UNCLASSIFIED// ROUTINE R 172045Z NOV 20 MID200000387827U FM SECNAV WASHINGTON DC TO ALNAV INFO SECNAV WASHINGTON DC CNO WASHINGTON DC CMC WASHINGTON DC BT UNCLAS ALNAV 097/20 MSGID/GENADMIN/SECNAV WASHINGTON DC/-/NOV// SUBJ/ORGANIZATIONAL INCIDENT OPERATIONAL NEXUS// REF/A/DOC/BUMED NOTICE6010/BUMED/15JUN20// NARR/REF A IS BUMED NOTICE 6010, IMPLEMENTATION OF ORGANIZATIONAL INCIDENT OPERATIONAL NEXUS// 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 the Navy. 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 usn.ncr.bumedfchva.mbx.orion(at)mail.mil. 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 Member. 7. Resources are available for use by leadership and SMDRs at: https://esportal.med.navy.mil/bumed/rh/m3/m33/nccosc/programs/orion /supportcenter/index.aspx 8. The BUMED point of contact for ORION is CDR Robert D. Lippy, available at (619) 532-7484 or via e-mail at usn.ncr.bumedfchva.mbx.orion@mail.mil. 9. This ALNAV will remain in effect until superseded or canceled, whichever occurs first. 10. Released by the Honorable Kenneth J. Braithwaite, Secretary of the Navy.// BT #0001 NNNN UNCLASSIFIED//