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A Sailor appears significantly distressed
Significant decline from prior functioning
On-duty performance or off-duty behavior has become increasingly problematic
Sudden onset of disciplinary problems
Comments aboutsuicide
Onset of problem interactions with peers/leaders
Persistent lack of motivation
Persistent failure to perform duties
Discuss the problem behaviors with the Sailor and inquire about suicidal thoughts
Communicate clear expectations regardingduty performance
Inquire about what factors might be contributing to the problem
Offer your support to the Sailor toward returning to full functioning, e.g., modified work schedule, temporary decrease in work-load/responsibilities
Discuss expectation that Sailor will adhere to Navy standards and follow-through with these expectations
Encourage self-referral to Mental Health, or to Medical
Consult with Mental Health Provider; specifically discuss any thoughts about suicidal behavior
If you suspect danger to self or others, or a severe mental disorder--initiate the emergency CDE procedures
Carefully document observed behaviors and counseling provided to member
If problem persists, contact a Mental Health Provider about a possible CDE
Suspected danger to self or others, or severe mental illness
Suicidecomments or threats
Threats to harm self or others
Delusions or hallucinations
Severe personality change
Prioritize the safety of the Sailor and others
Consult with Mental Health
Initiate emergency CDE procedures
Do not leave the Sailor unattended!
Use Security if necessary
CDE recommends return to duty with Mental Health follow-up suggested
Sailor participates in treatment
Communicate support for follow-up treatment
Continue to monitor the Sailor’s functioning, provide feedback, and document counseling
Notify Mental Health if there are any significant changes or if condition worsens
Reinforce improvement; acknowledge progress
CDE recommends administrative separation
Sailor refuses to participate in treatment
Sailor's ability to function in military environment is significantly impaired
Providesupport during the administrative separation
Encourage positive coping skills
CDE returns a diagnosis of "personality disorder"


Chronic conflicts with coworkers or leaders
Poor work performance
Difficulty acknowledging problems
Consistently engages in self-destructive behaviors
Counsel the Sailor about specific problems
Document behavior and counseling
Communicate with the provider and provide information on noted behaviors and concerns
Set clear limits with the Sailor, define the problem, and spell out expectations; hold Sailor accountable
Consideradministrative separation if performance and behavior problems persist 



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