Enlisted initial entry training policies and administration


-11. Injury prevention measures



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3-11. Injury prevention measures

In addition to the guidance in Field Manual (FM) 7-22, the following measures should be employed to mitigate overuse injuries:


a. Place Trainee/Soldiers in order of height (shortest to tallest) in running and marching formations.
b. Ensure march paces do not exceed five kilometers per hour.
c. Use the fittest Trainee/Soldiers for road guard duties.
d. Rotate road guard responsibilities.
e. Avoid high impact activities for corrective training (running, marching, jumping). There is no benefit to exceeding the PRT guidelines for running.
f. Encourage Trainee/Soldiers to apply ice to injured areas when prescribed by a health care provider or recommended by self-care guidelines.
g. Maximize transportation vehicles for moving Trainee/Soldiers to training areas.
h. Encourage Trainees to wear the sock liner under the cushion sole sock during the first three weeks of training (during new boot break in period), and for any foot march greater than five kilometers.

3-12. Suicide prevention

a. The POI for IET will include formal instruction on suicide awareness and identification of potentially suicidal Trainee/Soldiers. The commanders and orientations will instruct Trainee/Soldiers on the appropriate actions they should take in the event a fellow Trainee/Soldier talks to them about suicide; specifically, Trainee/Soldiers must recognize the need to immediately notify the first cadre member available in the chain of command.


b. Commanders must comply with the provisions of Department of Defense Directive 6490.1 and Department of Defense Instructions 6490.4, before sending Trainee/Soldiers for behavioral health evaluations to avoid violations of legal requirements. Commanders must counsel Trainee/Soldiers reported to have discussed or alluded to suicide. The commander will ensure Trainee/Soldiers in emergency/urgent situations are immediately referred to behavioral health care providers for counseling and evaluation, and accompanied by an NCO to the appointment until the behavioral health care provider assumes control. An NCO is required to pick the Trainee/Soldier up from the behavioral health facilities and to meet with the behavioral health care provider as a representative of the commander to ensure the Trainee/Soldier’s condition and diagnosis is clearly communicated to the unit. Trainee/Soldiers in this category will not be left alone or unsupervised. Escorts for subsequent appointments are not required to be an NCO. Counsel individuals in routine (non-emergency) situations, in accordance with Department of Defense Directive 6490.1, section F, prior to referral/meeting with behavioral health professionals.
c. Behavioral health care providers may return IET Trainee/Soldiers to their units, once they have determined the Trainee/Soldier is no longer an imminent threat to harm themselves or others, following an outpatient evaluation or upon discharge from the inpatient status.
(1) The behavioral health care provider may make precautionary recommendations to the commander that the Trainee/Soldier be watched for some period of time. The behavioral health care provider must stipulate specific guidance regarding precautions and must establish an appointment for follow-up as part of the release to the unit.
(2) TRADOC service schools and major subordinate commands will develop a unit watch program, which will involve supervised watch of the IET Trainee/Soldier in the implementation of behavioral health care provider guidance. The decision to place a Trainee/Soldier under supervised unit watch will always be made in close coordination and consultation with behavioral health care providers. In unit watch, the unit/cadre will observe/supervise the IET Trainee/Soldier pursuant to the precautionary timeframe and conditions recommended by the behavioral health care provider.
(a) The commander will create a positive environment for the Trainee/Soldier, utilizing teamwork and unit cohesion as the foundation for support for the Trainee/Soldier on watch. Trainees will not be marked in any way which identifies him or her publicly as a Trainee/Soldier at risk. Trainee/Soldiers will be treated with dignity and leaders will prohibit behaviors and comments which serve to stigmatize or ostracize them.
(b) 24-Hour Watch. A unit member is assigned to watch a Trainee/Soldier 24 hours of the day, to include while the individual sleeps. Staff duty personnel may have this responsibility, if a less stigmatizing way is not available.
(c) If a peer is assigned to watch the Trainee/Soldier, cadre must interact with the pair of Trainee/Soldiers hourly because the responsibility of watch can be difficult for a peer. In addition, a member of the leadership team must plan a brief meeting daily with the Trainee/Soldier at risk, to provide support and encouragement.
(d) The commander must solicit clear and specific guidance from the behavioral health care provider for the unit watch. A variety of interventions may be utilized by the command team for a unit watch to include searching the Trainee/Soldier’s belongings and living quarters for dangerous items, removing such items from their possession, prohibiting access to alcohol and drugs, minimizing contact with people that may negatively influence the Trainee/Soldier’s behavioral health, continuously observing the Trainee/Soldier, and ensuring behavioral health follow-ups are attended. Examples of dangerous items would include, but are not limited to, knives, cigarette lighters, and jewelry with sharp edges, blow dryers, and cleaning supplies. Silverware other than sharp knives is acceptable. Medications, to include over-the-counter Tylenol and Motrin, should be held by the unit and should be dispensed one dose at the time by a medic or NCO. Leadership may elect to tighten the restrictions recommended by the behavioral health provider. If any of the actions recommended by the behavioral health provider or established by command limit the Trainee/Soldier’s personal freedoms, the commander of the unit must first coordinate with the servicing trial counsel or judge advocate.
(e) The Trainee/Soldier will not carry a military issued firearm.
(3) The unit watch program is to complement the guidance established in Department of Defense Directive 6490.1 and Department of Defense Instructions 6490.4. The unit watch program must ensure:
(a) Positive control of the returned IET Trainee/Soldier, especially during periods of transition, between training events and from training events to other appointments.
(b) Trainee/Soldiers under watch are escorted at all times, and not left alone or unsupervised.
(c) Those entrusted to conduct unit watch are thoroughly briefed on the importance of being with the Trainee/Soldier at all times, and of the essence of mentorship and support as the foundation for guiding a Trainee/Soldier through a difficult period.
(d) While in unit watch status, the Trainee/Soldier requires follow-up with the behavioral health care provider within five days of the implementation of the watch. The Trainee/Soldier will be seen immediately if the chain of command sincerely believes that the Trainee/Soldier’s concerns are not remediating, and the Trainee/Soldier’s risk appears to be increasing.
d. IET Commanders will ensure all assigned DSs and PSGs, assigned cadre, and all members will receive training in the current Army-approved suicide prevention program, as follows:
(1) In accordance with TRADOC AR 600-63 (Army Health Promotion) and Policy Letter 4, subject: Ready and resilient Campaign (R2C) - reducing high risk behavior and preventing suicide, suicide prevention training must be conducted annually for all Soldiers.

(a) All permanent party will receive training in "Ask, Care, Escort" (ACE). Training products are accessible at the Army’s Suicide Prevention Web site. Additional training products (for example, "Shoulder to shoulder- Finding strength and Hope Together”) are published periodically on the same web site and can be used to supplement the ACE products.


(b) In addition, company level junior leaders and first line supervisors to include squad and section leaders, platoon sergeants, platoon leaders, first sergeants, executive officers, company commanders, and Army civilians assigned at the company level will complete the Ask, Care, Escort-Suicide Intervention (ACE-SI) Course. Personnel who are identified as “gatekeepers” will receive advanced suicide intervention skills training in accordance with AR 600-63, para 4-7i (1). Applied Suicide Intervention Skills Training (ASIST) is an additional product for suicide intervention training. Gatekeepers are individuals who, in the performance of their assigned duties and responsibilities, provide specific counseling to Soldiers and Army Civilians in Need. There are Primary and Secondary gatekeepers.
(c) Coordinate with the installation’s Suicide Prevention Program Manager for training in suicide awareness, identification, and prevention, with also applying suicide intervention techniques.
e. Commanders will solicit consultation and support through the installation’s Suicide Prevention Program Manager. Commanders should identify these local resources and coordinate services well before they are needed.



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