THE FOREIGN SERVICE JOURNAL | JULY AUGUST 2024 23 Of course, there are some parts of the world where specialty resources are simply not available on the local economy and/or difficult to access virtually. In those circumstances, we strongly encourage parents to reach back to MED to discuss their challenges and explore options together. FSJ: How is the department dealing with the increased demand for mental health services accompanied by a shortage of providers? Is State adding mental health provider positions to the 21 psychiatrists who serve overseas posts? Is the pilot program to bring on providers in addition to psychiatrists (licensed clinical social workers, for example) happening? Can you update us on those plans? JB: We are continuously exploring innovative solutions to meet the growing demand for mental health support overseas. We’re actively engaging in preventive projects to better prepare and equip individuals before their assignments, ensuring they’re both well informed about available resources and mentally equipped for their postings. For instance, we’re providing insights to future ambassadors and deputy chiefs of mission to help them understand the stress experienced by their staff and its long-term effects so they can have the tools to support their mission. The pilot project to deploy mental health practitioners to posts beyond a small collection of designated locations is underway. The inaugural position will be established in Doha this June. Although additional full-time equivalents haven’t yet been allocated for further expansion due to budget challenges, posts will soon have the flexibility to fund mental health practitioners’ positions and coordinate with MED for candidate selection. FSJ: What will budget cuts mean for mental health resources? Will the State Department have to cut back on its planned hiring of additional mental health professionals? JB: We are still evaluating the impact of this year’s budget cuts, but I anticipate it will take us longer than planned to further scale the program to the extent leadership had envisioned. MED is no stranger to working with such constraints, and we are going to continue working to ensure the department has sufficient resources to provide the excellent services our community expects—and deserves. FSJ: The COVID-19 pandemic and accompanying rising demand for mental health services also led to expanded options for telehealth for mental health care. This would seem to be an especially helpful change for the Foreign Service. What has State done to make telehealth more accessible for FS members? JB: I think there are ample opportunities for us to build on MED’s experience with telehealth. For more than a decade, MED has been providing video health services through Health Units, and many of our regional psychiatrists rely heavily on telehealth connections to regularly conduct private, high-impact sessions. There is every reason to expect that telehealth services will become more prevalent and common in the coming years, a fact that is reflected in MED’s modernized medical clearance process. MED’s mental health team is actively curating a list of virtual therapy clinics and mental health professionals around the globe, and I encourage your readers serving overseas to explore those opportunities by connecting with their respective regional medical officer psychiatrist. FSJ: As part of the FSJ focus on mental health care for the Foreign Service in the January-February 2016 edition, we reached out to FS members worldwide for their input on their own experiences with mental health care in the Foreign Service and asked for their recommendations. My editor’s letter summarized what we heard: People want (1) a clearer understanding of what services are available and how those can affect clearances, both medical and security; (2) assurances of privacy; (3) confidence that they will not be penalized for seeking help; (4) a destigmatization of mental health care; and (5) relief from toxic bosses and unrealistic workloads. That was eight years ago. Where are we today on these five asks? JB: Some of this was touched on earlier in our discussion— we’ve come a long way but still have some work to do. We’ve made great progress in modernizing the clearance process for individuals going overseas, including for mental health conditions. MED and DS strive to destigmatize their procedures, enhance the available information, and expand support provided 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.
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