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Real Warriors provides suicide prevention tools for all beneficiaries

Sunset light creates silhouette of two military personnel Soldiers from Delta Company, 2-108th Infantry Battalion, 27th Brigade, conduct a partnered-Afghan National Security Force security patrol at dusk. (Photo by Army 1st Lt. Jason Uhlig.)

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Suicide Prevention | Psychological Fitness | September Toolkit

Every September, the Department of Defense and the nation place the medical spotlight on suicide prevention with Suicide Prevention Month.

However, suicide prevention is important every day especially for our nation’s wounded, ill, and injured service members and their families. Recovering service members often face emotional or psychological concerns after experiencing a serious injury or illness, which can put them at greater risk for suicide.

Within the Defense Health Agency, the Real Warriors Campaign promotes a culture of support for psychological health by encouraging the military community to reach out for help if struggling with a psychological health concern.

Real Warriors supports the DHA’s Psychological Health Center of Excellence in its mission to break the stigma associated with psychological health concerns. The campaign focuses on encouraging help-seeking behavior among service members, veterans, and military families that may be coping with invisible wounds.

Significant changes in daily behavior and experiences may increase suicide ideation and suicide-related behavior. These changes may include the loss of a fellow warrior, friend, or loved one; trouble sleeping; disciplinary or legal action; health, financial, or relationship problems; feelings of failure; difficulties at work; or other personal issues.

“If you start to notice changes in a loved one’s behavior that seem to persist, it may be time to start a conversation with that person,” advised Dr. Nick Polizzi, a psychologist and the Real Warriors Campaign government action officer.

Real Warriors advises those in the military community to reach out for help if they experience or see these risk factors with their friends or loved ones.

Real Warriors also offers the following techniques to discuss with your provider in aiding your recovery:

  1. Confide in someone you trust. Speak with a family member, fellow warrior, unit leader, or military chaplain. Talking about what is bothering you is a great first step in the process of receiving support, getting other perspectives, and reducing distress.
  2. Make your environment safe. Give any potentially dangerous items to a trusted person if you feel such items are unsafe with you.
  3. Avoid alcohol and other substances. Substance misuse may feel like “medicine” for your stress level while making your thoughts worse.
  4. Take care of your mind and body. Healthy ways to manage stress include physical activities like walking and running, other activities and hobbies, and different forms of relaxation, such as deep breathing and mindfulness meditation.
  5. Write it out. Consider using a journal to express pain, anger, fear, or other emotions.

If you feel like you are in crisis or if you’re having suicidal thoughts, seek help from a health care provider.

All service members, veterans, and their families are encouraged to contact the Military Crisis Line at 800-273-8255 and press 1 to speak with a trained counselor. The support is free, confidential, and available every day 24/7.

If you or a loved one need information about psychological health concerns, contact the Psychological Health Resource Center at 866-966-1020 to confidentially speak with trained health resource consultants 24/7.

For additional information about suicide prevention, visit the Real Warriors Campaign.

Remember, reaching out is a sign of strength.

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This Defense Health Agency-Administrative Instruction (DHA-AI), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (s), establishes the Defense Health Agency's (DHA) procedures to: a. Set procedures, responsibilities, and implement guidance for administering the DHA RA Program in accordance with federal guidelines. b. Provide, submit, and respond to requests for RAs of qualified individuals with disabilities who are employees or applicants for employment. c. Process RA requests for DHA employees and applicants with disabilities to ensure an appropriate response in a timely manner. Further, these procedures establish criteria for collecting and annually reporting data on the numbers and types of request for RA considered.

  • Identification #: DHA AI 1020.01
  • Date: 11/2/2020
  • Type: Administrative Instructions
  • Topics: Physical Disability

DHA PM 6025-01: Primary Care Behavioral Health (PCBH) Standards

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This Defense Health Agency-Procedures Manual (DHA-PM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (i), establishes the Defense Health Agency’s (DHA) procedures to establish required standards for: a. Military Medical Treatment Facilities (MTFs) and primary care clinics for adult, child and adolescent, health behavior, behavioral medicine, and behavioral health services in primary care. b. Behavioral Health Consultants (BHCs). c. Behavioral Health Care Facilitators (BHCFs). d. External Behavioral Health Consultants (EBHCs). e. Primary Care Clinic Leaders.

DHA PI 6490.02: Behavioral Health (BH) Treatment and Outcomes Monitoring

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This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (k): a. Establishes the Defense Health Agency’s (DHA) procedures for the collection and analysis of BH outcome data. b. Addresses how DoD will standardize BH outcome data collection to: assess variations in mental health and substance use care among in-garrison medical treatment facilities (MTFs) and clinics; assess the relationship of treatment protocols and practices to BH outcomes; and identify barriers to provider implementation of evidence-based clinical guidance approved by DoD. c. Designates the Army as the DoD lead Service for maintenance and sustainment of the Behavioral Health Data Portal (BHDP) in specialty care mental health and substance use clinics, referred to collectively as BH clinics, until BHDP functionality can be integrated with GENESIS or another electronic health record (EHR) system managed by DHA. d. Designates DHA Information Operations (J-6) as lead on transitioning BHDP functional requirements related to outcomes monitoring to future EHR data collection platforms and processes.

  • Identification #: DHA PI 6490.02
  • Date: 7/12/2018
  • Type: DHA Procedural Instruction
  • Topics: Substance Abuse

DoD Instruction 6490.10: Continuity of Behavioral Health Care for Transferring and Transitioning Service Members

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In accordance with the authority in Reference (a), this Instruction establishes policy for the Military Departments, assigns responsibilities, and prescribes guidelines for establishment of Military Department policy and procedures to ensure continuity of behavioral health (BH) care at the losing and gaining installations when Service members transition from one health care provider (HCP) to another when transferring to a new duty station or transitioning out of the Service.

  • Identification #: DoD Instruction 6490.10
  • Date: 10/28/2015
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DoD Instruction 6490.15: Integration of Behavioral Health Personnel (BHP) Services Into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings

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This instruction establishes policy, assigns responsibilities, and prescribes procedures for attainment of inter-Service standards for developing, initiating, and maintaining adult behavioral health services in primary care.

  • Identification #: DoD Instruction 6490.15
  • Date: 11/20/2014
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DoD Instruction 6490.05: Maintenance of Psychological Health in Military Operations

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This instruction establishes policy and assigns responsibilities in accordance with References (c), (d), and (e) for developing combat and operational stress control (COSC) programs within the Military Departments, the Combatant Commands, and joint Service operations.

  • Identification #: DoD Instruction 6490.05
  • Date: 10/2/2013
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DoD Instruction 6490.12: Mental Health Assessments for Service Members Deployed in Connection with a Contingency Operation

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This instruction establishes the policy for person-to-person deployment mental health assessments for each member of the Military Services deployed in connection with a contingency operation according to Section 1074m of Title 10, United States Code (Reference (b)).

  • Identification #: DoD Instruction 6490.12
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DoD Instruction 6490.04: Mental Health Evaluations of Members of the Military Services

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Reissues DoD Instruction 6490.4 (Reference (b)), establishing policy, assigning responsibilities, and prescribing procedures for the referral, evaluation, treatment, and medical and command management of Service members who may require assessment for mental health issues, psychiatric hospitalization, and risk of imminent or potential danger to self or others.

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DoD Instruction 6490.08: Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members

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This instruction provides guidance for balance between patient confidentiality rights and the commander’s right to know for operation and risk management decisions.

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Mental Health Assessments for Members of the Armed Forces Deployed in Connection with a Contingency Operation

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Policy Guidance for Deployment-Limiting Psychiatric Conditions and Medications

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HA 97-017: Policy for Post-Deployment Mental Health Screening in the Bosnian Theater

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This memo describes a change in procedure for medical surveillance of U.S. forces deploying to Bosnia.

  • Identification #: HA 97-017
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