The Foreign Service Journal, January 2009

46 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 9 n the year since I wrote an article for the Foreign Service Journal (“Encouraging Employees to Seek Help”) detailing my interactions with the Bureaus of Diplomatic Security and Medical Services and the director general about my men- tal state, the following events occurred. My fa- ther spent four months seriously ill and then died; I suffered a disfiguring and debilitating illness; my spouse took a position in a wartorn country on another continent; and I’ve spent months helping my mother deal with her new life. Thanks in part, I assume, to my antidepressants and my weekly therapy, I reacted to all of this with great equa- nimity. There was, of course, some monetary cost involved as the Foreign Service Plan generally continued to pay just $49 of the $140 weekly fee for therapy. When the therapist or I engaged in lengthy discussions with the American Foreign Service Protective Association, or Coventry, they grudgingly paid $90 for a session or two. Then the bargaining and ne- gotiating would have to start all over again with the next month’s bill. In July, my therapist and I agreed that I was no longer in need of therapy, but I decided to stay on medication. At the same time, the FS bidding process started. I read the ca- bled and e-mailed instructions about medical clearances, went on MED’s Web site, and asked my therapist to write to MED addressing the three questions asked on the Web site. She did. I wasn’t worried about a clearance because someone in MED had assured me last year that my Class 2 medical clearance would only keep me out of Iraq and Afghanistan. I wasn’t happy about those exclusions, but I was relieved that the rest of the world was still available to me. Through the Looking Glass In August, I contacted MED to make sure it had every- thing it needed in order to clear me. Eventually a nurse told me that they lacked a statement from my psychiatrist. I ex- plained I didn’t have one. The nurse asked for a statement frommy internist since he had prescribed my medication. I rushed over to my internist with a detailed mental health questionnaire in hand. The internist faxed a letter to MED that same day. At this point I had bid on a variety of deputy chief of mission and principal officer positions, given a list of those posts to MED, and was anxious to get the post-specific clearances. In September, I contacted the same nurse to see where my clearance stood and was told they’d never received the letter from my internist. I requested that he send the fax M ENTAL H EALTH C ARE AT S TATE : A B ROKEN S YSTEM F OREIGN S ERVICE EMPLOYEES HAVE INCENTIVES TO HIDE THEIR MENTAL HEALTH TREATMENT OR , WORSE , TO LET THEIR PROBLEMS GO UNTREATED . B Y A NONYMOUS The author is the same Foreign Service officer who wrote about mental illness in the January 2008 issue of the Journal that focused on Post-Traumatic Stress Disorder, available at www. afsa.org/fsj/jan08/encouraging.pdf. I