Psychiatric abuse is also a problem in the US

ANDREI V. SNEZHNEVSKY, a Soviet physician, is held responsible by Western psychiatrists for the nightmarish abuses by which Soviet dissidents are imprisoned and ``treated'' in Soviet mental hospitals. The diagnostic theory Dr. Snezhnevsky supplied the KGB and its masters in the Kremlin is that a demand for justice beyond what is accorded in Soviet law masks hidden psychotic tendencies.

Despite condemnation of Snezhnevsky's theory by the United States government, there has long been reason to believe that the theory, and to a degree the abuses to which it gives rise, are accepted as routine in the US armed forces as a weapon to discredit ``whistle-blowers'' and other troublesome members. This derives from the power given to any military or civilian administrator in the Department of Defense to order service members and civilian employees to undergo psychiatric examination.

The Department of Defense acknowledges that ``the initial decision that a person may need an evaluation is an administrative one, not a medical one, and it is made by supervisors and personnel authorities.'' The Office of the Army Surgeon General, responsible for most of the military psychiatric examinations that are performed, says that it is ``in no position to judge events and administrative actions'' that lead to referral. It maintains, however, that it ``will avoid the abuses'' associated with ``misuse of our professional skills.''

In 1956, Ulus Jorden became the first black to be enlisted in the Pennsylvania Air National Guard. Twenty-five years later Sergeant Jorden filed a series of complaints alleging misappropriation of funds, by whom is not clear from the record made public thus far.

A senior Air National Guard officer, Col. John D. Campbell, ordered Jorden to undergo psychiatric evaluation. Jorden refused. He was then ordered dismissed from the Air National Guard and from his full-time job with the guard by the then Republican Pennsylvania adjutant general, Maj. Gen. Richard M. Scott.

General Scott has since been replaced by an appointee of Democratic Gov. Robert P. Casey. The Casey administration has continued to support Scott's action and is fighting Jorden's appeal to the Supreme Court.

Along the way, Jorden's petition for reinstatement in the Air National Guard and in his job was denied by a federal district court, but accepted on appeal at the circuit court level, less Jorden's claim for damages.

On Jan. 31, 1983, CBS News's ``60 Minutes'' reported a series of cases in which members of the armed forces had not only been relieved from duty but actually committed to psychiatric institutions as a result of various ``whistleblowing'' actions.

The regulations governing medical care in all of the armed services grant unlimited authority to any military administrator to order subordinates to undergo evaluation by military psychiatrists who are under the same chain of command as the officer ordering the evaluation. The psychiatrist who is called upon to make such an evaluation is aware that an adverse prejudgment has already been made by the chain of command and that he or she is expected to verify that prejudgment. Depending on the rank and influence of the officer initiating the referral, refusal of the psychiatrist to support the administrator could jeopardize the psychiatrist's own standing in the military.

Within the past several years there have been several instances in which psychiatrists whose licenses had been removed or were in jeopardy in civilian life obtained military appointments. Although military doctors are now required to hold a current civilian license, there remain military psychiatrists for whom the military is the employer of last resort.

Federal civil service employees in all military departments, also, are subject to orders from their supervisors to undergo mandatory psychiatric evaluation. No evidence need be submitted to justify such demands. The civilian employee, however, can choose a civilian psychiatrist. The report of examination must be submitted to the government administrator. Since matters germane to a ``whistle-blowing'' incident are likely to be discussed in the interview with the psychiatrist, the report can furnish information, such as identification of sources, useful to an administrator in covering up misdeeds. Refusal by the employee to undergo examination is grounds for dismissal. No matter how devastating the consequences of an unfounded or malicious referral, the employee concerned has no recourse for damages against either the government or the supervisor under the Supreme Court's ``Feres doctrine,'' at least as presently interpreted in the lower courts.

National Guard civilian ``technicians,'' such as Sergeant Jorden, come under both military and civil service regulations.

Although most of them are not aware of it, the several million members of the National Guard and Reserve who serve only part time, or who are only names on a roster, are also subject to mandatory psychiatric evaluation on the order of military superiors and their appointed and elected civilian chiefs.

There is no public record, thus far, of use of the National Guard and Reserve vulnerability for retribution on political, economic, or personal grounds by elected officials, but the potential is there. There is substantial evidence, however, that the mandatory evaluation requirement is used routinely to punish ``whistle-blowers'' and those who pursue claims of sex, age, or racial discrimination.

Most often, the demand for psychiatric evaluation is used to head off a hearing at which the matters at issue would be subject to due process.

Repeated written requests to the American Psychiatric Association to comment on this situation have not been answered. The association routinely condemns the Soviet abuses.

Whatever the views of the association, the existing and potential abuses argue, with equally compelling fiscal reasons, for removal of health care from the military chain of command and consolidation as an adjunct of the Public Health Service.

William V. Kennedy is a journalist specializing in military affairs.