Mental Health and ECS—What You Should Know

The State Department’s Employee Consultation Services can help members of the foreign affairs community resolve workplace and interpersonal concerns.


The ECS team. Back row, from left: Paulette Baldwin, Kristin Scholl, Jackie Pouncy-Smith, Dr. Vivian Sheliga, Christiana Montimny, Johanna MacGillivray and Pollenetta Douglas. Seated, from left: Ellen Millner and Dr. Chantay White.
Courtesy of ECS, U.S. State Department

Employee Consultation Services can help members of the foreign affairs community resolve workplace and interpersonal concerns. ECS provides short-term counseling to individuals, couples and families. Requests for services often include workplace stress, work-life balance, strengthening relationships, eldercare concerns, parenting, anxiety, stress, depression, isolation, life transitions and grief or loss. Working in collaboration with our medical colleagues in the field, our goal is to support the health and well-being of America’s diplomatic community. We also offer services to Civil Service employees. Referral information for services outside of the department is also available when indicated or upon request. Here are some frequently asked questions and the answers.

What are some of the barriers identified by members of the Foreign Service to seeking emotional or mental health support?

The fear of being labeled or stigmatized as mentally ill remains a barrier to treatment throughout our culture, and the Foreign Service is no different in this regard. In addition, FS members tend to hold themselves to a very high standard. We often hear statements like, “I should be able to handle this. I’m educated, well-trained and speak many languages; I should be able to shake this off.” Many people perceive seeking help as a personal weakness rather than an act of courage, believing “I should just suck it up.” Challenges in life circumstances can happen to anyone. However, help is available so that no one has to suffer in silence.

What happens to my medical and security clearance if I consult with an ECS clinician?

The medical clearance and security clearance processes are two separate and independent actions. The purpose of a medical clearance is to identify specific health needs and medical conditions that may require specialty management, follow-up or monitoring. The goal is to enhance an individual’s well-being by improving access to care. The security clearance process is not specific to medical or mental health treatment, and Diplomatic Security does not have access to medical records.

Further, ECS clinicians do not document in the official medical record. ECS does not share information disclosed during counseling sessions with anyone for medical clearance or for security clearance purposes.

When completing a security clearance application (SF-86), the correct response is “no” if the counseling is related to strictly marital, family or grief not related to violence by you; to adjustments from service in a military combat environment; or being the victim of sexual assault. In addition, 3-FAM 4166 (c) reads as follows: “To the extent permitted by law, information disclosed to staff of the ECS shall be considered privileged and not subject to disclosure in administrative and judicial proceedings.”

The bottom line is that counseling through ECS is an independent procedure that does not directly engage medical or security clearance processes.

Many people perceive seeking help as a personal weakness rather than an act of courage.

Do I really need counseling?

Life happens to everyone. No one is exempt. Everyone goes through difficult seasons and will experience stress, sadness, grief and conflict. When you are not feeling your best, it can be hard to know when to see a professional or whether you could benefit from some therapeutic intervention. You don’t have to handle your problems alone; the department offers resources. Anything that makes you feel overwhelmed or limits your ability to function can be addressed. An ECS clinician can offer a neutral, nonjudgmental space where people can process their thoughts and learn new strategies for addressing challenges. The earlier someone gets help, the easier it is to get through the problem.

How can counseling help me?

There are numerous benefits to participating in counseling. Counseling can help you to improve your mental well-being by enhancing problem-solving skills and promoting healthy coping strategies to manage anxiety, depression, relationship difficulties, grief, trauma and stress. Counseling can help you break unhelpful patterns; give you support and guidance; and suggest new ways to address parenting and family concerns, manage relationships and deal with marriage issues. Counseling can enhance your personal growth, helping you to develop skills to manage the stress and hassles of daily life. Counseling can help strengthen all of these domains in your life.

Are my sessions confidential?

Confidentiality is one of most important elements of our role as ECS counselors. The counseling relationship requires a high degree of trust because many topics are discussed in the counselor’s office that one would not freely or safely discuss elsewhere. ECS counselors maintain strict confidentiality (unless there is a danger to self or others, abuse or exploitation of a child or elderly adult, or a threat to national security—the federally mandated exceptions). Confidentiality is extremely important to ECS clinicians.

Am I required to take annual leave to receive ECS services?

Members of the foreign affairs community and other direct-hire personnel are not required to utilize annual leave to engage in services provided by ECS. Excused absence may be granted from official duty for up to two hours to allow an employee to use the service of a counselor provided by the department (see 3 FAH-1H-3461.4, Consultation with Counselors).

Does ECS provide services to members of the foreign affairs community overseas?

The regional medical officer/psychiatrist in each region should be your first point of contact for all mental health related concerns. ECS can supplement services overseas on request. ECS offers face-to-face, telephonic and digital video teleconferencing (DVC) services both locally and overseas. ECS also offers onsite workplace visits and management consultations on a case-by-case basis.

Chantay White, PhD, is a supervisory social worker and chief of the Employee Assistance Program with the State Department Employee Consultation Services. A Licensed Independent Clinical Social Worker with Board Certified Diplomate status, she has been in practice for 20 years. She previously served for two years as the State Department's director of deployment stress management, after serving two years in Baghdad. She has 16 years of military experience with the U.S. Army and U.S. Air Force.

Paulette Baldwin is a Licensed Clinical Social Worker with 16 years of varied practice. In addition to service at the Walter Reed National Military Medical Center, she has served as clinical director of the Prince George’s County Mental Health and Disabilities Administration and as senior director for clinical services at Center for the Homeless, Inc.