Recognizing Mental Health Risk

Indicators You Watch For

Mental health risk shows in patterns.

• Withdrawal from peers and unit life.
• Sleep changes (oversleeping, insomnia, fatigue patterns).
• Mood shifts (irritability, sadness, flat affect).
• Performance decline tracing back to a specific event.
• Expressed hopelessness, worthlessness, or "everyone would be better off without me."
• Substance use changes.
• Talk of saying goodbye, giving away possessions, sudden generosity.
• Family stress overflow.
• Recent loss of a relationship, job opportunity, family member.
• Recent disciplinary action.
• Deployment-return adjustment difficulty.

A pattern across multiple indicators warrants immediate referral.

The First Conversation

In private. Direct.

• Acknowledge what you have observed.
• Express concern without diagnosis.
• Ask the direct question. "Are you safe?" "Are you thinking about harming yourself?"
• Listen.
• Connect with a resource same day.

Asking the direct question does not plant the idea. It opens the door.

The Resource Set

For acute risk, engage immediately. For chronic indicators, Behavioral Health or Chaplain referral.

Confidentiality

Marines often hesitate to engage Behavioral Health for fear of career impact.

• Behavioral Health has clinical confidentiality with specific exceptions (imminent harm, security clearance, certain regulatory thresholds).
• Chaplain confidentiality is broader. Many Marines start there.
• MFLC has non-medical counselor confidentiality.
• 988 is confidential and not part of the unit chain.

Brief the Marine on the confidentiality protections so they choose the right resource.

Coordinating With the Chain

Chain involvement scales with risk level.

• Acute risk. Chain engaged immediately for safety planning.
• Chronic indicators. Chain awareness for assignment, deployment, and watch decisions.
• Treatment in progress. Chain awareness as appropriate to the Marine's clinical guidance.

The chain is not the clinician. The chain supports the Marine's care.

Force Preservation Coordination

Mental health indicators feeding a pattern often warrant Force Preservation referral.

• Document the pattern.
• Coordinate with chain.
• Submit the referral.
• Implement recommendations.

Force Preservation can pull resources together in ways the section alone cannot.

After the Referral

Track to engagement.

• Did the Marine attend the first appointment?
• Is the Marine continuing the recommended care?
• Is the indicator pattern shifting?
• Does the section need to adjust workload, assignment, or expectations?

Mental health work takes time. The section's role is supportive consistency over months.

When the Marine Refuses Help

Some Marines refuse referral.

• Continue the conversation across multiple counseling sessions.
• Brief on confidentiality protections.
• Engage chaplain as a lower-threshold first step.
• If risk rises to acute, the chain engages mandatory referral per MCO 1500.60MCO 1500.60.

Mandatory referral is a last step. Voluntary engagement produces better outcomes.

Common Mental Health Risk Failures

• Indicators dismissed as Marine being moody.
• Referral made but never followed up.
• Acute indicators treated as chronic, urgency lost.
• Marine fears of career impact never addressed.
• Section assumes someone else is handling it.

Where to Go Next

• Wellness overview for the broader risk framework.
• Routing resources for the comprehensive resource map.
• Force Preservation referral for the formal council process.