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Views and opinions expressed in this column are solely those of the author.


or (202) 647-8160

This issue’s State VP Voice is

by guest columnist and AFSA

Governing Board Secretary

William Haugh.

At more than 200 posts

around the world, in Wash-

ington and across the nation,

the strength of American

diplomacy begins with a

Foreign Service whose mem-

bers are competent, smart,

energetic, creative, caring

and resilient. It (almost) goes

without saying that the men-

tal health and well-being of

every member of the Foreign

Service family is fundamen-

tal to a “strong diplomacy”—

a guiding objective of this

AFSA Governing Board.

The Foreign Service life-

style means constant moves,

dangerous and unhealthy

environments, and unaccom-

panied assignments to active

war zones. Our competitive

Service rewards good work.

At the same time, it coldly

identifies those it deems not

making the grade. Even the

term “rank in person”—the

concept at the core of the

FS system—gives an inkling

of the all-consuming nature

of a career with a permeable

boundary between work and

personal life.

If this stress is an inevi-

table part of the Foreign

Service, we need to deal with

it on two levels:

• The State Department

has a duty to provide mental

health care not only because

of legal obligations under

the Foreign Service Act of

A Strong Foreign Service Begets Strong Diplomacy

1980, but because there is

a moral obligation to take

care of our people when they

and their families experience

psychological distress as a

result of faithfully fulfilling

their duties in difficult and

extreme circumstances.

The department’s medical

program has been a lifesaver

for many throughout the

years. But, even scratching

the surface of this topic—as

this issue of

The Foreign Ser-

vice Journal


perceived shortfalls. This is

not a reflection on the Office

of Medical Services’ practi-

tioners, rather a call for the

department to take a serious

look at a system with great

merits, but also perceived

weakness in its approach to

emerging challenges.

• We in the Foreign Ser-

vice should take responsibil-

ity to foster our own resil-

ience and care for our own

mental health.

Many good things are

happening already: Balanc-

ing Act aims to reduce stress

on working parents and

families; the Foreign Service

Institute’s Resilience Project

uses research to help com-

munities adapt to adversity;

the Culture of Leadership

Initiative highlights the

crucial role of positive lead-

ers; the Diplomatic Security

Peer Support Group helps

DS agents involved in high-

stress incidents; work-life

initiatives promote access to

lactation rooms and bike-to-

work programs.

AFSA supports and col-

laborates with many of these

programs and urges mem-

bers to become involved

where and when they can.

Regarding existing institu-

tional mental health support

for members of the Foreign

Service and their families,

three themes merit atten-





within the Service view the

department’s medical pro-

gram as not truly confiden-

tial and fear that using the

system may jeopardize their

medical or security clear-

ances. This is a longstanding

and widespread concern,

frequently addressed by

MED, but in unconvincing

ways. AFSA believes it’s time

for a comprehensive review

of MED’s confidentiality



Stress and Resilience.

With unaccompanied tours

and high-threat/high-stress

posts a permanent feature

of the assignment land-

scape, AFSA believes the

department’s Deployment

Stress Management Pro-

gram should have top-level

support and receive the

resources to care for the

Foreign Service community,

while proactively promoting



The Clearance


There is confusion

(even resentment) among

some Foreign Service per-

sonnel over the clearance

system for mental health

and medical conditions.

Member input suggests the

basis for medical clearance

decisions has never been

more unclear; some say that

MED is overly permissive in

some instances, unreason-

ably restrictive in others, and

the quality review process

seems neither rigorous nor

independent. AFSA asks

the department to address

these concerns and make

the clearance process fair,

understandable and mean-


The Foreign Service Act

calls for “minimizing the

impact of the hardships, dis-

ruptions, and other unusual

conditions of service abroad

upon the members of the

Foreign Service, and miti-

gating the special impact

of such conditions upon

their families.” On behalf of

its 16,500 members, AFSA

wants to see results from

the many ongoing efforts to

promote the mental health

and well-being of our com-



William Haugh retired

from the Senior Foreign

Service in April 2015 after a

35-year career that included

assignments in Washing-

ton, D.C., Rome, Stockholm,

Abidjan, Baghdad, Tunis and

Halifax. He is currently a

Re-employed Annuitant with

the Department of State’s

Bureau of European and

Eurasian Affairs.