The Foreign Service Journal, January-February 2016

38 JANUARY-FEBRUARY 2016 | THE FOREIGN SERVICE JOURNAL there were many factors well outside the control of the Foreign Service. In retrospect, however, I denied myself help because I feared being seen as “weak” or having mental health issues would have derailed my assignment. I do know a number of people who were treated for PTSD while and after serving in a war zone. Most reported good things, but some complained of their treat- ment derailing an assignment or delaying paneling. a Class 2 Medical Clearance I do not rate the mental health support for members of the Foreign Service very high. I called ECS from post and spoke to a back-up social worker for my region. He was fairly rude, as if contemplating divorce was not a big issue. My spouse and I sought mental health support from the RMO/P, and ultimately we were both sent on medevac—not my choice; my FS tandem spouse did not play nicely, and adequate mental health resources were not available at post. My mar- riage was deemed volatile, and given that we did not have positive support from State MED or my post, we both ended up curtailing. In the process of renewing my MED clearance in 2012, I was open about my weekly, then monthly, private therapist meet- ings due to my recent divorce. I told MED that I’d set up the possibility for continued support via Skype when I went to post along with my prescription for a low dosage of an anti-depres- sant/anti-anxiety medication. My mistake—I was told by MED that I’d be given a Class 2 because of seeking continued therapy. I thought that showing that I’d made arrangements for my mental health would ensure a Class 1, but instead that’s what gave me the Class 2. Geez, why be honest with MED—it could have cost me my assignment. Fortunately, my onward post could support a Class 2 because there was an RMO/P at post. I would appreciate it if management understood that employees doing the neces- sary to care for their own mental health should be recognized. I was no danger to myself or others. What about the cost to the department if my assignment had been broken? I will seek mental health care as needed, but I will not be forthcoming with MED about it. I have no worries about my DS security clearance because the investigators have been quite clear that seeking therapy for PTSD or marital types of issues does not need to be reported. a Mental Health Care Stigma A s a second-tour officer coming from the private sector late in my career, what I have found most surprising about the Foreign Service is the traditional culture within the department surrounding mental health care. Although the department has the infrastructure and mechanisms to support such care, the cultural attitude among officers is entirely different. During training, I heard A-100 colleagues’ advice from friends who had been in the diplomatic corps longer to never reveal mental health services for fear of security clearance risks. And over the past few years I have witnessed several col- leagues try to bury or cover up issues rather than seek help for that same reason. The career can be demanding for depen- dents, challenging for officers, stressful and even overwhelm- ing at some posts; and, unfortunately, the cycle of rotations encourages employees to just grin and bear it until the move. Through my own family’s experience, I have found the pro- fessionals within Mental Health Services at State to be respon- sive and informed. However, I do not believe this trickles down to all posts, and there remains a lack of clear understanding about the effects on clearance. I saw this misunderstanding most evident at AFSA, where it was assumed that DS had autonomous power to pull clear- ances. Clearly DS is not very transparent. But rather than provide more services, State needs to educate officers in writing about the real effects of receiving mental health care on the clearance. Without this, we may continue to see stressed-out managers venting their stress on subordinates who fear seeking help or taking action without tenure. a Concerns about Privacy and Security Clearances C onsidering what a stressful job this is, it’s too bad it’s so difficult to get help. I have been ordered twice to meet with a visiting regional psychiatrist—once when my colleague was murdered, and once when my house was broken into and my family lost $8,000 in personal possessions. I didn’t find these counseling services all that useful. The only time I met with an FS mental health professional of