22 JULY AUGUST 2024 | THE FOREIGN SERVICE JOURNAL JB: Yes, to some degree. The questionnaire for national security positions (Standard Form 86) is used across the federal government and does include questions relevant to psychological conditions. These questions are focused on psychotic disorder, schizophrenia, schizoaffective disorder, delusional disorder, bipolar mood disorder, borderline personality disorder, or antisocial personality disorder, and others that could have a substantial adverse impact on judgment, reliability, or trustworthiness, particularly if left untreated. FSJ: Can you or anyone else in leadership say unequivocally that seeking mental health care in and of itself will not have a negative impact on a security clearance? JB: I want to be clear: seeking mental health care, in and of itself, will not have a negative impact on a security clearance. It’s important to emphasize that unchecked actions or behavior, even those stemming from a mental health condition, are the primary concern from a national security standpoint. Even employees with diagnosed serious psychiatric conditions may hold a security clearance if there is evidence that treatment, including medication, effectively addresses the condition such that the employee’s judgment, stability, reliability, or trustworthiness are not impaired, and the individual has demonstrated ongoing and consistent compliance with the treatment plan. FSJ: What is the State Department doing to ensure seeking mental health support is not stigmatized? Does this require a cultural shift, and is that happening? JB: Like many aspects of how we operate around the world, our approach to mental health care is evolving. We’ve come a long way, but we still have some work to do. Asking for help is especially difficult in an organization of “can-do” people whose careers are centered on finding solutions to global problems and serving others. My overseas assignments have often been to countries that have suffered from conflict and terrorism. I’ve had a few close calls. I also felt deep grief when my first wife and fellow FSO died after living with cancer for many years. I’ve wrestled with fear, with doubt, and with survivor’s guilt. And several times, I reached out and asked for help from mental health professionals. Early in my career, I had to look outside the State Department, and I didn’t talk about it with colleagues. But over the past 15 years, I found support from the dedicated professionals in MED. The department’s mental health care professionals not only understand how traumatic experiences affect our mental and emotional health but also the particular challenges and stresses of a career serving our nation far from home. When I look across the department and our overseas missions, I see the stigma long associated with mental health care services declining—not uniformly everywhere, but to a much greater degree than 10 or certainly 20 years ago. I think this reflects a larger cultural shift that’s underway in our society. We’ve taken a number of steps to try to accelerate and reinforce this cultural shift within the department, including to benefit colleagues from other foreign affairs agencies. For MED, that means prioritizing personal well-being without fear of repercussion, and reforming its clearance protocols to emphasize education, counseling, and collaboration. MED is also strengthening its collaboration with DS to promote a culture of openness and support. Through joint educational initiatives, both bureaus are working to dispel the notion that seeking medical or mental health assistance will affect the security clearance process. Over the last two years, DS has ramped up messaging on this issue, encouraging potential applicants (and the workforce as a whole) to seek treatment and look out for their mental health without fear of security clearance implications. FSJ: Today, with what many see as a crisis in adolescent mental health, we hear frustration from members trying to get adequate mental health care for FS kids overseas. What is the department doing to help families access the mental health services their kids need? JB: We are acutely aware of the need and have prioritized securing additional funding, even in a tight fiscal environment, to provide additional services. MED is working hard to be responsive. Our regional psychiatrists provide equal time and services to children and adolescents as they do for adults, but the needs exceed the capacity of those regional personnel. MED is working hard to assess and review local resources, as available, and build a robust database of virtual services that can supplement department services. Undergoing mental health counseling in and of itself is not, and will not be, a reason for a negative security determination— full stop.
RkJQdWJsaXNoZXIy ODIyMDU=