R 181600Z SEP 23
MARADMIN 463/23
MSGID/GENADMIN/CMC WASHINGTON DC MRA MF//
SUBJ/SELF-INITIATED REFERRAL PROCESS FOR MENTAL HEALTH EVALUATIONS OF MARINES – THE BRANDON ACT//
REF/A/MSGID:DOC/DOD/YMD:20230505//
REF/B/MSGID:DOC/DOD/YMD:20200422//
REF/C/MSGID:DOC/DOD/YMD:20110817//
REF/D/MSGID:DOC/ALNAV/YMD:20230201//
REF/E/MSGID:DOC/ALNAV/YMD:20230711//
REF/F/MSGID:DOC/PUBLICLAW/YMD:20200625//
NARR/REF A IS DIRECTIVE-TYPE MEMORANDUM 23-005 – “SELF-INITIATED REFERRAL PROCESS FOR MENTAL HEALTH EVALUATIONS OF SERVICE MEMBERS.” REF B IS DEPARTMENT OF DEFENSE INSTRUCTION (DoDI)6490.04, MENTAL HEALTH EVALUATIONS OF MEMBERS OF THE MILITARY SERVICES. REF C IS DEPARTMENT OF DEFENSE INSTRUCTION 6490.08, COMMAND NOTIFICATION REQUIREMENTS TO DISPEL STIGMA IN PROVIDING MENTAL HEALTH CARE TO SERVICE MEMBERS. REF D IS ALNAV 015/23 INDIVIDUAL MEDICAL READINESS ELEMENTS, GOALS, AND METRICS POLICY UPDATE. REF E IS ALNAV 054/23 IMPLEMENTATION OF BRANDON ACT. REF F IS SECTION 704 OF PUBLIC LAW 117-81 THE BRANDON ACT.//
POC/TOMOMI OWENS/NAF5/MFC/TEL: 703-432-9797/EMAIL: TOMOMI.J.OWENS@USMC.MIL//
GENTEXT/REMARKS/1. Purpose. This MARADMIN announces the release of reference (a), Directive-Type Memorandum (DTM) 23-005 – “Self-Initiated Referral Process for Mental Health Evaluations of Service Members.” This MARADMIN sets forth the self-initiated referral process for the mental health evaluation (MHE) of Marines as directed in references (a) and (b). For Marines not serving on Active Duty, command plans and arrangements for referral requests will be established as soon as practicable.
2. Implementation of reference (a) is effective 5 May 2023, and will be incorporated into reference (b). This MARADMIN also aligns with reference (c), which calls for commands to dispel stigma associated with mental health care. Reference (d) addresses individual medical readiness and reporting requirements. Reference (e) addresses implementation of reference (f), known as the Brandon Act.
3. Background. Per reference (a), Marines may initiate a referral process for an MHE through their commanding officer (CO) or supervisor in the grade of E-6 or above. The Brandon Act aims to reduce stigma by allowing Marines and/or attached Service Members to seek mental health services and foster a culture of support to create an environment that promotes help-seeking behaviors.
4. Intent. Immediate implementation of the Brandon Act, per reference (a). Marines serving on Active Duty may request a referral for an MHE at any time and in any environment.
5. Method.
5.a. Mental health is health, and the health of our people is critical to being ready to fight and win. For most Marines, mentorship, support, and problem-solving skills will give them what they need to stay in the fight. In addition, command programs such as Combat and Operational Stress Control (COSC) are designed to help provide additional skills and coping mechanisms for managing the stress that accompanies Military Service. However, there are times when our people need additional help. Commanders, leaders, supervisors, and civilian and military managers at all levels must continue to normalize talking about mental health issues, destigmatize seeking mental health care, and strongly encourage Marines to make use of health and mental wellness resources throughout their careers.
5.b. Marines may request a referral for any reason or on any basis including, but not limited to, personal distress, personal concerns, and trouble performing duties and functioning in activities valued by the Marine that may impact possible changes in mental health. Marines are not required to provide a reason or basis for the request or referral. COs or leaders in the grade of E-6 or above will ensure measures are in place so Marines understand the procedures to request a referral for an MHE. COs or leaders will refer Marines to a mental health provider for an MHE as soon as practicable. Marines who prefer to have their chain of command involved with scheduling a mental health care appointment through the military health system, in line with reference (a), can receive assistance from the CO, or from an E-6 and above, by specifically requesting a self-initiated referral for an MHE. Procedures for a self-initiated referral for an MHE are outlined in reference (a). Referrals for MHEs should be treated in a manner similar to referrals for other medical services, to the maximum extent possible. Marines’ patient rights and confidentiality are protected as much as possible, in accordance with reference (a). If COs have concerns about a Marine’s behavior, significant changes in performance, or fitness for duty, see reference (b) for command-directed MHE procedures.
6. The Brandon Act does not change existing referral processes for network care. Marines cannot be seen for specialty care including mental health care in the civilian healthcare network without a referral. Referrals to the network are made by the Marine’s Primary Care Manager (PCM) or Mental Health Professional (MHP) at the local military medical treatment facility (MTF). For Marines in commands with an assigned embedded mental health provider, typically called the Operational Stress Control and Readiness (OSCAR) Provider, the embedded mental health provider is the primary source for mental health care. A referral is required for a Marine to be seen for specialty care in the civilian healthcare network. TRICARE patients are not authorized to be seen for behavioral health services in the civilian community without a referral from their PCM.
7. A Marine experiencing a suicidal ideation constitutes an emergency. Suicidal ideations are defined by thinking about, considering, or planning for suicide or self-harm.
7.a. Marines within the United States experiencing a suicidal ideation should call the Veterans Crisis Line at 988 and press 1 or go directly to the nearest emergency room.
7.b. In Europe, call 00800 1273 8255 or DSN 118. In Korea, call 080-855-5118 or DSN 118. In the Philippines, call #MYVA or 02-8550-3888 and press 7. In Japan, call 098-970-8255 or 098-954-0123 from a Japanese cellular phone. For all other locations, reach out via the Veterans Crisis Line by following the country code dialing procedures to call the CONUS 800 number 1-800-273-8225 and press 1. Alternatively, Marines can open a chat at https:(slash)(slash) www.veteranscrisisline.net/get-help-now/chat/ and request a phone call from the crisis line responder who will call them at any OCONUS location or follow local procedures to access emergency care.
7.c. Mental health issues that may affect Marines’ readiness to deploy, ability to perform their assigned mission, or fitness for retention in military service are reportable medical issues in line with reference (d). Marines have a responsibility to report mental health issues that may impact their individual medical readiness status, such mental health issues must be reported to their command in line with reference (d).
8. Leaders at all levels should be aware of and promote mental health and non-medical resources available to Marines: https:(slash)(slash) www.usmc-mccs.org. They should reinforce the “No Wrong Door” policy for Marines to receive support, which consists of accessing the full continuum of resources to ensure appropriate care and support.
9. This MARADMIN applies to Active-Duty Marines and members of the Active Reserve.
10. Reference (a) will expire effective 5 May 2024.
11. Release authorized by LtGen James F. Glynn, Deputy Commandant for Manpower and Reserve Affairs.//