Mental Health Issues and State

Diplopundit has a good piece on PTSD and people seeking counseling at State. She recommends State make a statement akin to the one released recently by the Department of Defense which changes the question on the security clearance form to remove counseling as it relates to PTSD. High time. We need it for State as well.

You can read Diplopundit's entire piece here.

On the Infamous Q21, PTSD and the Wholeness of People in the Foreign Service

Last week, Defense Secretary Robert Gates announced that applicants for government security clearances will no longer have to declare whether they sought mental health counseling after serving in combat zones. He emphasized while talking to reporters at a new PTSD center at Fort Bliss, Texas, that the troops’ psychiatric counseling for wartime mental health problems is "not going to count against them" if they apply for national security clearances for sensitive jobs. The announcement received wide media coverage. You can read the coverage by AP, WaPo, and Air Force Link by clicking on each hyperlink here.

The new policy revises the infamous Question 21 on the SF-86 Questionnaire for National Security Positions. The revised question excludes counseling related to marital, family, or grief issues, unless related to violence by the applicant. It also excludes counseling for adjustments from service in a military combat environment. You can read the official guidance from the Office of the Secretary of Defense dated April 18, 2008 here (the link will open as PDF file). The WaPo report also indicates that this change will apply not only to military and civilian employees of the Department of Defense but also to all applicants for security clearances.

Hmm …. I’ve looked at that guidance from OSD and it was only addressed to all military components . I’ve scoured the net for a similar guidance from OPM addressed to other Federal agencies but so far have come up empty. I’ve searched state.gov – nada (could not also find any easy reference to post traumatic stress disorder there).

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The group referred to in the second question runs an open blog called, Dead Men Working and they have written about the security clearance and PTSD recently here and here. This issue was a gut-wrenching read because anyone in the FS could easily imagine oneself in such a position, have friends who've been through this and could not rule this out as a potential affliction in everyone's card.

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Considering that State has its own clearance process and is a separate agency from DOD, I’m waiting for revised guidance for State Department personnel from Secretary Rice herself. Uhm, no offense intended; the guidance from “M” or “DGHR” or “DS” is fine but I don’t think that really cuts the cake here.

I’d like to see the Department of State, at the highest level of the 7th Floor, affirm and strongly endorse the practice of seeking professional help to address all health related concerns, including mental health. The press guidance above only refers to service in Iraq and Afghanistan, but what about service in the rest of the FS hardship assignments? The emotional toll of constant moving and relocation coupled with dangerous and challenging assignments is not something that we can or should ignore. Depression is a real cloud in our midst and unless we want a bunch of dysfunctional individuals running around trying to do their jobs, we must ensure that people get appropriate help without fear that their jobs could be jeopardized.

This issue impacts me personally. When you join State, you are required to fill out a questionnaire for your security clearance. On it is a question asking if you have ever received counseling for any reason. Lots of people who know better that I did just lie...they don't check that box even if they have received counseling. But silly me, I thought having recognized I needed help dealing with a problem and seeking that help would be seen as a good thing. Silly me.

The result of my checking that box, admitting I had sought counseling more than 15 years earlier, resulting in my having to have a telephone "interview" with a psychologist where I had to discuss very personal issues. She asked during the interview how I was feeling and I said annoyed. She seemed surprised and asked why. I said, "You are asking me to talk with a complete stranger about extremely personal issues, issues I dealt with and dealt with successfully 15 years ago. Issues I would not ordinarily discuss with a complete stranger. And then that complete stranger, based on talking to me for 45 minutes on the phone, gets to make a major decision about my future. And I find that annoying."

She admitted it would be.

Ultimately, she decided in that 45 minutes that I was fine, something I already knew. But it doesn't end there. Because we renew our clearances every five years, and because I was honest and checked the box, I will have to check it again. and I will have to go through that again. I heard a story at the party the other night of a woman who sought counseling after the death of her child. She had to discuss losing that child every single time she was up for her clearance renewal even though she had lost the child 30 YEARS earlier. How insane is that? Never mind insane...how inhuman is that?

And the flip side to all of this is that I later made the choice many make once in the department. When I was robbed at knife point, the post nurse asked if I wanted to talk to the regional psychiatrist. And my answer was, "Oh hell no." (Luckily, I found three weeks of R&R at the beach were the best therapy anyway!) I didn't (and don't) feel I needed traditional therapy for the incident, but I shudder to think about the folks who do, particularly after serving in places like Baghdad, who don't feel they can without jeopardizing their careers. It seems to me that this puts us all in danger