On many occasions I advocated for my patients on active duty who desperately wanted to remain in the military after recovery from an episode of mental illness. Patients taking medications who were in full remission from cyclothymia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, and other conditions that did not include psychotic symptoms were routinely discharged involuntarily in spite of expert military psychiatric opinion recommending retention. I would not deem this to be attrition; it was involuntary separation and, as such, should not be included in the attrition statistics. If an active duty member with an illness is not deemed "worldwide qualified," he or she is medically discharged, irrespective of his or her wishes and in spite of attaining full remission. This is true even if the service member’s job is clerical, secretarial, medical technical, or one of the majority of military careers that do not involve the use of—or access to—firearms, explosives, aircraft, nuclear weapons, or highly classified information. Another clear example of enforced involuntary separation—not attrition—is that any patient treated with lithium is not considered worldwide qualified, irrespective of diagnosis or clinical condition.