The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 37 a Breaking Taboos I was serving in an isolated post and having trouble at home. My wife and I were arguing constantly, and things seemed to be falling apart. So when our health unit advertised the visit of a regional psychiatrist, I signed up. Then came the medical clearance renewal form: Have you consulted with a mental health professional? I checked yes, and said I had felt depressed over the state of my personal life. Six months later, as I prepared to depart for my new post, I received word that my medical clearance was on hold. I was angry, but there was nothing to do but acquiesce to a series of meetings with MED’s Mental Health Services. This was a breakthrough experience. First, I realized MED/ MHS was trying to make sure I really was OK. Second, I learned a few things about myself. Anger had been part of the problem with my marriage and my life in general. There were some root causes going back to my youth that I fully understood. But an experienced counselor was able to walk me through ways other people have dealt with that. To say it improved my life is an understatement. In the end, I went to post on time. For a few more months, MED/MHS kept tabs on me, and then they signed off. Since then, I have been a big supporter of MED/MHS. More and more officers understand the need to deal with mental health as just another medical issue. However, we still have too many officers who treat mental health counseling as taboo. Senior officers, in particular, need to set the example by ensuring that their employees understand that a mental health issue, like any ailment, is best addressed early. Until they do, we will all still sign notes like this as… Anonymous . a Attitudes I started taking a light dose of an anti-depressant after a difficult break-up that happened shortly before I left to go back over- seas. When I arrived at post and met with the regional medical officer, he advised that I stop taking anti-depressants, because they “weren’t a good thing.” I told him that it was helping me to feel better and sleep regularly. I really dislike the attitude of the State Department toward mental health care and treatment. Here’s another example: During a rough patch in a rela- tionship, my partner and I sought couples counseling. When my security clearance was up for renewal, I was grilled by the investigator regarding this counseling. I had to defend myself for wanting counseling, and the harsh and critical tone she took for me wanting to do what I needed for my relation- ship was upsetting. I got the clearance, but it was a stressful process. a Denying PTSD to Preserve Security Clearance S ervices for family members have improved considerably, but much remains to be done. Concerns about possible adverse impacts of mental health issues on employees or fami- lies are justified. After service in Iraq, there is no doubt in my mind that I suffered from PTSD. Now (several years later), I see my symp- toms as both classic and obvious. At the time I was suffering, however, I hid my symptoms out of fear that knowledge that I suffered from PTSD would harmmy career. That concern was heightened by the intense questioning I endured by a Diplo- matic Security agent conducting a security clearance update when I was serving in Iraq. When it became known that I had sought mental health care, I was hassled and forced to repeat the content of a private discussion with a mental health professional to a DS agent with zero mental health training. I found the entire episode both distasteful and inappropriate. According to the agent, because I was having a “special” security clearance update done (I was up for a chief-of-mission slot), I was required to tell him what I discussed with a State Department mental health practitioner. When I objected, he said my clearance would be held up “for at least six months and probably longer” since someone at DS would have to review my objection, refer it to lawyers for an opinion, etc. He made it clear that failure to answer all of his questions about my conversation with a mental health professional would negatively impact my career. This experience led me to deny having PTSD symptoms during a post-service interview. Concern over mental health issues was one of the factors that led me to take early retirement. (Shortly after retirement, I began seeing a mental health professional.) I do not “blame” the Foreign Service; these were my issues to deal with, and