Page 37 - JSOM Fall 2024

TABLE 2 Acute Suicide Risk 15
Stratification High acute risk Intermediate acute risk Low acute risk
Essential features Current suicidal ideation with Current suicidal ideation with lack of No current suicidal ideation
intent and plan, recent attempt intent and ability to agree to safety plan, or plan, no recent preparatory
lack of preparatory behaviors behaviors
Recommended actions Psychiatric hospitalization, direct Consider psychiatric hospitalization if risk Can be managed in primary care,
observation factors responsive to hospitalization outpatient mental health if co-
occurring conditions exist

TABLE 3 Chronic Suicide Risk 15
Stratification High chronic risk Intermediate chronic risk Low chronic risk
Essential features Chronic suicidal ideation and Similar to high chronic risk group in terms Lack of history of chronic
mental health disorder, history of of history but presence of protective factors suicidal ideation or behaviors
suicide attempts
Recommended actions Routine mental health follow-up, Routine mental health follow-up, well- Primary care or mental health
well-articulated safety plan (with articulated safety plan (with restriction follow on as needed basis
restriction of lethal means) lethal means)

BOX 4 Combat Psychiatric Care Algorithm Disclosures
If patient is: The author has no potential competing interests to disclose.
• Non-agitated & nonpsychotic  PIES  STAY IN THEATER Disclaimer
• Agitated & nonpsychotic  verbal de-escalation and/or The views expressed in this article are of the author and do
benzodiazepine then PIES  STAY IN THEATER or consider
MEDEVAC not necessarily reflect the official policy or position of the 2nd
• Non-agitated & psychotic/manic  antipsychotic  MEDEVAC Medical Battalion, 2nd Marine Logistics Group, United States
• Agitated & psychotic/manic  antipsychotic and/or restraints  Marine Corps, Department of Navy, Department of Defense,
MEDEVAC or the U.S. Government.
• Suicidal thoughts  PIES  STAY IN THEATER or consider
MEDEVAC Funding
• Suicidal behaviors PIES  MEDEVAC No funding was received for this work.
• Malingering  PIES  STAY IN THEATER
MEDEVAC = medical evacuation; PIES = Proximity, Immediacy, Ex- References
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