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State Department Employees Discouraged from Seeking Mental Health Treatment Due to Stigmatization

 A new internal report for the State Department suggests that more needs to be done to desensitize the stigma surrounding mental health treatment for State employees.

Released July 27, the State Department Office of Inspector General’s (OIG) report finds that although much has been done to improve access to mental health resources for employees returning from high-stress or high-threat deployments, employees are being deterred from these services due to stigmatization.

For example, the State recently created more accessible mental health services, such as the Deployment Stress Management Program (DSMP) in the Office of Medical Services that is designed to identify, counsel, and treat State employees suffering from mental health conditions. Also, the DSMP has increased its number of mental health care professionals, making treatment more feasible for employees returning from their postings. Although these medical services have become more available, a high number of employees are still discouraged from seeking treatment because of the believed stigma that surrounds mental health issues. The Inspector General recommends that the State Department issue a high-priority statement to its employees expressing the significance of mental health counseling and treatment to leading a normal, healthy life.

According to the U.S. Center for Disease Control and Prevention (CDC), the leading barrier preventing individuals suffering from a mental illness from seeking treatment is stigmatization. Admitting to having a mental illness can generate many negative feelings for an adult, such as a sense of failure, shame, guilt, or weakness. Feeling judged or ostracized makes two out of every three individuals diagnosed with a mental disorder refuse to seek treatment, and even more individuals remain undiagnosed. Even with treatment, many feel outcast by their disorder and may experience further complications to their mental health, such as depression or anxiety disorders.

For State employees who must be capable of withstanding high-stress, high-threat, or unaccompanied posts abroad, admitting to a mental health problem may appear as detrimental to their job. However, when these employees fail to seek counseling or treatment, they instead are further jeopardizing their health and occupational functionality. The State Department needs to depend on these individuals for intense, and sometimes extraordinary, stressful situations. For this reason, the State has made several attempts to expand its mental health services, which have improved dramatically in recent years. However, the majority of employees are refusing treatment even when it is mandatory.

According to the report, less than 60% of returnees from Iraq and Afghanistan are attending the mandatory High Stress Assignment Outbrief, a program that has proven to be quite proactive for employees. For those whose attendance is voluntary to the Outbrief, even fewer numbers choose to participate. The Inspector General suggests that the State do more to regulate attendance to this program following deployment. The report also recommends that the State establish more consistent mental health support throughout its multiple embassies so that employees may access the same quality of care wherever they are stationed, and transition and adjust to new assignments more easily.

In the State’s embassies in Kabul and Baghdad, the number of social workers and regional psychiatrists has significantly increased, but still more counseling services may be needed, according to the report. The OIG noticed heightened stress among leadership, which has the potential to cause serious implications to the Department’s functionality; senior and mid-level leaders are encouraged to take remedial action including training and counseling to diffuse high stress levels. Furthermore, the report cites a need for more recognition among its serving employees, such as certificates of recognition for returnees, which could spread appreciation and help boost employees’ morale after completing high-stress deployments.

Source: Washington Post, Josh Rogin, Report: ‘Stigma’ at State Department for those seeking mental health treatment, August 5, 2010

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