The Foreign Service Journal - January/February 2016
Table of Contents Table of Contents
Previous Page  8 / 104 Next Page
Basic version Information
Show Menu
Previous Page 8 / 104 Next Page
Page Background






Considering Mental Health



Shawn Dorman is the editor of

The Foreign Service Journal.

members via AFSAnet regarding their

experiences with mental health care in

the Foreign Service, and we asked for

their recommendations.

Based on that input, it is clear that

there is much confusion—about what

help is available, what mental health care

needs to be reported and what might have

an impact on a medical or security clear-

ance, among other things.

You’ll see themes emerge in “Mental Health Services Checkup,” where some

45 FS members weigh in. People want (1)

a clearer understanding of what services

are available and how those can affect

clearances, both medical and security;

(2) assurances of privacy; (3) confidence

that they will not be penalized for seeking

help; (4) a de-stigmatization of mental

health care; and (5) relief from toxic

bosses and unrealistic workloads.

We sincerely thank all those who

shared their personal journeys and per-


In addition to input from the field,

veteran MED mental health provider and former Director of Mental Health Ser- vices SamThielman presents a history of MED’s mental health program. In a Q&A format, Chantay White and Paulette Baldwin of State MED’s Employee Con- sultation Services staff explain how their office can help.

f all the focus sections I have

worked on during more than a

decade with the


, this may

have been the most chal-

lenging. Mental health is so personal,

so sensitive, so private. And yet, if you

are in the Foreign Service, it is also “of

official concern,” as your employer must

determine, each time it sends you out

to a new post, whether you are healthy

enough to go.

There is a basic “dual agency” issue

at play—that the employer is both

responsible for providing care and for

determining fitness for duty—which

can complicate both the willingness of

Foreign Service members to seek mental

health care assistance when it might be

needed, and the resulting impact of get-

ting (or not getting) that help.

The FSJ Editorial Board decided to

shine a spotlight on mental health care

for the Foreign Service in the hope that

breathing air into a somewhat taboo

subject and facilitating a conversation

might lead to improvements and better


In this issue, we hear frommedical

professionals from the State Department

and frommembers in the field, coping

with an inherently stressful work-life

reality involving regular moves across

the world, dangerous environments and,

often, tremendous

workloads, all to serve

and represent the

United States.

We requested input

from Foreign Service

Mental Health Services Director Ste- phen Young shows us the view from the side of the regional psychiatrist, and for- mer DS Agent Ronald Holloway bravely shares his journey frommental illness to health. We also take a heartbreaking walk down the Alzheimer’s path with a devoted Foreign Service spouse.

As it happens, MED is—right now—

undergoing a transformation. The Office

of Medical Services is being “promoted”

to the Bureau of Medical Services, with

reorganization along the way. A Dec. 4

State Department Notice called the

change “part of an extensive realign-

ment of MED’s internal organizational

structure that will be implemented over

the next year to facilitate enhanced

delivery of services and execution of core


MED further clarified for the



the the bureau will have three direc-

torates: Medical Program Operations,

Clinical Programs and Mental Health

Programs. Perhaps this is, indeed, the

best time to share ideas frommembers

on how to improve services.

For additional fascinating content

related to medical issues, I would also

call your attention to two back issues

of the


: the

January 2008


on PTSD; and the

September 2010

issue examining MED, both online at


We hope that breathing air into a somewhat

taboo subject and facilitating a conversation

might lead to improvements and better