DoDI 6490.04: Command-Directed Mental Health Evaluations

A command-directed mental health evaluation is a lawful military order sending you to a qualified mental health provider so the provider can assess your fitness for duty and report back to your command. The authority, the triggers, the limits on what the provider can share, and the protections against misuse all sit in DoD Instruction 6490.04, which applies across the Military Departments and the Coast Guard.¹

Who Can Order One

Not every senior in your chain can send you for an evaluation. For routine, non-emergency referrals, only two people qualify: a commander who holds command authority over you, or a supervisor who is a commissioned officer (or a civilian at a comparable grade) with supervisory authority. A supervisor outside your direct chain can step in when involving your actual commanding officer would be impractical.

Emergencies widen the circle. A senior enlisted service member designated in advance by the commander can direct an immediate evaluation when there is no time to route the decision through a commissioned officer.

When a Commander Can Order One

The instruction requires a good-faith belief that you need an evaluation, and that belief has to rest on observable facts. Personal friction with leadership is not a basis. Two scenarios qualify.

Non-Emergency

A commander or supervisor may direct an evaluation when your behavior, performance, or general functioning has changed enough that leadership has a legitimate concern about your ability to do your job. The referral has to connect to specific, observable behavior or incidents. Vague dissatisfaction with your attitude does not clear the bar.

Before the appointment, your commander or supervisor is required to tell you there is no stigma associated with getting mental health care, and to give you the name and contact of the provider along with the date, time, and location of the appointment.¹

Emergency

Emergency evaluations are triggered when a service member, through words or actions, appears likely to cause serious injury to themselves or others. Actual violence, attempted violence, or a credible threat all qualify, as does a commander’s belief that the member may be in a severe mental health crisis. The member is sent for evaluation as soon as practicable, and the commander passes the relevant circumstances to the provider before or while the member is en route.¹

Your Rights Before the Appointment

Before a non-emergency appointment, you have the right to consult with a chaplain or with legal counsel. Use it. This is where you find out what the evaluation involves, what the possible outcomes are, and whether the referral itself looks proper. Emergency referrals may not leave room for that consultation, but it is a standard right for every routine referral.¹

The instruction flatly prohibits using a mental health referral as reprisal for a protected communication, such as a report to an Inspector General, a member of Congress, or someone in your chain. That prohibition is backed by 10 U.S.C. 1034, which bars unfavorable personnel actions taken as retaliation against a service member for making or preparing a lawful disclosure. Prohibited retaliatory actions include threats, withholding favorable actions, significant duty changes not matching the member’s grade, and investigations whose primary purpose is to punish or harass.²

If a referral looks retaliatory, raise it through your legal assistance office or the Inspector General. Do that in parallel with attending the appointment, not instead of it (see below).

What the Provider Tells Your Command

The evaluation is conducted by a qualified mental health provider — a psychiatrist, clinical psychologist, doctoral-level clinical social worker, or psychiatric nurse practitioner, with licensed clinical social workers permitted for outpatient evaluations. The provider is a neutral clinical evaluator, not an extension of the command.

What the commander gets back is limited to the minimum information needed to make duty decisions: duty limitations, monitoring recommendations, treatment needs, and whether further evaluation or a medical board referral is warranted. Therapy content, personal disclosures, and diagnostic detail beyond what duty decisions require stay in your medical record.¹

The report typically lands in one of several places:

Return to full duty, with no identified condition affecting fitness.
Continued duty with specific limitations, such as restrictions on classified access or firearms.
A recommendation for treatment, with the commander responsible for supporting it.
Referral to a Medical Evaluation Board through the Disability Evaluation System if a condition may render the member unfit for continued service.
A recommendation for administrative separation in cases involving a personality disorder or general unsuitability for military service.

Under Army-specific guidance, the treatment facility must complete its report within five working days, covering risk level, duty recommendations, and safety information.³ Timelines vary across branches.

Effect on Security Clearance and Career

This is where most of the anxiety sits, and the paperwork is more reassuring than people expect. The Standard Form 86, used for national security positions, asks in Section 21B whether a court or administrative agency has ever ordered you to consult with a mental health professional. The form itself states that an order from a superior officer to a military member falls outside the scope of that question and does not require an affirmative answer.⁴

Section 21A goes further: mental health treatment and counseling, by itself, is not a basis for revoking or denying a security clearance, federal employment, or access to government facilities and information systems. The form notes that seeking or receiving mental health care for personal wellness may contribute favorably to eligibility decisions.⁴

If You Refuse

A command-directed evaluation has the same legal status as any other lawful military order.¹ Refusing to attend puts you in the same position as refusing any other direct order.

Depending on who issued it, refusal can be prosecuted under UCMJ Article 90, which covers willfully disobeying a lawful command from a superior commissioned officer and carries a punishment “as a court-martial may direct.”⁵ It can also fall under Article 92 for failure to obey a lawful order or regulation.⁶ Non-judicial punishment under Article 15 and adverse administrative action are also on the table.

If you believe the referral is unlawful, retaliatory, or came from someone without authority, comply with the order and challenge it in parallel through legal counsel, the Inspector General, or your chain. Refusing first and arguing later rarely works.

If You Disagree With the Result

You are not necessarily stuck with a single provider’s conclusions. Under Army policy, a service member can request a second clinical opinion by submitting a written request to the evaluating provider or the Installation Director of Psychological Health, stating the reason and contact information.⁷

The Director can conduct the re-evaluation personally or assign another provider, ideally the initial evaluator’s supervisor or clinic chief. If the two opinions conflict, the Director reviews both and issues a final determination documented in the medical record, and both the service member and the commander receive the result.⁷ Other branches run their own second-opinion procedures; ask your legal assistance office or patient advocate what applies in your service.

1
Department of Defense. DoDI 6490.04, Mental Health Evaluations of Members of the Military Services
2
Office of the Law Revision Counsel. 10 USC 1034 – Protected Communications; Prohibition of Retaliatory Personnel Actions
3
Keller Army Community Hospital. Command Directed Mental Health Evaluation Referral Algorithm
4
U.S. Office of Personnel Management. Standard Form 86 – Questionnaire for National Security Positions
5
Office of the Law Revision Counsel. 10 USC 890 – Art 90 Willfully Disobeying Superior Commissioned Officer
6
Office of the Law Revision Counsel. 10 USC 892 – Art 92 Failure to Obey Order or Regulation
7
U.S. Army Reserve. OTSG/MEDCOM Policy Memo 22-020 – Command Directed Behavioral Health Evaluations