What Is Part 6 of Form I-693 (Mental Health and Substance Use)?
Quick Answer
Part 6 of Form I-693 documents the civil surgeon's evaluation of the applicant's mental health and substance use history. The civil surgeon assesses whether the applicant has a physical or mental disorder associated with harmful behavior, or a history of substance abuse or addiction, which are potential grounds of inadmissibility under U.S. immigration law.
What Does the Civil Surgeon Evaluate in Part 6?
The civil surgeon conducts a clinical assessment of the applicant's mental health and substance use history during the physical examination. This includes asking about any history of psychiatric diagnoses, hospitalizations, mental health treatment, and substance use or addiction. The civil surgeon also observes the applicant's behavior and demeanor during the appointment. Findings are documented in Part 6 of Form I-693.
What Triggers Further Evaluation?
If the civil surgeon identifies signs or symptoms of a mental health condition or substance use disorder during the examination, further evaluation may be required. This can include referral to a mental health specialist for a formal psychiatric evaluation. The civil surgeon cannot complete Form I-693 until the specialist's report is received and reviewed. Conditions that trigger further evaluation include active psychosis, severe depression, documented history of harmful behavior, and current substance abuse.
What Mental Health Conditions Are Grounds for Inadmissibility?
Under the Immigration and Nationality Act, a physical or mental disorder associated with harmful behavior — or a history of such behavior that is likely to recur — is a ground of inadmissibility. The key factor is not the diagnosis itself, but whether the condition is associated with behavior that poses a threat to the applicant or others. Many mental health conditions, including depression, anxiety, and PTSD, are not grounds of inadmissibility unless they are associated with harmful behavior.
Substance Abuse and Addiction
Drug abuse and drug addiction are separate grounds of inadmissibility under U.S. immigration law. The civil surgeon evaluates the applicant's substance use history and documents findings in Part 6. Current drug abuse or addiction must be reported. A history of substance use that is in remission may still be documented, but the civil surgeon will assess whether it currently constitutes a ground of inadmissibility. Alcohol use disorder is evaluated under the mental disorder provisions.
How Are Findings Documented?
The civil surgeon documents findings in Part 6 by indicating whether the applicant has a physical or mental disorder associated with harmful behavior, a history of such a disorder, or a substance use disorder. If any of these conditions are present, the civil surgeon provides additional detail and may attach a specialist's report. If no such conditions are identified, the civil surgeon indicates that the applicant has no findings in this section. Most applicants have no reportable findings in Part 6.
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