R 172045Z NOV 20 MID200000387827U
FM SECNAV WASHINGTON DC
INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC
CMC WASHINGTON DC
MSGID/GENADMIN/SECNAV WASHINGTON DC/-/NOV//
SUBJ/ORGANIZATIONAL INCIDENT OPERATIONAL NEXUS//
NARR/REF A IS BUMED NOTICE 6010, IMPLEMENTATION OF ORGANIZATIONAL INCIDENT
RMKS/1. This ALNAV provides an overview of the Organizational Incident
Operational Nexus (ORION) program, which Navy Medicine (NAVMED) began
implementation on 15 June 2020.
2. ORION is NAVMED's program for tracking exposure to unit-level
psychological trauma and conducting targeted outreach to Service Members in
the Navy and Marine Corps.
3. Following the Navy's 2017 maritime collisions involving the USS JOHN S.
MCCAIN (DDG 56) and USS FITZGERALD (DDG 62), NAVMED conducted a comprehensive
review of current psychological trauma tracking systems and touchpoints
across NAVMED to identify how Service Members involved in the collisions
could be followed over time in order to mitigate the risks of future adverse
psychological outcomes. The review revealed there was no enterprise-wide
system for tracking Sailors and Marines exposed to non-combat related trauma.
Subsequently, the Navy developed ORION, a program designed to provide
comprehensive tracking of psychological trauma exposure and conduct targeted
outreach (caring contacts) to Service Members at elevated risk for
psychological injury. The Bureau of Medicine and Surgery (BUMED) conducted a
one-year proof of concept ORION pilot with crews from the 2017 maritime
collisions and two commands who utilized special psychiatric rapid
intervention team (SPRINT) support after suicides. The pilot demonstrated
that ORION was successful in identifying Service Members in need of mental
health follow up and connecting them to available resources up to a year
after the traumatic event, even when the members of the crews had dispersed
to over 200 new commands around the globe. NAVMED is committed to ensuring a
"no wrong door" philosophy leveraging all available options for Service
Members to receive mental health services when needed. Embedded mental
health and SPRINT continue to serve as NAVMED's primary tools for immediate
mental health support after traumatic events. Service Members also complete
the Periodic Health Assessment and Mental Health Assessment annually which
includes items that screen for various mental health disorders. ORION serves
as a critical, additional tool to provide extended, comprehensive tracking
for impacted Service Members and ensures no Service Member is lost during
follow up; even if they have transferred to another command or separated from
4. ORION is designed for utilization by all Navy and Marine Corps commands
that experience a unit-level, non-combat trauma in which the trauma involves
any loss of life or presumed or expected loss of life and occurs while in the
performance of official duties. Commanding officers, in coordination with
their Senior Medical Department Representatives (SMDR), will determine if a
unit-level, non-combat trauma meets these criteria for ORION activation. For
traumatic incidents that do not meet these criteria, ORION may be utilized
for tracking and targeted outreach at a commanding officer's discretion.
5. If an incident meets ORION activation criteria or the commanding officer
elects to use ORION, the SMDR or a designated medical lead will access the
ORION registry within 10-days of a traumatic event. SMDRs or a designated
medical lead will stratify Service Members within their command into exposure
categories based on their proximity to the incident, as described in
reference (a). The exposure category will determine each Service Member's
risk level and the specified interval for targeted outreach.
a. The ORION registry is currently in development as an application
within CarePoint. A secure ORION-specific web address for SMDRs or a
designated medical lead to access ORION registry will be disseminated as soon
as it is available.
b. Until the ORION registry is available, the SMDR or a designated
medical lead will activate ORION by notifying the Naval Center for Combat and
Operational Stress Control (NCCOSC) at (619) 532-7484 or e-mail at
c. If a command does not have an SMDR or a designated medical lead,
coordinate ORION activation by contacting NCCOSC.
d. Formal message request is not required for ORION activation.
6. ORION Outreach Coordinators will conduct targeted outreach at specified
intervals for 12 months post-incident according to the Service Member's
exposure category and risk level for psychological sequelae (6 and 12 months
for moderate risk; 4, 8 and 12 months for high risk). Caring Contacts are
non -clinical (not documented in the Service Member's electronic medical
record) and involve reaching out to Service Members over e-mail or by phone,
and connecting them to mental health resources as desired by the Service
7. Resources are available for use by leadership and SMDRs at:
8. The BUMED point of contact for ORION is CDR Robert D. Lippy, available at
(619) 532-7484 or via e-mail at firstname.lastname@example.org.
9. This ALNAV will remain in effect until superseded or canceled, whichever
10. Released by the Honorable Kenneth J. Braithwaite, Secretary of the