The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 39 my own accord, it was very helpful. The therapist helped me put things into perspective and greatly assisted in my recovery from a short stint of depression. Privacy concerns: Even filling out this survey without having true anonymity (you can see my email address) makes me ner- vous. The worst part about seeking mental health care is know- ing that DS will ask if we’ve sought mental health care when we renew our security clearance every five years. I met with a thera- pist who told me he never wrote anything down because all of his FS clients were terrified of getting caught seeking assistance for their stress-related problems. It’s sad. Concerns about security clearances have a big effect on whether or not I seek mental health care. a Recovering from Trauma I experienced a personal trauma, and my supervisors and post leadership were terrific. But I found our mental health profes- sionals overseas inadequate to the job. I do not believe they are prepared to deal with grief, certainly not traumatic grief. If you appear to be functioning, they will basically ignore you in favor of more squeaky wheels. I feel that if I had declared myself an alcoholic I would have gotten more attention fromMED than when I was traumatized and sat in my office working, feeling like an isolated zombie. A professional should come to post to see individuals who have experienced serious trauma. We had compounded trauma, yet all we got were phone calls in a place without adequate local English-speaking psychological support. I am not concerned about my privacy for something like grief. If I had depression or other mental health problems, I would never see a State Department medical practitioner. I would curtail if overseas and see someone private in the United States. I would never tell Diplomatic Security or MED about outside mental health services, but would seek the help I need. I am an honest person, but in this case I feel that State should do with mental health what they do with physical health—a spot assess- ment every few years for suitability for service abroad—and leave it at that. There’s no need to find out if I have ever sought counseling, any more than if I have ever broken a bone. The question should be whether I am on medication now, whether I need help and, if I do, whether I get a Class 1, 2 or other type of medical clearance. Once I accidentally ticked the box stating that I had received mental health counseling, then explained that it had been many years ago and strictly family counseling. Still, I was forced to get a statement frommy medical provider that I was not under care for a mental health issue. I argued that perhaps I should get my doctor to tell them all the diseases and illnesses of the body I also did not have. I certainly suffered from PTSD as a result of my trauma and feel that no one fromMED could be bothered as long as I showed up to work. I am not functioning at my best now, but I am functioning, so I suppose that’s good enough. a Self-Medicating A lthough I have not personally experienced a denial of clearance, I was concerned during the clearance process about questions regarding anxiety medication I had taken dur- ing some personally stressful times in our family from a loss of one income and a cancer diagnosis. Once I joined the Foreign Service, I could easily understand why there is an impression that the Service has an alcohol abuse problem—it’s self-medication that is easy to hide from a clearance process. I find that distressing and disturbing and extremely unsupportive. a Avoiding Care B ecause I have known other employees who had difficulty with their security clearance updates as a result of seeking mental health care or counseling, I have always avoided seeking mental health care. Doing so would require that when my secu- rity clearance renewal was due, DS would require me to obtain information from the health care provider and would want to know what happened. It is an additional administrative burden that I do not need, would not be something that I would want to talk about with an investigator, and it would undoubtedly slow down the process. Despite former Secretary of State Hillary Clinton’s message a few years ago telling employees that their clearance will not be affected by seeking mental health treatment, that is not what happens in practice. DS investigators zero in on this, consid- ering it a red flag, as if mental health were any different than