Security Clearance & Mental Health: What You Can (and Can't) Do Without Losing Clearance

Bottom Line Up Front: Seeking mental health treatment does NOT automatically disqualify you from security clearance. What matters: Are you a security risk (foreign influence, blackmail vulnerability, inability to handle classified info)? Safe: TRICARE therapy, Military OneSource counseling, voluntary PTSD treatment, depression/anxiety medication. Red flags: Refusing treatment, hiding treatment, psychosis, inability to distinguish reality, being hospitalized involuntarily. SF-86 asks about specific issues (not "Have you ever seen a therapist?"). Honesty is key - lying on clearance forms = automatic denial. Thousands hold clearances while treating PTSD, depression, anxiety.

Mental Health Treatment vs. Security Clearance (The Truth)

The Myth

FALSE: "If I see a therapist, I'll lose my clearance"

Reality: Mental health treatment alone does NOT disqualify you

What Actually Matters for Clearance

Adjudication Guideline I (Psychological Conditions)

Security concern: Does your condition impair:

• Judgment
• Stability
• Reliability
• Ability to protect classified information

Questions they ask:

1. Are you currently a security risk?
2. Is your condition under control/being treated?
3. Are you compliant with treatment?
4. Can you handle stress/pressure?

Treatment + compliance = GOOD (shows responsibility)
Untreated mental health crisis = BAD (shows risk)

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What You MUST Report on SF-86

Section 21: Psychological & Emotional Health

Question asked (exact wording): "In the last 7 years, have you consulted with a health care professional regarding an emotional or mental health condition or were you hospitalized for such a condition?"

What to report:

• ✅ YES if: Hospitalized (inpatient psychiatric care)
• ✅ YES if: Court-ordered treatment
• ✅ YES if: Diagnosed with serious condition (psychosis, schizophrenia, bipolar, severe depression)

What you DON'T have to report:

• ❌ Marriage counseling
• ❌ Grief counseling (death in family)
• ❌ Strictly related to adjustments from service in a military combat environment
• ❌ Military OneSource counseling (short-term)
• ❌ Deployment stress counseling

Note: The question changed in 2016 to be MORE lenient (previously asked about ANY mental health consultation)

How to Answer Honestly

If YES, you provide:

• Name of provider
• Dates of treatment
• Diagnosis (if given)
• Current status (still in treatment? condition controlled?)

What they're looking for:

• Are you being treated? (GOOD)
• Is condition improving? (GOOD)
• Are you compliant? (GOOD)

Red flag answers:

• "I was diagnosed but refuse treatment" (BAD - shows poor judgment)
• "I lied to get out of treatment" (BAD - dishonesty)
• "I hear voices telling me to..." (BAD - psychosis = security risk)

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Conditions That Usually DON'T Affect Clearance

PTSD (Very Common in Military)

Reality:

• 10-20% of combat veterans have PTSD
• Many hold Top Secret clearances while treating PTSD

What matters:

• Are you in treatment? ✅
• Is it improving? ✅
• Can you still do your job? ✅

If YES to all three: Clearance is safe

Example approved case:

• Marine, Afghanistan veteran, PTSD diagnosis
• In therapy, taking medications
• Compliant with treatment
• Still deploys, still performs job
• Top Secret clearance renewed

Depression & Anxiety

Very common (20%+ of military)

Treatment:

• Therapy (CBT, talk therapy)
• Medications (Zoloft, Lexapro, Prozac)

Impact on clearance:

• Usually NONE if condition is stable
• Medication compliance = GOOD (shows responsibility)

Red flag:

• Suicidal ideation (past is OK if treated, active = immediate security concern)
• Inability to work (can't perform duties)

Medication (Antidepressants, Anti-Anxiety)

Common misconception: "Taking meds = lose clearance"

Reality: Thousands hold clearances while on:

• SSRIs (Zoloft, Lexapro, Prozac)
• SNRIs (Effexor, Cymbalta)
• Benzodiazepines (Xanax, Klonopin - if prescribed, not abused)

What matters:

• Prescribed by doctor ✅
• Taking as prescribed ✅
• Stable on medication ✅
• Can still perform duties ✅

Red flag:

• Abusing medications (taking more than prescribed)
• Mixing with alcohol
• Refusing prescribed medications

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Conditions That MAY Affect Clearance

Psychosis (Schizophrenia, Severe Bipolar, Delusions)

Why it matters:

• Inability to distinguish reality = can't protect classified info
• Paranoia = potential security risk

Can you keep clearance?

• Maybe, if:
  • Controlled with medication
  • No recent psychotic episodes
  • Can perform duties
  • No hospitalization in past year

Likely lose clearance if:

• Active psychosis
• Refusing treatment
• Recent hospitalization for psychotic episode

Hospitalization (Inpatient Psychiatric)

Voluntary hospitalization:

• Usually OK if:
  • You voluntarily sought help
  • You've been discharged and stable
  • You're compliant with aftercare

Involuntary hospitalization:

• Bigger red flag
• You were a danger to self/others
• May lose clearance (temporary or permanent)

Mitigation:

• Length of time since hospitalization
• Compliance with treatment since
• No repeat incidents

Suicide Attempt

Past attempt:

• Will be investigated
• If long ago (5+ years) + stable since = usually OK

Recent attempt (<2 years):

• Red flag
• May suspend clearance pending treatment
• Can regain after demonstrating stability

Current suicidal ideation:

• Immediate security concern
• Clearance suspended
• Treatment required before reinstatement

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How to Seek Mental Health Help WITHOUT Jeopardizing Clearance

Best Options (Low/No Clearance Impact)

1. Military OneSource (Completely Confidential)

• 12 free sessions/year
• NO reporting to command
• NO impact on clearance
• Best for: Stress, deployment adjustment, relationship issues

2. TRICARE Mental Health (Through Network Provider)

• See civilian therapist
• Confidential (not reported to command unless danger to self/others)
• Covered by TRICARE
• Best for: Ongoing therapy, medication management

3. Base Mental Health Clinic

• Confidential (unless suicidal/homicidal)
• FREE
• May be documented in medical record (but that's OK)
• Best for: Ongoing treatment, access to psychiatrist

What gets reported to command:

• Hospitalization (inpatient psychiatric)
• Immediate threat to self/others
• Unable to perform duties (profile limiting work)

What does NOT get reported:

• Outpatient therapy
• Medication for depression/anxiety
• Voluntary counseling

What to Tell Your Security Manager

Before seeking treatment:

• You DON'T need permission
• You DON'T need to notify security manager

If asked during periodic reinvestigation:

• Be honest
• Explain: Diagnosis, treatment, current status
• Emphasize: Compliance, improvement, stability

Example: "Yes, I've been seeing a therapist for PTSD since [date]. I'm taking medication and it's well-controlled. I've had no issues performing my duties."

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Lying on SF-86 (DON'T DO IT)

Why People Lie

Fear:

• "If I admit to therapy, I'll lose clearance"

Result:

• They lie on SF-86
• Investigator discovers (they ALWAYS find out)
• Clearance DENIED for dishonesty

Reality:

• Mental health treatment = Usually OK
• Lying about mental health treatment = ALWAYS DENIED

How They Find Out

Investigation methods:

• Interview everyone you listed as references
• Contact former employers, commanders
• Pull medical records (TRICARE, VA)
• Interview neighbors, friends
• Run credit check, criminal check

If you lied, they WILL discover it

Consequences of Lying

Clearance denied for:

• Dishonesty (not the mental health issue!)
• Lack of trustworthiness
• Potential blackmail risk ("What else are they hiding?")

Career impact:

• Job loss (if job requires clearance)
• Discharge possible (security clearance required jobs)
• Ban from future clearances (5-10 years)

Criminal charges possible:

• False statements (18 USC 1001)
• Rarely prosecuted but POSSIBLE

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Real Case Examples (Approved)

Case 1: PTSD + Depression

Service member:

• Army E-7, Iraq veteran
• PTSD diagnosis, depression
• In therapy 3 years, taking Zoloft

Reported on SF-86: YES (hospitalized once voluntarily for depression)

Investigation:

• Reviewed medical records
• Interviewed therapist (with service member's permission)
• Confirmed: Stable, compliant, no issues performing duties

Result: Top Secret clearance RENEWED

Why approved: Treatment compliance, stability, honesty

Case 2: Suicide Attempt (5 Years Ago)

Service member:

• Navy O-3, suicide attempt 5 years prior

Reported on SF-86: YES (hospitalized)

Investigation:

• Reviewed medical records
• Interviewed current therapist
• Confirmed: No incidents since, stable on medication, excellent job performance

Result: Secret clearance APPROVED

Why approved: Time passed, demonstrated stability, treatment compliance

Case 3: Active Psychosis (DENIED)

Service member:

• Marines E-5, diagnosed schizophrenia
• Refused medication
• Recent psychotic episode (thought classified docs were trying to communicate with him)

Result: Clearance REVOKED

Why denied: Active psychosis, inability to distinguish reality, refusing treatment

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Action Steps

If You Need Mental Health Help:

1. ✅ Seek help immediately (don't wait)
2. ✅ Use Military OneSource (800-342-9647) if concerned about confidentiality
3. ✅ Be honest with provider (they can only help if you're honest)

When Filling Out SF-86:

1. ✅ Read questions carefully (don't assume you have to report everything)
2. ✅ Be honest (if question applies, answer YES)
3. ✅ Provide details (diagnosis, treatment, current status)
4. ✅ Emphasize stability and compliance

During Investigation:

1. ✅ Cooperate fully
2. ✅ Provide medical records if requested
3. ✅ Be honest in interviews
4. ✅ Explain how treatment has helped you

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Related Guides

• PTSD Symptoms, Treatment & VA Disability
• Mental Health Resources for Service Members
• VA Disability Claims Step-by-Step

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Remember: Mental health treatment does NOT automatically disqualify you from security clearance. What matters: Are you a security risk? Treatment + compliance = responsible behavior. Untreated crisis = potential risk. Lying = automatic denial. Be honest on SF-86. Thousands hold clearances while treating PTSD, depression, anxiety. Seek help when needed. Your clearance AND mental health matter.