Soldiers who suffer from physical and behavioral health issues are in particular need of oversight and risk mitigation from leadership, as well as potential medical intervention. Each Warrior Transition Unit (WTU) Commander should seek input from subject matter experts (SMEs) such as the U.S. Army Medical Command’s (MEDCOM’s) behavioral health staff , the U.S. Army Public Health Command and the U.S. Preventative Services Task Force (USPSTF) to identify and manage high risk Soldiers.
Additional tools and resources are available to help you determine a Soldier’s risk level and mitigate risks such as the Composite Risk Management and Environmental Considerations section of AR 350-1 or contacting your local military treatment facility (MTF) Risk Management Team for additional information on monthly risk utilization meetings and hospital resources.
Whenever a Soldier at risk is identified, the following persons are typically involved in gathering the information:
Squad Leaders, NCMs, and behavioral health and medical providers are each responsible for conducting an independent evaluation of the Soldier’s risk level and informing the Company Commander, who is responsible for developing the Commander’s Risk Assessment. For additional information on the Commander’s Risk Assessment, reference Warrior Care and Transition Program (WCTP) Policy Memo 13-010 .
Once screening is complete, the Commander, in collaboration with the Soldier’s Triad of Care, should decide upon and implement any necessary mitigation measures. Risk assessments and mitigation actions should be recorded in the Army Warrior Care and Transition System (AWCTS), with risk levels (low-green, moderate low-amber, moderate-red, high-black) recorded.
Events that cause consideration of immediate reassessment:
The following risks assessments should be performed:
Events that cause consideration of immediate reassessment:
Cadre should attempt to get to know their Soldiers, which is the first line in identifying and mitigating risk. Cadre should recognize their Soldiers’ involvement in high risk behaviors such as substance and alcohol use, as well as multi-medication use and family issues. Awareness, early recognition and intervention can mitigate risk.
The LCSW uses PBH-TERM, to determine a Soldier’s risk level. This tool uses standardized, evidence-based informed screening questions and a behavioral health case complexity scale to support clinical decision-making for risk estimation, assessment and management. This information should be entered into AWCTS to communicate the identified behavioral health risks to members of the Triad of Care, so that they can mitigate and monitor risks.
Soldiers’ answers to questions in the assessment tool can trigger red flags that may signal future behavior that Cadre should continue to investigate. Commanders can help mitigate risk by learning the coping mechanisms of their Soldiers and selecting risk mitigations actions specific to the Soldier’s level of risk and extenuating circumstances. Soldiers at any risk level may have the following mitigation actions:
For high-risk Soldiers, specific mitigation actions may include:
For additional information on Soldier risk assessments, reference the following policies and resources:
When must the initial risk assessment be completed?
Who must complete/enter risk assessment information in AWCTS?
How often should the Licensed Clinical Social Worker (LCSW) conduct the risk assessment?
Who is responsible for designating the overall risk for the risk assessment and the risk mitigation plan?
The initial risk assessment must be completed within 24 hours of a Soldier’s arrival at a WTU.
The Squad Leader, Nurse Case Manager, LCSW, and the Commander must enter risk assessment information in AWCTS.
The LCSW should conduct a risk assessment weekly for high -risk, monthly for moderate-risk, and every three months for low-risk Soldiers.
The Commander is responsible for making the risk level designation and finalizing the risk mitigation plan.