If you’re in the military, you already know that many military and government jobs require a security clearance. To get or maintain a clearance, you must complete Standard Form 86, “Questionnaire for National Security Positions.” Section 21 of the form, “Psychological and Emotional Health,” asks if the applicant has consulted with a health care professional about an emotional or mental health condition in the previous seven years. This question may raise concerns for those who received care in the past or those who hold an active clearance and are considering seeking care. Below are key questions and answers related to Question 21.

Will receiving psychological health care automatically impact my ability to obtain or maintain a security clearance?

No. In fact, there’s a disclaimer at the top of Section 21 which states “Mental health counseling in and of itself is not a reason to revoke or deny eligibility for access to classified information or for a sensitive position, suitability or fitness to obtain or retain Federal employment, or eligibility for physical or logical access to federally controlled facilities or information systems.” Defense Department guidance on Question 21 has further reaffirmed that a person’s decision to seek mental health counseling alone cannot form the basis of a denial of a security clearance.

In what situations could a person’s clearance be denied or revoked based on their psychological health?

Clearances have been denied or revoked only in rare cases, when a psychological health condition(s) severely impacted someone’s ability to perform, function and demonstrate appropriate judgment and reliability in safeguarding classified materials. If you are fully participating in treatment and your symptoms are improving, or if you have demonstrated responsible actions to mitigate a condition in the past, that is what security managers and adjudicators want to see. In reality, only a very small number of applicants are denied a security clearance based on mental health concerns.

What types of psychological health care exempt me from answering “Yes” to Question 21?

An individual may respond “No” if the psychological health counseling was strictly related to:

• Grief, marital or family counseling unrelated to violence by the applicant
• Adjustments from service in a combat zone
• Being a victim of sexual assault (Director of National Intelligence explains that Question 21 does not apply to counseling for sexual assault)

Above all, be honest. If you’re unsure if the care you received falls within these categories, you should know it is OK to answer “Yes,” and you should not feel ashamed. A person who recognizes that he or she is in distress and could benefit from mental health treatment shows sound judgment. The government recognizes the importance of maintaining one’s overall health and supports proactive management of psychological health conditions. In fact, national security is enhanced when government and military members receive the mental health support they need.

Are psychological health providers required to share information about an applicant?

Defense Department policies protect the patient privacy rights of those who answer “Yes” to Question 21 and limit the information that can be obtained about their care. When credentialed personnel security investigators contact an applicant’s psychological health care provider, they must first ask if the applicant is coping with a psychological health concern that could impair his or her judgment, reliability or ability to safeguard classified information. If the provider answers “No,” then no further questions are authorized. If the provider answers “Yes,” an investigator may interview the provider and applicant confidentially to gather enough information to determine the level of security risk. Applicants may report suspected privacy violations to the Defense Department Inspector General hotline at 800-424-9098.

Should concern about Question 21 deter someone from seeking psychological health care?

Question 21 can perpetuate mental health stigma, particularly for those with a mental health diagnosis or who have past clinical encounters. For some, it represents a barrier to accessing critically important care. I emphasize this key message: Question 21 should never deter someone from getting the care they need. Any delay in seeking professional help may cause symptoms to worsen and lead to a more serious condition, which could impact a person’s ability to perform sensitive duties.

If you or someone you know could benefit from psychological health care or support, contact the DCoE Outreach Center at 866-966-1020 to connect to resources and services in your area, or the Military Crisis Line at 800-273-8255, press 1 to speak immediately with a counselor.

Also see our previous story on this topic, “How to Answer Security Clearance Question 21 on Psychological Health.”