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Suicide and Homicide Risk Management

EXHIBIT 26-5

UNIT WATCH DISCONTINUATION MEMORANDUM

Date:

MEMORANDUM FOR (Commander, Unit)

SUBJECT: Release from Twenty Four Hour Watch/Buddy Watch for _____________________________

SSN: _____________________________________________________________________

1. The above named service member was recommended for Twenty Four hour Watch/Buddy Watch on ________ .

2. The above named service member was evaluated at _____________ Behavioral Health clinic again on ________ . I

currently do not believe that the service member is an imminent risk to self or others and recommend the service

member be removed from Twenty-Four Hour Watch/Buddy Watch.

3. Although this service member is not currently at significant risk for dangerousness to self or others, please under-

stand that the service member’s risk level may change.

4. If the service member experiences a recurrence of suicidal or homicidal thoughts or demonstrates other behaviors

indicating there is risk for harm to self or others, the service member should be escorted to the clinic (duty hours)

or to the Emergency Department (after hours) for evaluation.

5. The service member’s next scheduled appointment at Outpatient Behavioral Health Services is on __________________

at ____________.

6. Point of contact for this memorandum is the undersigned at xxx-xxxx.

________________________________

Clinician

this watch are outlined in Exhibit 26-2.

a unit watch. This document provides education for the

The procedures outlined for both types of unit watch

command team and may alleviate concerns about the

are designed to give the commander specific guidance

safety and value of a unit watch. Command support

regarding measures to ensure the soldier’s safety. This

of the unit watch is crucial. If not fully informed and

written guidance helps to reduce confusion, which of-

educated about the unit watch, unit leaders may feel

ten results if a more vague verbal recommendation for

compelled to intervene further and attempt to force the

a unit watch is used to communicate with the chain of

mental health system to psychiatrically hospitalize the

command. The 24-hour watch is at times useful in the

service member.

management of a soldier with military-specific suicidal

Exhibit 26-4 is an example of a standard operating

or homicidal ideation who has very few risk factors

procedure for the behavioral health team, providing a

except for a verbalized threat, such as “I will kill myself

general guide for the use of unit watch in a garrison set-

(or my squad leader) if I have to go back to my unit.”

ting. Clinicians’ beliefs about the need for psychiatric

It is often, though not necessarily, used in conjunction

hospitalization in various situations differ significantly,

with an environmental change, for instance, an agree-

so no absolute guidelines about which clinical factors

ment with the commander that the service member

require hospitalization over unit watch are included in

will be moved to a different platoon, if the threats of

this chapter. This variation in decisions regarding hos-

suicide or homicide are specific to alleged harassment

pitalization reinforces the critical role of documenting

by a noncommissioned officer in the service member’s

the clinical assessment and decision-making process in

section, squad, or platoon.

each case. Finally, when the clinician decides to recom-

In addition to the memoranda outlining specific rec-

mend discontinuation of the unit watch, it is helpful to

ommendations, the authors suggest that a unit watch

forward to the command team a standard document

information paper (Exhibit 26-3) be forwarded to the

with this recommendation. Commanders may wait for

commander, especially if the commander expresses

such written notification before discontinuing a watch.

confusion or skepticism about the recommendation for

Exhibit 26-5 is a sample memorandum.

433

Suicide And Homicide Risk Management Page 11

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