The Cable

Report: 'Stigma' at State Department for those seeking mental health treatment

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Josh Rogin
Foreign Policy
Thursday, August 5, 2010

The State Department is moving to improve how it handles mental health services for employees coming back from high-stress or high-threat postings, but there's still a great deal of stigma attached to seeking this kind of help and the department needs to do more, according to a new internal report.

"Employees believe there is still a significant stigma attached to seeking mental health assistance," the State Department Office of Inspector General (OIG) said in a report released last week. The OIG called on State to remove the stigma by issuing a high-level statement encouraging returning diplomats to use the mental health tools at their disposal.

State has been ramping up its efforts, including creating the Deployment Stress Management Program in the Office of Medical Services, and increasing the number of mental-health professionals at the ready. There is also a consultation and interview process called the "High Stress Assignment Outbrief" for when Foreign Service officers get back from the field, but less than 60 percent of those returning from Iraq and Afghanistan go through it. For other high-stress postings, the usage rate is much lower.

There are also more social workers and psychiatrists than ever at the embassies in Baghdad and Kabul, but according to the OIG it's unclear whether there are enough. The report recommends the department survey the war zones to see if diplomats' mental needs are being adequately addressed.

Sometimes, simply letting officers know their time abroad was appreciated can go a long way, according to the OIG.

"Some returnees felt a lack of recognition for their service," the report stated. "The Department could consider such steps as certificates of recognition from the Secretary or more meetings between returnees and senior officials at the Department and posts."

Kerry-Lugar bill seeks to lure capital to Pakistan

Sens. John F. Kerry (D-Mass.) and Richard G. Lugar (R-Ind.) have put forth a bill that would create a fund to lure private enterprise to Pakistan, using funds out of their own aid bill.

The idea is to use money to help drive capital and foreign direct investment into Pakistan. It's based on similar programs Congress has funded in other parts of the world, such as the Support for East European Development Act and the Freedom Support Act, which authorized nearly $1.2 billion for the U.S. Agency for International Development to establish funds throughout Central and Eastern Europe and the former Soviet Union.

"The United States can help the Pakistani private sector provide jobs, opportunity, and hope to Pakistanis using creative tools such as this Enterprise Fund," Kerry said in a statement.

On her recent trip to Pakistan, Secretary of State Hillary Rodham Clinton announced a set of major projects focused on building up Pakistan's ailing energy, water and agriculture sectors.

According to the original bill, the money was to be spent primarily in five areas: building democratic institutions, expanding the rule of law, promoting economic development, investing in education and strengthening public diplomacy. These are admittedly difficult and ambitious goals, but the administration's focus on infrastructure doesn't really get at them, some on the Hill are saying.

"This is another tool for them to consider how to spend the funds," a staffer on the Senate Foreign Relations Committee told The Cable. "It's not meant to micromanage the process in any way or to show umbrage at what the administration is doing."

Panel: U.S. military not ready for wars of future

The U.S. military isn't organized to fight the wars of the future and needs to start building and expanding now, a bipartisan panel of prominent defense experts and former officials has concluded.

The report by the high-level group, led by former national security adviser Stephen J. Hadley and former defense secretary William Perry, explicitly warns about the "growing gap" between what the military is able to do and what it may be called on to do in the future. It advocates an expansion of the Navy and calls for continued increases in an annual defense budget that has more than doubled since 2001.

The congressionally mandated report differs in significant respects from the official Quadrennial Defense Review, in which Defense Secretary Robert M. Gates and his team argued for rebalancing the military away from the huge weapons systems the United States has been building since World War II and toward more manpower-intensive, small-war capabilities like those being used in Iraq and Afghanistan.


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