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Today, more colleagues are

serving at more high-threat,

austere and significant hard-

ship posts than ever before.

AFSA is working to ensure

that members receive the

language and security aware-

ness training necessary to

safely and e’ectively engage

while overseas, and the men-

tal and physical care they

need while there and when

they return.

In 2013, Mental Health

Services—under the

Ožce of Medical Services

umbrella—was reorganized

to focus more attention on

the mental health needs of

employees and their families.

The Employee Consulta-

tion Service was split into

the Employee Assistance

Program and the Deployment

Stress Management Program,

and a separate Child and

Family Program.

Deployment Stress

Management Program

In 2007, Congress directed

the State Department to

establish a unique program

for Foreign Service members

en route to or returning from

high-threat, high-risk posts.

The result is the Deployment

Stress Management Pro-

gram, which covers the entire

deployment cycle.

In September, AFSA

discussed with Employee

Consultation Service sta’

their outreach e’orts and

employee assistance pro-

grams. At that time employ-

Mental Health and the Foreign Service

ees could receive prolonged

exposure treatment con-

sisting of 8 to 10 in-house


This intensive treatment,

coupled with a six-month rein-

tegration program, ensured

that employees received in-

house assistance from prac-

titioners familiar with Foreign

Service employment. Each

year, approximately a dozen

or so employees have availed

of this in-house assistance.

Utilizing best practices

and guidelines recommended

by the American Psychiatric

Association and the Depart-

ment of Veterans A’airs

National Center for PTSD, the

Ožce of Medical Services is

improving the comprehen-

sive diagnosis and treatment

of employees with deploy-

ment stress-related medical,

neurologic and psychiatric


MED is developing referral

networks for employees, both

in theWashington, D.C., area

and at other nationally recog-

nized centers of excellence.

AFSA encourages MED

to continue to review these

changes and their impact on

the quality of care for employ-

ees. We believe it is impor-

tant that employees have

access to the best resources,

whether in house or through

external partners, to address

“the sacrifices and strains of

the work we’ve all chosen to

do together”—as Secretary of

State John Kerry wrote in his

May 2013 letter to employees.

Clinical Social


In March, while visiting col-

leagues in Kabul and Islam-

abad, I had the opportunity to

meet with a Foreign Service

clinical social worker.

The Service currently has

five social workers on limited

non-career appointments

serving in Baghdad, Kabul

and Islamabad, in addition to

the regional medical ožcers

and regional medical psychia-

trists covering the region.

These medical profession-

als serve on the front lines

ensuring that employees

receive the mental care and

assistance required.


department introduced the

social workers in 2005, and

they have been well received

by post management,

employees and MED.

AFSA welcomes these

new members to the Service

and encourages the depart-

ment to consider expanding

their presence to the other

high-threat, high-risk posts.

Moreover, if and when posts

go through authorized or

ordered departures (or, as

in the case of Baghdad, a

“temporary relocation”), MED

and AFSA strongly support

mission management’s inclu-

sion of these individuals on

the minimal stažng lists.

It is exactly in those more

stressful situations that their

services are most needed.

Medical and Security


Employees often ask about

potential negative conse-

quences of disclosing mental

health issues. However, the

medical and security clear-

ance processes are con-

ducted completely indepen-

dently of one another.

Counseling is provided

on a confidential basis, with

a disclosure exception for

employees believed to be a

danger to self, others or our

national security.

As Sec. Kerry has stated,

“No one at the department

has lost a clearance because

he or she sought mental

health counseling or treat-


See “Mental Health” in

the October 2010 edition of

State Magazine


StateMag1010) for more on

mental health and security


The Foreign Service is

unique, and AFSA is working

to ensure that we have access

to the best in-house and

external resources necessary

to support our employees.

Moreover, in the event that

an employee is physically or

mentally injured overseas,

he or she must know that

the State Department will do

everything it can to provide

the protections, care and

administrative leave autho-

rized in department regula-

tions (3 FAM 3464.5).


Next Month: Marijuana

Decriminalization, Legalization

and the Foreign Service




Views and opinions expressed in this column are solely those of the AFSA State VP.


| (202) 647-8160 | @matthewasada