Liz Luras was a promising U.S. Army private, tracked to do intelligence work because of her high test scores, when she was raped by her date to the Marine Corps ball in the early 2000s. When another soldier reported what had happened, Luras says she became the subject of hazing and abuse. She was raped two more times and kept silent about it. Still, Luras says that not long after the latter assault, her drill sergeant ordered her to sign papers agreeing to her discharge. It was only later, when she looked closely at the papers, that she realized they described her as having a “personality disorder”—a mental health condition with which she had never been diagnosed. That label changed the course of Luras’ life, barring her from reenlisting in the military and lowering her chances of securing other work. Now an activist for other survivors, Luras says that even within the veteran community, she has felt “this whole other layer of shame.”

Luras is one of over 200 sexual assault survivors from all branches of the U.S. Armed Forces whose stories are part of a new Human Rights Watch report. It’s an old strategy to undermine a victim of sexual assault by calling her crazy—and this is exactly what the U.S. military is accused of doing to thousands of servicemen and women. “‘Personality Disorder’ discharges—a term used to describe a mental health condition that can disqualify someone from military service—were once ‘the fastest and easiest way to get rid of someone’ in the military,” the report explains. From 2001 to 2010, over 31,000 service members received PD discharges, “often after only a single cursory interaction with a doctor.” The report continues: “PD does not have greater prevalence among females. However, between 2000 and 2010, the services discharged women for PD at rates nearly double what would be expected given the proportion of women in service.”

In some cases, survivors were even slapped with an “Other Than Honorable” discharge, often making them ineligible to receive any of their military benefits—including the medical benefits that would have allowed them to seek treatment for any post-traumatic stress that had resulted from sexual assault. These “OTH” discharges were often punishment for fleeing the base to escape a rapist, an act that superiors considered going AWOL, regardless of the circumstances.

The report is especially critical of the dead-ends that await former service members who try to have a discharge upgraded to “honorable” status, or a false diagnosis of mental illness erased, with the help of a military branch’s Discharge Review Board or the Board for Correction of Military Records. As Human Rights Watch explains, “well over 90 percent of those applying to the Boards are rejected with almost no opportunity to be heard or meaningful review,” and “between January 2009 and December 2012 the BCNR granted upgrades to just 1 percent of the 4,189 Other Than Honorable discharges it reviewed,” according to data provided by the Navy. In sum, the report says, “Because of the low likelihood of success, a military law expert described the Boards as ‘a virtual graveyard.’”

In recent years, the Department of Defense has begun to enact sweeping changes of its handling of sexual assault under a 2014 law authored by U.S. Senator Claire McCaskill. This follows a series of 2008 reforms that made it harder to discharge servicemembers for mental health reasons without the diagnosis of a qualified expert, eliminating the “PD discharge” as a fast-track way of ridding a unit of anyone deemed a troublemaker. McCaskill’s law guarantees that every person who reports a sexual assault is assigned an independent lawyer to defend his or her interests, and establishes a new system through which rape victims can seek to have their discharges changed or overturned. As the HRW report notes, “DOD has not collected information on whether that policy has been implemented, so it is difficult to know to what extent service members have been willing to challenge their separations.” Still, a military-wide RAND Corporation survey returned promising results in 2015: It calculated that cases of “unwanted sexual contact” declined by 27 percent between 2012 and 2014, and that the number of reports surged 70 percent in the same timeframe.

The HRW report makes clear that, though rape victims are less likely to be wrongly branded with a “Personality Disorder” or an “Other Than Honorable” discharge than they were in Luras’ time, military survivors still face many injustices. For those who were sexually assaulted before the latest round of reforms, the “virtual graveyard” of the old system remains the only available recourse; the report closes by urging both Congress and the Secretary of Defense to reform the review boards into a real source of redress.

Whether or not lawmakers heed that call, Senator Claire McCaskill is continuing her efforts: This spring, she teamed up with Senator Joni Ernst to introduce a bill that would make retaliation against survivors a unique offense under the military justice code. RAND’s survey found that 62 percent of women who reported sexual harassment or assault experienced some form of social or professional punishment in return. In some cases, this retaliation may still include bogus diagnoses of mental health problems: HRW contends that, even in the wake of reforms, the military doesn’t keep good enough records to say for sure if commanders are following the rules devised to keep this from happening. At the very least, the problem hasn’t been entirely eliminated. As one Navy seaman wrote, in 2010, “I was drugged and raped. I couldn’t take it anymore and when I tried to report it, I was instead sent to a mental hospital and discharged for having ‘depressed mood.’”