In July 2013 the ABCMR rejected that appeal, saying its own physician did not believe the documentation warranted removal of the diagnosis. (The ABCMR provided no substantive responses to questions for this article.)

Now, ten years after her discharge, in a stunning reversal, the Army has granted her appeal, acknowledging that she was “subjected to a traumatic event”—without specifying whether that is a reference to sexual assault or the brain and leg injuries—and it has changed the reason for discharging her to “Secretarial Authority,” indicating that her release was simply a decision by the Secretary of the Army.

Feminist attorney and victims of violence advocate Wendy Murphy filed and won the earliest cases against Harvard Law School and other universities about their mishandling of sexual assault and is a top expert about such assaults in the military and a frequent media commentator. Referring to Patterson’s public acknowledgment about her experiences, Murphy has said, “All victims should proudly speak up about all sexual violence and injustice, and we as a collective should celebrate them the same way we celebrate and embrace those who bravely speak up about racist violence and injustice.”

Beginning in 2007, Congress and the media exposed the huge numbers of military discharges due to personality disorder diagnoses. Since that time, the numbers of PD discharges declined significantly from about 1,000 annually, but since 2008, Army discharges based on another psychiatric label, adjustment disorder (AD), have skyrocketed to 2,000 per year. Although AD might at first seem less harmful because it does not signify a lifelong problem, to call suffering due to trauma any psychiatric disorder rather than a deeply human reaction is problematic.