Patient Administration - Army Publishing Directorate - U.S. Army

5–14. Psychiatric patients
a. At MTFs that do not furnish specialized psychiatric care, the patient will be transferred to an MTF that furnishes
the required care. This procedure will apply when most of the available clinical evidence indicates a military patient
has a psychiatric condition and treatment, observation, or evaluation for a period of 7 days is indicated. The transfer
will normally take place within 7 days of the date of admission.
b. At MTFs designated as psychiatric STSs, patients with psychosis ordinarily will undergo prolonged periods of
observation to determine the permanency of the disability. The patient’s response to treatment will be evaluated as soon
as practicable after a definite diagnosis has been made. When treatment does not result in substantial improvement,
disposition will be made as quickly as practicable. Usually intensive treatment for a period of under 90 days will be
sufficient to establish the degree of disability and provide optimum improvement. (See para 5-15 for processing of
psychiatric prisoner patients.)
c. A commander is responsible for exercising all reasonable measures to protect the personal affairs of a psychiatric
patient as well as other members of the command. Legal assistance officers will be contacted for counsel and advice.
Psychiatric Soldiers, despite their mental illness, may be sufficiently competent to execute a legally acceptable power
of attorney or other instrument authorizing another person to act on their behalf in personal matters. Mental incompetence
may vary in degree and in relation to specific situations. Opinion as to competency will be obtained from a
psychiatrist on specific situations that arise in the settlement of personal affairs.
5–15. Psychiatric prisoner patients
When a prisoner suffering from psychosis is admitted to an MTF or local confinement facility, the MTF commander
will ascertain whether the issue of insanity was raised at the time of trial or if there is anything in the record of trial
that may support a reasonable doubt as to the patient’s sanity at the time of the offense or trial. If the information
concerning the patient’s sanity is not in the patient’s available records, this information will be requested from HQDA
(DAJA-CL), Washington, DC 20310-2200. When received, the information will be included with the patient’s ITR.
(See para 7-6 for sanity board policy.)
5–16. Notification of release of criminal Army members
a. A criminal Army member, as used in this paragraph, is a psychiatric patient who has a history of reported
involvement in major crimes or antisocial behavior and is considered to have significant potential for recurrence of
such behavior. Examples are crimes of violence such as murder, rape, or prolonged absences associated with threats of
violent behavior. When such patients have been administratively cleared for medical separation from the Service, they
will be reported by the Army MTF to OTSG (DASG-HSZ), 5109 Leesburg Pike, Falls Church, VA 22041-3258.
Copies of the following documents will be included in the notification, if available:
(1) Applicable criminal investigation activities, military police, and/or civilian police investigations.
(2) Investigations under the provisions of The Uniform Code of Military Justice (UCMJ), Article 32.
(3) SJAs advice to the general courts-martial.
(4) Record of trial.
(5) Sanity board proceedings. (See para 7-6.)
(6) MEB proceedings including a copy of the narrative summary (see para 7-24) prepared in lieu of sanity board
proceedings or prepared separately.
(7) Indictments, complaints, other investigative files, and court orders.
(8) Proposed date, place, and basis of release from the MTF including identification of the receiving facility and
estimated date of separation from the Service.
b. Absence of any of the listed documents in a above must be explained.
c. Reports required above will be dispatched no later than 72 hours before actual physical disposition (departure) of
the patient from the MTF.
d. If reporting as described in this paragraph is questionable, the case will be forwarded as prescribed in a above.
e. Notifications prescribed by this paragraph are exempt from reports control under AR 335-15.
5–17. Final disposition procedures for military patients
a. Patients who are fit for duty will be returned to duty as soon as possible. Attached military patients will be
returned to their units of assignment. Those assigned to WTUs will be reported for reassignment per paragraphs 8-9
and 8-10 (see chap 7 for MEB requirements).
b. Patients who are unfit for duty and are assigned to WTUs will be processed for separation by the transfer point
which supports the MTF. Patients who are not assigned to the WTU will be returned to their units of assignment for
separation action. The additional instructions in (1) through (5), below, apply.
(1) Patients who are fit for retention but do not meet procurement medical fitness standards will be processed as
provided in paragraph 5-3 and AR 635-200.
(2) Patients who have been referred to PEBs and are approved for continuance on AD as provided in AR 635-40
will be processed according to instructions from the U.S. Army Physical Disability Agency (TAPD-PDB).
42 AR 40–400 27 January 2010