The Stress Continuum Model
While various life circumstances can produce added stress for the Sailor aside from the demands of his/her rate and work duties, it is recommended that Navy leaders encourage Sailors to voluntarily seek assistance when signs of distress appear and the sailor may have difficulty coping. Staff such as the Military Treatment Facility (MTF) Mental Health Department and embedded Mental Health Professionals at some commands are available to provide psychological evaluation and counseling services. Additional local counseling resources include Fleet and Family Support Centers (FFSC), Marine Corps Community Services (MCCS) and Military OneSource at 1-800-342-9647
Commanders can demonstrate leadership and direct involvement in the development of a culture of total well-being of sailors/service members by providing consistent and ongoing messaging and support for the benefits and value of voluntarily seeking mental health care and substance abuse education.
In accordance with the DoD Instruction 6490.04 (“Mental Health Evaluations of Members of the Military Services,” March 4, 2013), the Commanding Officer (CO) or a Supervisor may direct the Sailor to undergo a mental health evaluation. A command directed mental health evaluation is appropriate for a variety of reasons such as when the CO believes in good faith that the Sailor's mental health state renders them a risk to themselves or others, for fitness for duty or due to marked changes in their behavior and performance.
A command directed mental health evaluation is not needed and does not apply for the following situations-
There are two types of Command Directed Mental Health Evaluations. These include non-emergency MHE and emergency MHE.
The responsibility for determining whether a command directed mental health evaluation is needed rests upon the Commander or supervisor at the time of the referral. A senior enlisted member may be designated by the commander or supervisor for ordering an emergency command directed evaluation. In instances involving an officer, an officer of rank senior to the officer to be referred may be designated.
When a commander or supervisor, in good faith, believes that a sailor/service member may require a command directed mental health evaluation, he/she will-
An emergency command directed mental health evaluation may be initiated by the CO as soon as practical under the following-
When the command refers the sailor/service member for an emergency mental health evaluation, due to concerns about potential or imminent danger to self or to others, these safety and communication principles and strategies are suggested.
Commanding Officers and supervisors may make informal, non-mandatory recommendations for sailors/service members to seek care from a Mental Health Professional when circumstances do not require a command directed evaluation based on safety or mission concerns. The commander or supervisor will inform the sailor/service member that he/she is providing a recommendation for voluntary self-referral and not ordering the care.
Commanders and supervisors may educate sailors/service members with additional options for assistance, including confidential counseling from Military OneSource and chaplains and options for assistance with financial, legal, childcare, housing and educational issues.
Commanders and supervisors will not substitute alternative approaches to CDE when there is significant concern regarding a sailor/service member’s safety or performance of duty or concern for the safety of others
Any sailor/service member who believes that a command directed evaluation is a reprisal for the service member having made a protected communication may file a complaint with the DoD IG Hotline or a Military Department IG. DoD Directive 7050.06 “Military Whistleblower Protection” July 23, 2007.
Commander or supervisors:
No one may refer a Service member for a MHE as a reprisal for making or preparing a lawful communication of the type described in section 1034 of Title 10, United States Code and in DoD Directive 7050.06
Following a CDE request, the Commander may anticipate the following-
REMEMBER: A SAILOR/SERVICE MEMBER IN IMMINENT DANGER OF HARM TO SELF OR TO OTHERS MUST BE TAKEN TO MEDICAL OR THE NEAREST EMERGENCY ROOM IMMEDIATELY. IF PROPER REFERRAL PROCEDURES HAVE NOT YET BEEN FOLLOWED FOR A FULL EVALAUTION, A BRIEF SAFETY ASSESSMENT WILL STILL BE CONDUCTED.
NOTE: SECNAVINST 6320.4A was cancelled, effective 19 June 2013
Bureau of Medicine and Surgery
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