This article is the second installment in a three-part series on psychological considerations for security clearance holders.

For security clearance holders seeing a psychologist, psychiatrist, or other mental health professional, chances are good that the government is aware of your mental health history and has adjudicated it favorably. After all, you are required to self-report any mental health consultations, hospitalizations, or treatment within the last seven years on the SF-86 form, and the prudent clearance holder self-reports such information if it occurs between regularly scheduled investigations.*.

Like any medical condition, however, mental health conditions can be fluid and can be either diminished or exacerbated over time based on a variety of factors: genetics, overall health, socialization, medication, substance abuse, and compliance with other forms of treatment, just to name a few. That means that even a security clearance holder who has had mental health treatment favorably adjudicated in the past could suddenly find him or herself facing questions from the government during either a scheduled re-investigation or as the result of an incident like a workplace dispute or a DUI arrest. If that happens to you, are you confident that your mental health practitioner will provide a favorable opinion of your condition to government investigators? There is a very easy way to find out: ask.

Far too many security clearance holders have never had this frank conversation with their mental health provider. I advise anyone currently in treatment of any kind to avoid nasty surprises and ask the questions now that your background investigator will eventually be asking in some form:

  1. In your professional opinion, does my condition adversely impact my ability or willingness to safeguard classified information or perform a critical job-related duty?
  2. Am I compliant with my treatment program?
  3. Is there anything else that you believe I should be doing to improve my prognosis (i.e. the long-term outlook of my condition)?

In fair warning, not all mental health professionals may be willing to answer these questions – particularly if they feel that their answers may be challenged or could result in a worsening of your condition. But a refusal to answer these questions, provided you ask them calmly and in a non-confrontational manner, may itself tell you something about your provider’s opinion.

Regardless of the outcome, my philosophy as an attorney is that I do not like surprises. Considering the fact that many mental health cases are treatable, you shouldn’t either. If there is something that you can or should be doing to obtain a more favorable report by your provider (not to mention improve your own health), knowing about it now is far better than waiting until your career is on the line.


*Note: There is an argument to be made that because mental health treatment is not, in and of itself, considered “adverse” information, one does not need to self-report it to the government between regularly scheduled investigations. When the facts of a case require it, we have successfully made that argument. However, I do not generally advise security clearance holders to play semantics with this issue.


This article is intended as general information only and should not be construed as legal advice. Consult an attorney regarding your specific situation.

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Sean M. Bigley retired from the practice of law in 2023, after a decade representing clients in the security clearance process. He was previously an investigator for the Defense Counterintelligence and Security Agency (then-U.S. Office of Personnel Management) and served from 2020-2024 as a presidentially-appointed member of the National Security Education Board. For security clearance assistance, readers may wish to consider Attorney John Berry, who is available to advise and represent clients in all phases of the security clearance process, including pre-application counseling, denials, revocations, and appeals. Mr. Berry can be found at