THE FOREIGN SERVICE JOURNAL
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
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.
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(www.fsyf.org
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.
BY K I M DEBLAUW
ON MENTAL HEALTH CARE FOR THE FOREIGN SERVICE