Diplomats, Aid Workers Fear to Treat Stress

By Barber, Ben | The World and I, October 2011 | Go to article overview

Diplomats, Aid Workers Fear to Treat Stress


Barber, Ben, The World and I


Some U.S. diplomats and aid workers returning from Iraq and Afghanistan have anxiety and stress disorders but fear that seeking treatment will cause them to lose security clearance and end their careers, according to a recent survey by the American Foreign Service Association (AFSA).

"Forty-seven percent of foreign service respondents to a survey [last year] by AFSA said they felt receiving counseling for stress or mental health issues could negatively affect their career or security clearance," said Daniel Hirsch, AFSA vice president for the State Department.

"On the written side there are assurances [that seeking care for mental health issues] won't affect security clearance. But there are real issues with the way Diplomatic Security (DS) adjudicates clearances that call into question whether these statements are being applied.

"AFSA has not seen evidence DS is doing whole person adjudications in every case. That opens door to possibility people could lose security clearances."

An AFSA officer said that "the issue with DC is that they maintain opacity in the way they adjudicate clearance. We want to see proof they do a whole person review that requires not just looking at the fact that Joe ducks under tables every time he hears a loud noise. We need to see everything about Joe and not make determination without looking at everything about a person and weighing it."

Post Traumatic Stress Disorders not uncommon

The percentage of returning civilian diplomats and aid workers suffering from Post Traumatic Stress Disorder (PTSD) is reported to be about the same as for returning military, although those seeing combat have higher rates. While soldiers see far more combat and death up close, both groups experience the threat of attack on a daily and nightly basis for months and years.

In Baghdad's Green Zone and other diplomatic compounds for example, rockets crashed into the open areas, houses and offices with only a few seconds warning to seek shelter. At night, civilians slept for months or years in thin skinned trailers, later modified by adding sandbags to the roof and around the sides.

Aid workers and diplomats may leave the uncertain security of what they call "bubble"--the fortified compound in Baghdad, Basra, Kabul, Kandahar and other cities, to meet with local officials, set up development projects, offer funding for local government projects and carry out other tasks.

Civilian diplomats and aid workers wear armored vests and helmets and are escorted in the field in armored vehicles by U.S. or allied troops or by armed guards from private security contractors such as Triple Canopy, Blackwater and Dyncorps.

However civilians are not allowed to carry guns to defend themselves. And they are not trained in the arts of warfare.

"Working in Iraq and Afghanistan is obviously very stressful," said Hirsch of AFSA, which is a sort of labor union representing Foreign Service employees at State and USAID. "People do develop a variety of [of symptoms]. Some get full fledged PTSD. Some get anxiety problems."

"Some foreign service officers are badly injured in these places. They have seen others killed. Those things take the same toll as they do on military people."

For many years, seeking treatment for stress after service in combat was seen as a sign of weakness.

In World War II Gen. George Patton was relieved of his command for several months after he slapped two soldiers in 1943 suffering from what was then called "shell shock" or "battle fatigue," calling them cowards. Patton later apologized.

Military and civilians returning from service in Korea and Vietnam were often reluctant to seek treatment for mental problems related to service in war zones.

Dr. Christopher Flynn, a psychiatrist and director of mental health services for the Department of State, said that State does not have "numbers" of civilians returning with stress symptoms after service in Iraq and Afghanistan. …

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