Operational Psychiatry



  • Identify common mental health problems
  • Discuss the common problems
  • Impart practical advice on management
  • Review administrative issues
  • Identify three steps you must take prior to deployment


  • Suicidal thoughts
  • Suicidal behavior
  • Depression
  • Grief
  • Psychosis
  • Posttraumatic stress


  • Suicide gesture vs attempt
  • Suicidal thoughts vs behavior
  • Suicide continuum

wondering, thinking, planning, resolve, action

  • Common ways to commit suicide

pills, cutting, jumping, CO, hanging, GSW

  • Quick demographics of suicidal behavior


  • More than depressed mood
  • Diagnosis requires symptoms, classically:
    • loss of interest, loss of sleep, loss of energy, loss of weight or appetite, loss of activity, loss of concentration, guilty thoughts, thoughts of suicide
  • Symptoms present for at least two weeks
  • Under diagnosed and under treated when diagnosed


  • Emotional distress at the loss of a loved one is not pathological; it is normal
  • Loss is personal, you have to see it from their eyes
  • Death of a parent is very hard
  • Loss includes more than death, it includes relationships
  • Marital rejection can be seen as grief

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  • Two major illness: Bipolar Disorder and Schizophrenia
  • To distinguish, look at sleep
  • Symptoms: hallucinations, paranoia, bizarre thoughts, unusual emotional expression, behavior that crosses the line
  • Bipolars can be aggressive
  • Command hallucinations


  • Exposure to life-threatening trauma: combat, disaster, rape, assault, injury
  • Symptoms: re-experiencing the trauma, life events trigger the trauma, and autonomic hyperarousal
  • May include aggression and seclusion
  • May induce shame
  • Past trauma predisposes PTSD


  • Respond to thoughts, take all behavior seriously
  • Being suicidal is temporary
  • People kill themselves when they are alone
  • Create a safe place in public
  • Address issues that caused the suicidal thoughts/behavior

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Lecture by

CAPT Doug Kempf, MC, USN
Surface Warfare Medicine Institute

2006 Surface Warfare Medical Officer Indoctrination Course
Naval Operational Medicine Institute
340 Huise Road
Pensacola FL 32508-1092

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