In recent years, psychiatrists have been asked to consult on security clearance eligibility. In The Psychiatrist in the Security Clearance Process, psychiatry expert witness Brian Crowley, MD, DLFAPA, writes:
Psychiatrists are asked to participate in the security clearance process in either of two ways….
In the second scenario, a psychiatrist is asked to perform an independent psychiatric evaluation for an individual he has not met, addressing the issue of eligibility to obtain or to hold a security clearance. The evaluation may be requested either by a government agency or by an individual; in the latter case, he/she is usually represented by an attorney. Such an evaluation should be performed by a psychiatrist with considerable experience working at the interface of psychiatry and the law. While this is a forensic psychiatric procedure, in my view it does not require that the psychiatrist has taken a forensic fellowship – when I started working at the psychiatry/law interface there were no such fellowships – but it does take one who has deep knowledge and appreciation for how the law undergirds all psychiatric practice.
The doctor gathers all relevant information to understand the problems and issues presented, reviews the materials, sees the individual (I recommend twice) in the office for personal evaluation, consults with appropriate parties as indicated, and writes a good report. The report need not be long but should be thoughtful, well-crafted, succinct, readable and interesting. In my experience, an 87-page forensic psychiatry report is almost always inferior to one that is five-pages long. If the written report does not resolve the matter, a hearing will likely be scheduled to decide the case. These hearings are usually held in a standard administrative hearing format with attorneys for both sides present. Evidence is introduced, including expert as well as lay witnesses, and the hearing is presided over by an administrative law judge who makes a written ruling. It has been my experience that the individual regularly receives a fair consideration in such a hearing, with ample opportunity to show eligibility to hold a clearance, and where problem conditions are identified and mitigated.
In the federal government, the standard is the Adjudicative Guidelines for Determining Eligibility for Access to Classified Information. The Guidelines, promulgated by The White House, have been in use since the 1950s and revised periodically through successive administrations. I find them clear, sensible, and nuanced – facilitating a quality evaluation and report. The guidelines are more concerned with behavior than with formal diagnosis, and speak of “behavior that casts doubt on an individual’s judgment, reliability, or trustworthiness.” “Conditions that could raise a security concern and may be disqualifying” are balanced against “conditions that could mitigate security concerns” in making the judgment to grant or deny a security clearance.
Importantly, the Guidelines provide explicitly that “No negative inference concerning the standards in this Guideline may be raised solely on the basis of seeking mental health counseling.” This helps reduce the fear of some that being in treatment is hazardous to their job health. In my long career I have found that this fear has not proven realistic. In fact, it is just the reverse: leaving symptoms of mental disorder unattended to and untreated is hazardous to the person’s standing at work as well as to the rest of his or her functioning in life. Employers generally would rather have an employee who is productive and stable with ongoing treatment rather than an undiagnosed or untreated bundle of behavioral dysfunction.
No specific mental health diagnoses, or behaviors, are listed in the Guidelines as automatically disqualifying. An individuals is not deemed a security risk if that person has a psychological or behavioral problem and that condition can be mitigated if “the identified condition is readily controllable with treatment, and the individual has demonstrated ongoing and consistent compliance with the treatment plan,” or there is “a recent opinion by a duly qualified mental health professional employed by, or acceptable to and approved by the U.S. Government, that an individual’s previous condition is under control or in remission, and has a low probability of recurrence or exacerbation.”
A number of my patients and former patients have gone on to serve with great credit and satisfaction in significant jobs, after negotiating the security clearance process. On the forensic (evaluative) side, it continues to be interesting, challenging yet rewarding work to conduct these evaluations and to participate in the adjudication process, including the administrative hearings.
As printed in the The Washington Psychiatrist.
Dr. Crowley‘s areas of expertise include Testamentary Capacity and Undue Influence, Fitness for Duty, Security Clearances, Independent Medical Examinations Dangerousness Assessments,