Command Directed Evaluations

• General Considerations
• Is a Command Directed Evaluation (CDE) Appropriate?
• Routine CDE
• Emergency CDE
• Rights and Referrals
• What Commands Can Expect From the Mental Health Provider
• Checklist for Command Directed Mental Health Referrals

GENERAL CONSIDERATIONS

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.

IS A COMMAND DIRECTED MENTAL HEALTH EVALUATION (MHE) APPROPRIATE?

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-

• Voluntary self-referrals.
• Periodic pre- and post-deployment mental health assessments for Service members deployed in connection with a contingency operation in alignment with DoDI 6490.12, clinical judgments.
• Evaluations for special duty or occupational classifications and other evaluations expressly required by applicable DoD issuance or Service regulation that are not subject to the commanders’ discretion.
• Interviews conducted in accordance with guidelines established for drug or alcohol abuse rehabilitation programs in DoD Directive 1010.4
• Interviews conducted in accordance with guidelines established for the Family Advocacy Program.
• Responsibility and competency inquires in accordance with the Rule for Courts Martials 706 of the Manual for Courts-Martial.
• Clinical referrals requested by healthcare providers as a matter of clinical judgment and when the service member consents to the evaluation.
• Evaluations under authorized law enforcement or corrections system procedures.

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.

• Voluntary self-referrals.
• Periodic pre- and post-deployment mental health assessments for Service members deployed in connection with a contingency operation in alignment with DoDI 6490.12, clinical judgments.
• Evaluations for special duty or occupational classifications and other evaluations expressly required by applicable DoD issuance or Service regulation that are not subject to the commanders’ discretion.

NON-EMERGENCY MENTAL HEALTH EVALUATION

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-

• Advise the sailor/service member that there is no stigma associated with obtaining mental health services.
• Refer the sailor/service member to a Mental Health Provider, and give both their name and contact information.
• Tell the sailor/service member the date, time and place of the scheduled mental health evaluation.

EMERGENCY COMMAND DIRECTED MHE

An emergency command directed mental health evaluation may be initiated by the CO as soon as practical under the following-

• When a sailor/service member, by action or by words, engages in actual, attempted or threatened violence, intends or is likely to cause serious injury to self or to others.
• When the facts and circumstances indicate that a sailor/service member’s intent to cause an injury.
• When the CO believes that the sailor/service member may be suffering from a severe mental health disorder.

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.

• When a service member is exhibiting dangerous behavior, the first priority of the commander is to ensure that precautions are taken to protect the safety of the sailor/service member and others, pending arrangements for transportation of the sailor to the location of the emergency evaluation.
• The Commander will report to the mental health provider circumstances and observations regarding the sailor/service member that led to the emergency referral either prior to or while the sailor is en route to the emergency evaluation.

TOTAL WELL-BEING/NON MANDATORY COUNSELING

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

RIGHTS AND REFERRALS

Sailors:

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

WHAT COMMANDS CAN EXPECT FROM THE MENTAL HEALTH PROVIDER

Following a CDE request, the Commander may anticipate the following-

• Mental health providers will report to the Commanding Officer or the supervisor who makes the command directed evaluation and will make the minimum necessary disclosure, and will advise how the commander can assist the sailors/service member’s treatment.
• The Mental health provider will advise on any duty limitations or recommendations for monitoring or additional evaluation, recommendations for treatment, referral to a Medical Evaluation Board, or administrative separation for personality disorder or unsuitability for continued military service.

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.

REFERENCES

NOTE: SECNAVINST 6320.4A was cancelled, effective 19 June 2013