The Foreign Service Journal, January-February 2016

THE FOREIGN SERVICE JOURNAL | JANUARY-FEBRUARY 2016 43 ress has been the topic of psychiatry seminars, and the funding for therapy cited as a large contributor to the equation for his success. Without this support, I would have had to drop out of the Foreign Service. Thank you. In order to join State, on account of having seen a psychia- trist in the past, I had to visit a State psychiatrist. Having worked with people I would call “out of touch” with their psychiatric issues, I explained how ironic I found the fact that a raging psy- chopath with no psychiatric treatment would have no problem getting a job at State, while a mildly depressed guy in treatment has to be screened by a psychiatrist. If mental health is a criterion for employment, all new hires should be screened accordingly. Otherwise, only those respon- sible enough to identify an issue and seek treatment will be screened out, to the detriment of the Foreign Service. I am now a Foreign Service old-timer and can say that, in spite of the often Kafka-esque bureaucratic mire we wade through, this is a fantastic workplace for a mildly depressed guy in treatment. Regarding treatment overseas, and its maddeningly incon- sistent effect on clearances, I could say a great deal. I could tell disheartening stories about my spouse, who received life- threatening, actionable malpractice from bad RMO/Ps. I could tell uplifting stories about RMO/Ps going above and beyond the call of duty to provide exceptional care. But I’m sure similar stories will make their way to AFSA through this effort. a It’s No Joke T he first MED-directed mental health intervention that was provided in Tripoli after the Benghazi attacks on Sept. 11, 2012, was a video conference in April 2013, conveniently less than a week before the Director General arrived for a visit to Libya. Prior to that, the only service provided was a discussion with the nurse about “fostering resiliency” several months after the attack…hardly a useful assist. The half-day course for those returning from hardship posts is a joke. I took it after my first (!) unaccompanied tour (UT), and both the instructor and some of the other students made fun of me for enrolling, since at the time my tour was seen as one of the “cupcake UTs,” without an active war going on outside the embassy walls. I refused to take the course after my second UT. No one from HR or my bureau asked if I’d taken it or even how I was doing after the second UT. An RMO/P made fun of some of my coworkers in a high- stress, high-threat post that happened to be a popular destina- tion for American tourists. He told them that they had no idea what serving in an actually difficult post was like, comparing it to the regional city where he was based. Never mind the fact that almost every person at that highly desirable but still chal- lenging post got there via a tour in Iraq or Afghanistan. I have neither respect for nor faith in MED’s mental health efforts. As long as MED is staffed with people who see mental health as an inconvenience, supported by State leadership (from the very top down) who barely pay lip service to mental health and a work-life balance, there’s no hope for anyone who suffers in the aftermath of an emotionally catastrophic tour abroad. At least there is solidarity among those who survived terrible times abroad. a On Managing Grief I obtained grief counseling after my husband of 25 years passed away quite suddenly. The counseling was tremendously help- ful. I worked with an excellent psychiatrist who covered more than 30 countries. There were times when I needed very much to see her but she was unavailable due to her work travels. I am grateful for the mental health assistance available to me. If it weren’t for grief counseling, I would have qualms about seeing the RMO/P, because I’d need to disclose this in the five-yearly security update. And while that disclosure might not affect my security clearance, I still think there’s a stigma attached to the fact that I needed mental health assistance. a Access to Services A s a veteran of two priority staffing post (PSP) tours— one in Iraq (2007–2008) and the other in Afghanistan (2013–2014)—my experience with transition support has been abysmal. Just getting authorization to attend out briefings and to access mental health services was impossible. At the end of my tour in Iraq, the department had just gone out with a cable requiring all officers returning from PSP tours to return to Washington to participate in the then-new out-briefing program. When I approached the HR office in Baghdad for orders Please turn to page 46