The Foreign Service Journal, June 2016

THE FOREIGN SERVICE JOURNAL | JUNE 2016 49 day, how peers perceive and treat him, as well as how he sees himself. I think MED really tries to try to meet the mental health needs of our special education children, but it sometimes seems like the right hand and left hand are not working together, maybe because they work out of separate pots of money. Shouldn’t the overall well-being of the child be more impor- tant? Those handling the Special Needs Education Allowance funds need to pay attention to the health care provider and be more respectful of those professionals at post who know and interact with the child. Having your child’s school needs met should not be a parent’s full-time job. a Focus on the Kids W hen our daughter had a difficult time adjusting to the United States as she began college in 2010, we consulted the embassy health unit during one of her visits to post. They referred her to a local provider who recommended follow-on treatment in the United States. The health unit’s response was helpful, based on knowledge of local providers. I do not know if they also discussed the issue with the nonresident RMO/P, but we did meet with him dur- ing one of his visits to post (without our daughter present). He seemed dismissive of the diagnosis she got in the United States, but did not provide any specific advice or support regarding referrals or resources. The only time in my 30-year career that I saw an effort to seriously address family mental health concerns was under Dr. Elmore Rigamer’s leadership. His effort to raise awareness, educate and obtain research to mitigate and treat mental health conditions was exemplary. Now there are significantly more staff in MED, but their policies and services are not clear. There seems to be no specific attention to children and adolescents, as there was in the 1990s under Dr. Rigamer’s leadership. I was delighted to hear last year that the relatively new Child and Family Program office was staffed with child specialists, but their mission is not clear and is already being truncated. I have heard from families who benefited from CFP support that enabled them to complete their assignments and access neces- sary treatment (including therapeutic boarding schools or other U.S. resources). I’ve also heard that CFP mitigated mental health situations through video consultations, which is well-suited to the Foreign Service population and fulfills MED’s commitment to telemedicine. There is a growing perception among FS families that any indication of a mental health concern in a child is cause for immediate medevac. This funnels people directly into a hospital environment, which may not be the optimal setting for a juve- nile or for the family. I don’t see any effort to mitigate mental health conditions through education, training and provision of resources to help families and communities create a positive environment. Nor is there support for families returning to the Washington, D.C., area who need to find specialized profes- sional services. I have heard some parents say they would not disclose children’s mental health concerns in order to avoid limiting their availability to serve overseas. Employees do not have a solid understanding of the medical clearance process when it involves mental health issues. Some arrive at post without adequate local support. The Youth Mental Health Initiative, which was started in Feb- ruary 2015, was based on officer-parent perceptions that there are significant mental health concerns among FS youth. The ini- tiative led to a worldwide cable and webinar that outlined exist- ing resources. But efforts to build on this were suddenly stopped by some participating offices, despite earlier agreement. Why? a Getting Cut Off I am a State annuitant and my wife is active-duty Foreign Service. When my son was 13, I took him, at MED expense, from post to Washington, D.C., to meet with a psychologist and a psychiatrist where he was diagnosed with attention deficit dis- order (ADD). Back at post and at subsequent posts, the health unit would provide a prescription for ADD medication that he would take on school days. He would also regularly talk with the regional psychiatrist. After graduation from high school at our present post, my son went on to a U.S. liberal arts college. He continued to meet with the RMO/P when on breaks from college. When my son missed a visit to post and I attempted to get a new 90-day pre- scription for his medication from the post health unit, the new RMO/P dismissed me, saying: “We do not know this young man, and we will not write him a prescription”—even though MED and the post health unit had extensive records on my son. When my son came to post for his winter break, he met with