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The findings of a U.S. Navy investigation into a deadly shooting in Hawaii last December, made public Tuesday, will inform a series of military policy reviews in the coming months, officials said.

On Dec. 4, 2019, Gabriel Romero, a 22-year-old Navy sailor assigned to the submarine USS Columbia, killed two civilian workers and injured one when he opened fire on them during guard duty before killing himself.

The investigation didn’t determine a motive, but found serious problems that set the stage for the fatal incident and resulted in several recommendations.

Among the priorities are a major overhaul of Naval Submarine Support Command’s Embedded Mental Health Program, or eMHP.

“As a result of the investigation, (Submarine Force Pacific) is conducting a comprehensive review of the eMPH program and how to better communicate medical treatment while respecting patient privacy,” U.S. Pacific Fleet spokesman Cmrd. Myers Vasquez told Civil Beat in an email Thursday.

The report’s findings pointed to wider problems aboard the Columbia. A command climate survey conducted in October 2019 for the sub found 35.5% of those on the crew knew someone who thought of suicide and that 6.6% knew someone who had attempted suicide.

When evaluating an anonymous suicidal response left for the survey, one senior leader on the sub said that Romero wasn’t even considered because “other Sailors worried (him) more at the time.”

In addition to concerns about the mental health programs, lessons from the investigation in Hawaii are being combined with a separate investigation into the shooting at Naval Air Station Pensacola in Florida that occurred just two days after the killings at Pearl Harbor.

Saudi military officer Mohammed Saeed Alshamrani, who was training at the flight school at Pensacola as a foreign student, shot and killed three sailors. Investigators have since discovered that for months before the shooting.

The conclusions from both investigations will be part of a broader review of the military’s insider threat program.

In a letter accompanying the report, Pacific Fleet commander Adm. John Aquilino wrote, “We must work to restore confidence in the Navy’s ability to protect its most valuable assets – its people – from threats, both external and insider.”

However, the report also raised questions about Romero’s supervisors as well as whether stigma around mental health further hampered efforts.

Sailors reported low morale, poor organization, high stress and that many were “unwilling to seek help for mental health issues due to fear of negative impacts on their security clearance or job.”

Investigators wrestled with how to better identify potential threats and share data without further stigmatizing service members seeking mental health.

“DoD policy on confidentiality is central to removing the stigma of seeking mental health treatment and building trust between medical providers and patients,” the report said.

But it added that “high-risk personnel are identified and appropriately monitored, especially where Sailors are given access to means that can kill or cause serious injury.”

The investigation also called for the launch of further reviews and made recommendations on possible accountability for how personnel handled Romero’s case and the climate on the Columbia. That section of the report was redacted.

However, in his letter, Aquilino said he felt that “leadership did not engage the chain of command to ensure the safety of the entire crew” and that “leadership cannot assume a cavalier or complacent attitude toward anonymous complaints and assume they are not valid simply because the unit is in a challenging shipyard environment.”