Concerned Foreign Service Officers Warning On Mental Health Treatment

Mental Health of Foreign Service Officers

A recent article comments by the State Department's spokesperson, and recent efforts to poll Foreign Service Officers on mental health issues related to overseas postings prompt Concerned Foreign Service Officers to issue the following warning to members of the Foreign Service:

PTSD and other stress- or trauma-related mental illnesses are serious problems requiring medical care, and CFSOs urges anyone who may be suffering from such disorders to seek immediate treatment. We strongly urge, however, that FSOs seek such treatment from a private mental health care provider, and not through the Office of Medical Services of the U.S. Department of State (M/MED).

Concerns about the effect of mental health care treatment on security clearances, as reported in USA Today by former DG Pearson, are real. CFSOs has seen numerous cases where even allegations of mental health issues, ranging from PTSD to depression to marital discord to stress-related substance abuse have been referred by M/MED to Diplomatic Security (DS), usually resulting in recommendations to revoke a clearance. The issue is aggravated by the fact that M/MED keeps medical records related to such cases, including initial diagnoses, outside of normal medical files, in administrative files shared with, and sometimes even stored by, DS.

The State Department has asserted that such files are not subject to the HIPAA Act. Consequently, medical information will be shared with DS, with Human Resources employees, and even with security services of other agencies which may clear an employee, but not with the employee him/herself. It may take an employee three or four years to be able to access such information through the Privacy Act, and access may be denied completely. It is M/MED's stated policy not to remove or amend inaccurate information in its files, meaning that if a medical interview is inaccurately portrayed by the recording psychiatrist, it will stand as fact. We have seen cases where DS has based clearance revocations on 12-year-old medical information regarding conditions of which the employee has demonstrably been cured. We have also seen cases where files were destroyed, leaving employees with revoked clearances and no evidence to dispute. The Office of Medical Services has one patient and one patient only: The U.S. Department of State. As stated by a former Director of Mental Health Services, their "job is to prevent people like you from ever serving overseas again."

M/MED continues to maintain improper files, to withhold information from patients, and to regard themselves as "cops in doc's clothing." For these reasons, we urge any employee seeking mental health treatment to obtain such treatment privately. The employee may still be required to share information with M/MED and DS, but at least the employee will be able to compel HIPAA Act compliance and have a legal record, beyond the State Department's ability to suppress, of what actually transpired.