An estimated 21% of U.S. adults experienced mental illness in 2020, according to the National Institute of Health (NIH). Nearly two-thirds of these people do not seek treatment; some because of the stigma that is associated with mental health treatment, according to separate reports by the surgeon general.  Mental health issues can adversely affect an individual’s eligibility for a federal security clearance, but many clearance applicants worry unnecessarily and sometimes choose not to seek treatment due to fears that it could result in the denial or revocation of a clearance.

Guideline I (Psychological Conditions) of the “Adjudicative Guidelines for Determining Eligibility for Access to Classified Information” is one of the least understood criteria for being granted a security clearance. Regarding the standards for eligibility for access to classified information, Executive Order 12968, issued in 1995, states:

“No negative inference concerning the standards in this section may be raised solely on the basis of mental health counseling. . . . However, mental health counseling, where relevant to the adjudication of access to classified information, may justify further inquiry to determine whether the standards of subsection (b) of this section are satisfied, and mental health may be considered where it directly relates to those standards.”

The most recent version of the Standard Form 86—SF-86 (Questionnaire for National Security Positions) clarifies that mental health treatment in and of itself is not a reason for security clearance denial, however. “Mental health treatment and counseling, in and of itself, is not a reason to revoke or deny eligibility for access to classified information or for holding a sensitive position, suitability or fitness to obtain or retain Federal or contract employment, or eligibility for physical or logical access to federally controlled facilities or information systems. Seeking or receiving mental health care for personal wellness and recovery may contribute favorably to decisions about your eligibility,” the form states.

Of the thousands of security clearance applications processed each year through the Department of Defense, only 11 applicants were denied clearances in 2021 by Defense Office of Hearings and Appeals (DOHA)  administrative judges because of psychological conditions.


A past or present mental, emotional, or personality disorder is not by itself a disqualifying condition for a final security clearance. A psychological condition does not have to be formally diagnosed as a disorder to be a security concern. The security concern arises when the possibility of future unreliable or dysfunctional behavior is indicated by either abnormal behavior or the opinion of a qualified mental health practitioner. When a psychological condition (or the side effects of medication) adversely affects a person’s judgment and behavior, such things as disappointment, failure, or perceive injustice or betrayal may cause reactions that are irresponsible, self-destructive, retaliatory, and/or unlawful. This can result in willful or negligent compromise of classified information, violence, sabotage, or espionage.


A “yes” response to the “Mental and Emotional Health” question on the S-86 indicates that additional information beyond the required dates of treatment and identification of the health care provider is needed to make a final security clearance determination. Wording of the original question was somewhat confusing. The most recent version of the SF-86 clarifies the mental health question by asking: “Do you have a mental health or other health condition that substantially adversely affects your judgment, reliability, or trustworthiness even if you are not experiencing such symptoms today?” It further adds: “If your judgment, reliability, or trustworthiness is not substantially adversely affected by a mental health or other condition, then you should answer “no” even if you have a mental health or other condition requiring treatment.”

If there is any doubt about whether counseling or hospitalization should be disclosed, it is always preferable to answer “yes” to the question and provide both the required information and a detailed explanation in the comment section or continuation space on the SF-86, however.

When applicants answer “yes” to this question they are directed to complete an “Authorization for the Release of Medical Information.” This form is on the last page of the SF-86 and authorizes a mental health practitioner to answer 3 questions:

Does the person under investigation have a condition that could impair his or her judgment, reliability or ability to properly safeguard classified national security information?

If so, describe the nature of the condition and the extent and duration of the impairment or treatment.

What is the prognosis?

When the mental health practitioner(s) answer(s) “no” to the first question, there is no further investigation of this issue, unless the investigation surfaces contradictory information from some other record or personal source. When there is a “yes” to the first question, the applicant is usually required to complete an INV Form 16A, Specific Medical Release, which is used to obtain more detailed information regarding medication, other treatment, test results, and medical opinions regarding health, recovery and/or rehabilitation. If necessary a security adjudicator will consult with a qualified government mental health practitioner, and if any doubt remains about an applicant’s reliability, the applicant can be required to undergo a medical evaluation by a psychiatric consultant.

There is a presumption that mental health treatment that occurred more than 7 years ago or any treatment related to one of the exceptions to the “Mental and Emotional Health” question on the SF-86 is not relevant or material to a security clearance determination. However if information is developed during an investigation that unlisted mental health treatment is relevant, information about the treatment can be pursued.


Guideline I of the Adjudicative Guidelines lists 3 specific examples of potentially disqualifying conditions and 5 specific examples of mitigating conditions. Ultimately almost all cases where a final clearance is denied due to psychological conditions involve 1 of the 4 following situations:

  1. The applicant has displayed dysfunctional or abnormal behavior, and the applicant refuses to seek treatment or refuses to undergo medical evaluation.
  2. A qualified medical practitioner has determined that the applicant’s condition could impair his or her judgment or reliability, and the applicant has failed to take medication or participate in other treatment as prescribed.
  3. A qualified medical practitioner has determined that the applicant’s condition could impair his or her judgment or reliability and the condition can not be adequately treated.
  4. A qualified medical practitioner has determined that the applicant’s condition could impair his or her judgment or reliability and there is a lack of persuasive evidence that the condition is under control and will remain so for the foreseeable future.


The federal policy against drawing negative inferences solely on the basis of mental health treatment and the very low denial rates for final clearances do not apply to interim security clearances. Unless properly documented mitigating information is submitted with clearance applications, interim clearances are frequently declined when applicants list mental health treatment on their SF-86.  See the article entitled Mental Health and Interim Security Clearances.

Copyright © 2010 Last Post Publishing. All rights reserved.


Article updated in March 2022.

Related News

William H. Henderson is a former Army Counterintelligence Agent and a retired federal clearance investigator. In 2007 he began helping clearance applicants from the pre-application stage through representation at hearings and appeals. Since 2012, he’s been the Principal Consultant at the Federal Clearance Assistance Service (FEDCAS). His first two books on security clearances have been used at five universities and colleges. He recently published the 2nd Edition of Issue Mitigation Handbook. He’s contributed scores of articles to, and he’s been retained as an expert witness in several state and federal lawsuits.