Mental Health in the Foreign Service

President’s Views


It is gratifying to see The Foreign Service Journal devoting this edition to the issue of mental health in the Foreign Service. For too long, seeking mental health resources has been the province of stigma and fear—of losing one’s security clearance or of being seen as weak and unable to handle Foreign Service work.

Back in the day the response was “suck it up, buttercup” to anyone who evinced the need for help. Although more must be done, we are thankfully getting beyond that mindset, which was clearly not the way to address mental health in the Foreign Service or anywhere else.

Thank you to those who contributed their thoughts and stories to this edition. I am particularly heartened to see Acting Under Secretary for Political Affairs (and Under Secretary for Management) Ambassador John Bass emphasize that “seeking and receiving treatment actually is viewed favorably in the security clearance adjudication process” and “in and of itself is not, and will not be, a reason for a negative security determination—full stop.”

Under Secretary Bass also relates his own need at difficult times in his life to reach out for help. Seeing our department leaders speak openly about protecting their mental health gives confidence for others in the workforce to do so, as well.

Our profession, while rewarding and satisfying, is one that has a lot of unique stressors. It takes a toll moving every two to three years, having to be essentially on duty 24/7 when working overseas as a representative of the American people, often living in inhospitable and dangerous environments, dealing with all manner of crises, and sometimes being separated from family and friends for long periods.

I am certain most, if not all, of us have experienced times in our careers when things seemed overwhelming. For me, one of those times was when I served as the provincial reconstruction team (PRT) leader and then the consul general in Kirkuk, Iraq, in 2011-2012.

The work was incredibly interesting, but being subject to rocket attack three to four times a week and living in spartan conditions on a desolate Iraqi airbase, I could sometimes sense our team coming apart at the seams. This was particularly true when, in early 2012, one rocket attack tragically killed two young U.S. servicemen who lived only 150 meters from us. They were there to help train the Iraqi army.

Mental health resources were not as available then as they are now, but I was grateful that a regional mental health professional came out to Kirkuk regularly to check on our well-being. Although I admit to being a bit skeptical at first, these visits proved enormously helpful.

This individual, who is still with the Bureau of Medical Services (MED), spoke to nearly all of us one-on-one and gave me ideas on what I could do to alleviate the stress for myself and my team. Being able to talk with a trained professional about the struggles we were all going through made us feel better.

As attitudes have evolved about addressing mental health issues in the Foreign Service, AFSA has fought for hiring more mental health professionals and for more and better access to mental health services for our members. Section 6222 of the Fiscal Year 2024 National Defense Authorization Act (NDAA) deals with improving mental health services for the Foreign Service and Civil Service.

Section 6222 says the Secretary shall seek to employ no fewer than 10 additional personnel in MED. It requires the department to produce a report on the accessibility of mental health care providers at diplomatic posts and in the U.S. along with steps to improve such accessibility.

While this provision is a welcome development and has the force of law, it is dependent on sufficient funding to be fully implemented. As you may know, the FY24 department budget has in effect been cut by 6 percent, making these increased mental health resources uncertain. AFSA will continue to follow up with department leadership to make this funding a priority because it is so desperately needed.

Please let me know your thoughts at or

Tom Yazdgerdi is the president of the American Foreign Service Association.


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