The Foreign Service Journal, January 2008

26 F O R E I G N S E R V I C E J O U R N A L / J A N U A R Y 2 0 0 8 riting in the Decem- ber 2006 Foreign Ser- vice Journal , FSO Beth Payne recounted her struggle with Post-Trau- matic Stress Disorder fol- lowing her service in Iraq. The entire article, “Living with Iraq” (www.afsa.org/fsj/dec06/livingwithiraq.pdf) , is well worth reading, but the following two paragraphs sum up our purpose in devoting this month’s issue to the topic: “Why am I now sharing this story with my fellow FSOs, particularly given my concern about clearances and my reputation? These concerns (which were not well-founded) almost stopped me from getting help. Without help, I do not think I would have recovered from PTSD — and, based on my research, my mental and, eventually, physical health problems would have become worse over time. “A significant number of Foreign Service personnel and family members have already experienced events that place them at high risk for PTSD. Given the num- ber of people who now serve in dangerous posts and the high risk of being targeted by terrorists, the number will continue to grow over the next few years. For those who have the condition, untreated symptoms can cause med- ical problems, destroy families and sideline careers.” The MED/FLO Survey Last summer, recognizing the gravity of this chal- lenge, the Office of Medical Services and the Family Liaison Office jointly surveyed FS employees who had served unaccompanied tours between 2002 and mid- 2007. (The survey took place on the intranet and ran from June 1 to July 15.) Of the 2,600 employees who completed unaccompanied tours during the indicated years, 877 — or one third — submitted responses. Of that total, 358 had served in Iraq, 208 in Afghanistan, 185 in Pakistan and 138 in Saudi Arabia. (Twenty-six percent of them had done unaccompanied tours in more than one place.) The survey asked about exposure to physical danger and the impact of danger- and isolation-related stressors upon a broad range of psychological symptoms and psy- chosocial functioning in these employees. Unsurprising- ly, the results indicate widespread stress-related symp- toms among such employees, though there was a falloff in the incidence of those symptoms over time after com- pletion of the tour. Among a list of 17 symptoms often found in persons enduring chronically high levels of stress, 10 were expe- rienced by more than 20 percent of the respondents. For example, 47 percent admitted to insomnia and 33 percent reported being irritable or unusually hostile during the tour, while 55 percent reported problems in relating to their spouse or partner even after completing the tour. (State Department employees can read the full report on MED’s intranet site at http://med.state . gov/.) F O C U S O N P T SD & T H E F O R E I G N S E R V I C E Steven Alan Honley, the editor of the Journal , was a Foreign Service officer from 1985 to 1997, serving in Mexico City, Wellington and Washington, D.C. P OST -T RAUMATIC S TRESS D ISORDER : H OW B IG A P ROBLEM ? B Y S TEVEN A LAN H ONLEY W