Key Question:

Should a psychologist include detailed information about an applicant’s gender identity and associated medical treatment (e.g., hormone therapy for gender dysphoria) in a psychological evaluation report, particularly when the information is already disclosed on the F-3?

Answer:

This question arose regarding the inclusion of gender identity and medical treatment for gender dysphoria in a psychological report. The applicant self-identified as a transgender male and disclosed this information on the F-3 form. The original draft of the report included clinical details such as the year of diagnosis, the treatment received (hormone replacement therapy), and an explanatory paragraph defining gender dysphoria.

Given that the applicant already disclosed this matter on the F-3 and is considered a medical—not psychological—issue, the detailed clinical history should not be included in the report. Instead, the information should be summarized factually and succinctly, with no elaboration on diagnosis or treatment specifics. This approach maintains relevance to the psychological purpose of the report, avoids unnecessary detail, and respects the applicant’s privacy.

The recommended language is:
"Applicant reported identifying as a transgender male, born biologically female. As a result, he receives ongoing medical maintenance for this matter but no mental health treatment."

Summary:

Do not include diagnostic labels or treatment details related to gender identity if the applicant has disclosed this on the F-3 and it is not tied to current mental health concerns. Use brief, factual language to acknowledge the disclosure while keeping the focus on psychological relevance.

Key Question:
How should clinicians address cases in which an applicant has a mental health diagnosis, recent medication use, and past trauma—particularly when those factors may be linked to terminations from law enforcement roles?

Answer:
When evaluating an applicant with current or recent psychiatric medication use or therapy, clinicians must always request medical records using either a signed ROI or the FMRT Med Release form. This is essential for verifying the applicant’s reported treatment, confirming stability, and identifying any red flags (e.g., medication non-compliance, hospitalization, or undisclosed diagnoses). Even if a Not Suitable (NS) decision is anticipated, documentation from a treatment provider protects FMRT’s liability and supports a well-founded conclusion.

In cases involving prior terminations from law enforcement, especially if mental health was cited as a contributing factor, it is critical to provide additional context in the report. This ensures alignment with what the applicant disclosed to the employer and informs the department of the potential risk. If claims about terminations involve alleged bias or interpersonal dynamics, the language should be objective and attributed to the applicant’s perspective (e.g., “according to the applicant”), avoiding unintended validation of one-sided accounts.

Finally, when applicants disclose past trauma (e.g., exposure to domestic violence or sexual abuse), clinicians should thoughtfully explore how these experiences may impact future performance. Specifically, consider whether unresolved trauma could be triggered during calls for service and whether the applicant has processed the events through treatment, reported them to law enforcement, or still holds strong emotional responses that may compromise objectivity or judgment.

Summary:
Always request records when psychiatric treatment is reported within the past year. Clarify and contextualize prior law enforcement terminations, and thoughtfully explore how trauma history might affect future performance. These steps improve report accuracy and protect FMRT and the hiring agency.

Key Question:

What presenting issues or behavioral patterns commonly justify a “Not Suitable” (NS) recommendation in a public safety pre-employment psychological evaluation, and what level of evidence should support that decision?

Answer:

Several recurring factors frequently warrant an NS determination when they indicate ongoing risk, unresolved issues, or patterns likely to impact future performance in high-stress public safety roles. These include:

• Uncontrolled or recent mental health symptoms: Active or recently active psychiatric conditions (e.g., depression, anxiety, panic, psychosis) that are not well managed through treatment or demonstrate instability.

• Suicidality: Recent suicidal ideation or behavior that has not been fully addressed or stabilized through appropriate clinical care.

• Unresolved trauma history: Past traumatic events (e.g., PTSD, physical/sexual abuse, life-threatening incidents) that the applicant claims are “in the past” but appear suppressed rather than resolved. Unprocessed trauma often resurfaces when exposed to calls involving violence, fatalities, or victims—leading to future decompensation or extended leave.

• Substance misuse: Current or historical patterns of alcohol or drug use to manage stress, emotion, or sleep. Such tendencies are likely to worsen under occupational strain, disrupted schedules, and exposure to trauma.

• Integrity concerns: Evidence of dishonesty during the evaluation or within the applicant’s personal, legal, or occupational history (e.g., minimizing substance use, concealing terminations, falsifying information). Lack of integrity is one of the strongest predictors of future misconduct or disciplinary issues.

• Interpersonal or behavioral issues: Poor boundaries, hostility, inappropriate behavior (e.g., sexual harassment), lack of empathy, or absence of command presence—all of which impair functioning within a team-based, high-stress environment.

In all cases, objective evidence must substantiate these concerns. Elevated assessment scores or isolated historical events are insufficient on their own. When a red flag emerges, the evaluator should explore collateral details, patterns, and contextual information to determine whether the issue is both clinically significant and predictive of future impairment or misconduct.

Summary:

An NS determination should be grounded in clear, defensible evidence of ongoing or unresolved psychological, behavioral, or integrity risks that are likely to recur under the demands of public safety work. Evaluators should differentiate between historical, resolved issues and those that remain active or unaddressed—and document the rationale for how identified risks may translate into future performance concerns.

Key Question:

How should an evaluator describe longstanding developmental or social-perception difficulties in a clear, non-diagnostic manner that is appropriate for a lay audience and focuses on job-relevant implications?

Answer:

When an individual shows a pattern of difficulty recognizing social cues—whether rooted in early development or simply part of their lifelong communication style—it is best to avoid any terminology that resembles a medical or clinical diagnosis. Diagnostic labels can be misinterpreted by non-clinical readers, may introduce legal concerns, and are unnecessary for conveying the relevant behavioral information.

Instead, the report should use plain, behavior-focused descriptions such as:

• “A longstanding difficulty accurately reading subtle social cues,”

• “A tendency to miss signs that others are frustrated, hurried, or uncomfortable,” or

• “A communication style that is quieter or more limited in facial expressiveness than is typical.”

The emphasis should remain on functional workplace impact, not origins or diagnostic naming. Appropriate examples include:

• He may need more direct or concrete communication to ensure clarity.

• He may not readily detect nuanced emotional tones in coworkers or members of the public.

• He may require occasional clarification to fully understand expectations or interpersonal dynamics.

• These traits do not inherently indicate poor performance but help the employer understand communication needs.

This approach allows the evaluator to be transparent about observed patterns while maintaining neutrality, avoiding clinical labels, and giving the employer practical information that supports supervision and performance management.

Summary:

Use broad, behavioral terms rather than diagnostic ones. Focus on how the individual’s communication and social-perception style may present in the workplace and what supervisory approaches can support success.

Key Question

When an evaluator issues a Weak but Suitable (WBS) recommendation based largely on mental health considerations, how much clinical detail is required in the report to support that determination?

Answer

When mental health factors play a central role in a Weak but Suitable determination, the report must clearly explain the specific clinical concerns that justify this designation. General statements such as “more to unpack” or references to ongoing therapy, without further clarification, are typically insufficient to support a WBS finding.

Evaluators should document concrete symptoms, functional impairments, emotional vulnerabilities, or clinically relevant stressors that meaningfully impact occupational readiness. If the applicant is asymptomatic, functioning well at work, and reporting no significant distress, the rationale for a WBS determination should be carefully reconsidered.

If ongoing therapy is cited, the report should explain whether this reflects active symptom management, unresolved trauma, emotional instability, or preventive/supportive care. Distinguishing between adaptive help-seeking and clinically concerning vulnerability is essential.

Additionally, evaluators should ensure consistency between narrative findings and overall conclusions. Statements indicating no acute symptoms should not conflict with a recommendation suggesting elevated concern.

Clear, specific documentation supports transparency, protects clinical credibility, and reduces the risk of misunderstanding by agencies and applicants.

Summary

When mental health factors drive a WBS recommendation, evaluators must clearly describe specific symptoms or functional concerns. Vague references to therapy or “unresolved issues” are insufficient without documented clinical impact.

Key Question

May a psychologist reference clinically relevant information obtained during a prior Fitness-for-Duty Evaluation (FFDE) when conducting a subsequent Pre-Employment Psychological Evaluation (PEP), and if so, what limitations apply?

Answer

Yes. Clinically relevant information obtained during a prior FFDE may be used during a subsequent PEP under specific conditions and with appropriate limitations:

• Information from a prior FFDE may be referenced generically (e.g., “in a prior evaluation at The FMRT Group”) when it is clinically relevant to the current assessment.

• The psychologist may not disclose:

  • That the prior evaluation was an FFDE

  • The outcome (fit / not fit)

  • The agency for which the FFDE was conducted

  • The specific sources of records or consultations (e.g., hospital names, treating providers)

• This information should only be introduced when necessary, such as when an applicant denies, minimizes, or omits significant historical information that is material to risk assessment or clinical interpretation.

• The applicant may be asked directly about the issue (e.g., past depression, hospitalization, current functioning), without attributing the information to a specific prior evaluation type.

From a legal standpoint, because FMRT is the entity that holds the information for both the prior FFDE and the current PEP—and the psychologists function as contractors—HIPAA redisclosure limitations are not implicated in this context. The information was disclosed to FMRT, not to an individual psychologist, and remains within FMRT’s custody.

Summary

Clinically relevant information from a prior FFDE may be referenced in a subsequent PEP in a non-attributable, non-outcome-based manner when necessary for accurate assessment, while avoiding disclosure of evaluation type, findings, agency, or record sources.