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n the Washington, D.C., area, mental health topics

are regularly featured in the media, on web-

sites and in social media. There are workshops

and support groups for parents and mandatory

training in “mental health first aid” for school

personnel. Students have direct access to licensed

counselors, psychologists, social workers and

crisis hotlines. Mental health topics are required

components of health curricula for students of

all ages. And although specialized medical professionals are

in short supply across the United States, more children and ado-

lescents are accessing treatment, including via telemedicine.

Foreign Service families have little exposure to the topic and,

given the nature of our lifestyle, limited access to these kinds of

resources; yet our families are not immune frommental health

concerns. Parents are asking: Are we doing enough for Foreign

Service kids?

Third Culture Kids

TCKs are children who spend most of their developmen-

tal years outside of their parents’ culture. Like their parents,

TCKs weather frequent moves, separations, loss and trauma.

Like their parents, our TCKs are assumed to be adaptable and

resilient—and many are. But kids often lack the developmental

maturity and a sense of identity or belonging that are essential

KimDeBlauw is amember of the Senior Foreign Service,

class of minister-counselor. She joined the Foreign Service

in 1986 and has served at posts in Latin America, Africa

and Europe, as well as inWashington, D.C. She and her

husband, Juan Ramirez, have three children. The views

expressed are those of the author and not necessarily those of the U.S.


to managing these transitions. This can result in symptoms of

depression, anxiety, adjustment disorders and even post-trau-

matic stress disorder.

Among the global population, 20 percent of youth (ages

13-18) live with a mental health condition; and, according to

the National Alliance on Mental Illness, half of all lifetime cases

of mental illness begin by age 14. While the State Department

does not track mental health data, Foreign Service families

experience medevacs, assignment curtailments and even some

painful tragedies due to child or teen mental health issues. Chil-

dren of employees assigned to Washington, D.C., or college-age

dependents may also need treatment, but families and young

adults must negotiate the bewildering U.S. mental health care

system on their own.

Research about TCK development suggests that kids benefit

from strong family and community support, deliberate prepara-

tion for transition and affirmation of their emotions along with

other resilience skills. Parents may assume their children have

the same resilience as they do; but individuals, even within the

same family, can have different abilities to cope. Counseling

and other professional support should acknowledge the unique

environment and history of the globally mobile child for opti-

mal diagnosis and treatment.

Current Resources

This past year, available State Department and some exter-

nal resources were compiled and disseminated—for the first

time—via cable and in a global webinar. They are featured,

along with relevant publications and websites, on the website

of the Foreign Service Youth Foundation


.). State

Department offices focus their support for families overseas

with information, consultations and training on resiliency. This

support includes the Office of Medical Services’s network of

What About Our Kids?


Foreign Service children are just as at risk of mental health problems

as the average American child, if not more so.