The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 41 back to D.C., but from there the entire process was riddled with problems and was extraordinarily disappointing. I’ve never felt so abandoned. At the time, MED was contracting with a facility that had no established contacts to assist State employees dealing with PTSD or any understanding of the Foreign Service working environments. (Even the regional psychiatrist was stunned that there was nothing in place.) I was placed in an outpatient facility that specialized in dealing with patients transitioning from a 24-hour in-hospital mental health care facility. It was a locked-in day program. On the first day I knew this wasn’t what I needed. I was told to give it a try for a week as an evaluation. Multiple medications were prescribed and a sleep study was ordered to rule out any physical problems for the sleep disrup- tion. At the end of the week, I again asked for a different treatment option. Again I was told to stay. Mental Health Services left me there for another week—a total of three weeks—at consider- able cost. The facility knew that there was nothing they could do for me. I eventually found a psychiatrist to help me, and MED agreed. Throughout the ordeal, I had been encouraged to curtail, so that I could return to D.C. for long-term treatment. I translated this to mean: “Curtail and then you won’t be our responsibility.” I did return to post. I was still having most of the symptoms, though some had decreased after working with the PTSD psychiatrist. My sleep problems continued to the point that I was having trouble getting up in the morning to go to work. Needless to say, this was causing problems with my boss. I felt I wasn’t going to get better while still working for State, so I opted to retire. Apparently I was the first person to be sent to D.C. from post for a PTSD evaluation. State didn’t seem to think there was a problem with PTSD. (It’s not that no problems exist; but after being separated from family for more than a year, most people do not want to self-identify a problem that could potentially result in a curtailment and disrupt their families’ lives again.) MED had assured me that everything would be reimbursed, but I later learned that because I was not hospitalized, many of my expenses would not be reimbursed. More troubling was that after more than a decade in war zones, MED’s regulations for reimbursement had never been updated to deal with the reali- ties of our work environment. The mandatory out brief improved between the time I returned from Afghanistan in 2007 and 2012, when I returned from Iraq. However, both times I was told that the symptoms in the PTSD questionnaire are normal for six months and not to worry unless they persist. (And I was offended when taken aside after the briefing and asked how pervasive I thought infidelity was in Baghdad.) I understand that State had determined that performance levels of employees returning from war zones decline. Knowing this, I do not understand why more wasn’t being done to under- stand the link with PTSD. a Coping with PTSD D uring my first tour, I was diagnosed with PTSD and medevac’d for treatment. My symptoms were so severe that I spent a month hospitalized and from then on worked with a therapist on a weekly basis. During the onward assignments process, MED refused to consider my needs as identified by my therapist, instead assigning me to a post where there was no one in-country who could serve as an appropriate psychiatrist. There, I raised an issue of concern with the health unit nurse, who in turn shared it with the management officer, who then told my supervisor that I was “nuts.” This was not only a viola- tion of my privacy; it reflected total ignorance on the manage- ment officer’s part of what PTSD and its symptoms are. I continue to go to therapy. I have been tenured and promoted. I recently became engaged. In other words, I have learned how to cope. However, I did all this with no support from the Foreign Service, which instead stigmatized my condi- tion and assigned me to posts that were inappropriate for me at the time. I would like to hear an apology frommanagement and a promise to treat other officers with mental health needs with care and concern. a We Need Privacy S tate medical care has been fantastic, except for one regional psychiatrist, whom I won’t name for fear of retali- ation. Due to the incompetence of that doctor, we were forced to seek psychiatric care locally. Luckily things have worked out; but it is a shame that a bully is in such a position to deal with mentally ill people. My biggest complaint is the lack of confidentiality due to