The Foreign Service Journal, January-February 2016

42 JANUARY-FEBRUARY 2016 | THE FOREIGN SERVICE JOURNAL the physical setup of overseas health units for mental health patients. The health unit willingly sets up appointments for visiting regional psychiatrists, but there is absolutely no way to keep these visits confidential given that everyone knows when the psychiatrist is visiting and the person is required to either wait in the hall outside of the health unit or in the reception area in full view of everyone else with appointments with the doctor. This does not encourage people to seek help. There must be a better way. a Medevac for PTSD I had to be medevac’d out of my first assignment due to mental health problems related to work and entered a treatment pro- gram in coordination with MED. I have since exited the program and moved on with my career. I would rate the mental health support at 3 out of 10, with 10 being the best. Working in a high-stress post that was not a “high-threat” post, my colleagues and I were given limited support in a time of crisis. Further, MED was unwilling to cover full treatment for my condition due to the situation, and my psychiatrist believes I should have had further therapy before coming back to my job. MED was unprofessional when it came to extending the length of the treatment program I was in and did not refer me well to an available psychiatrist. I saw it as a betrayal by the institution I have worked so hard for. Improvements to the medevac system, as well as more training for MED, might miti- gate these issues. Many of my colleagues cautioned me not to see a psychia- trist or therapist because of clearance concerns. However, I strongly recommend that if colleagues have problems, they go for treatment. Your mental health is just as important as your physical health and is necessary to do this job. I hesitated for two days after a panic attack to seek medi- cal attention because I was concerned about my privacy and security clearance. After feeling like I was having another one, I sought medical help. Security clearances had a profound effect on my decision, primarily because I was a first-tour officer. I did not want to ruin my career. I have only just been diagnosed with PTSD, but now that I’ve had it, I’m noticing it in other people who have been to non- “high-threat” posts. a Security Clearance— Checking That Box W e have had incredible medical staff at all our posts (five). We have had to use them for all sorts of odd medical stuff, and have been 100-percent satisfied. Top-level, smart, caring, hard-working, conscientious...or we have been extremely lucky. However, I had three bouts of depression during these years with State that were related to stress at work and not having time to properly take care of myself after caring for family and work. I learned my lesson and now put my health and well- being first (i.e., ensuring I have daily exercise, eat well, meditate, etc.), but that doesn’t always jive with certain elements of the department. The culture does not lend itself to putting ones’ health first, unfortunately, and all depends on who is in charge. After the second bout, I coincidently had to renew my secu- rity clearance and made a conscious decision to admit to the illness and subsequent medication. It was horrible. I spent an inordinate amount of time dealing with MED in Washington, and then DS, explaining, justifying, verifying, goodness knows what else, all while on home leave between countries. In the end, I answered all their questions, filled out all the paperwork, did all the “visits” and evaluations that were required, and did get my clearance renewed. Needless to say, I’m not doing that again. Did I say it was a nightmare? I also have dealt with some odd-ball psychiatrists in the State Department; one had anger issues and displayed inappropriate behavior in public forums. So I have not had a great experience with the State mental health professionals, who do not seem to be of the same caliber as our GP doctors and nurses. There needs to be more focus on mental health issues in the Foreign Service, less stigma and more work on the condi- tions that make life stressful. I don’t just mean in war zones—I mean bosses who yell and scream, as well the pressures put on people to excel, work extra hard, all so that they can, maybe, get promoted. a Kafka-esque Bureaucracy L et me laud the Special Needs Education Allowance program. State has provided a level of cognitive behavioral therapy to my mildly autistic son that staggers the imagination. His prog-