The US Army reportedly allowed the enlistment of thousands of people afflicted with issues such as mood disorders and histories of self-mutilation, according to data obtained from the US military.

The data shows that from October 2016 until October 2017, around 1,064 waivers were issued for mood disorders and 95 for self-mutilators, making up less than 1% of the 117,554 who were pushed into military service last year.

Of the mood disorders that received waivers, bipolar disorder was on the list, though the US Army Secretary Mark Esper says waivers are only for resolved or misdiagnosed medical issues.

“As the stigma of seeking therapy or counseling becomes less of an issue than when I grew up, you’ll see probably more cause for waivers,” Esper said. “But again, the waiver is only for an historical condition that we look at and assess. We do not allow anybody in who is undergoing therapy, who is a cutter or was a cutter, identified clearly as a cutter or is using drugs. They are not allowed into the service. And I will not accept them. Quality trumps quantity every single day of the week.”

For some medical specialists, however, this is particularly worrying.

“Bipolar in most cases is a lifelong challenge,” said Elspeth Cameron Ritchie, a psychiatrist who retired from the Army as a colonel in 2010 and is an expert on waivers for military service. “It is more of a challenge when you’re younger and is not something you can simply be clear of. You’re often on medication for life.”

According to USA Today, Republican Senator from Arizona John McCain criticized the Army last year for letting self-mutilators into their ranks.

With bipolar disorder, medication often has to be administered and monitored carefully, something that is near impossible on the battlefield, where supplies run low and aggravating factors such as sleep deprivation are common.

“When you’re manic, your judgment isn’t good,” Ritchie said. “You shouldn’t be driving a tank when you’re manic. You shouldn’t have a rifle if you’re manic.”

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