The U.S. Department of State’s Mental Health Services: A Model for Integrated Care

Abstract

Since it was established in 1979, the U.S. Department of State's mental health service has functioned as a unique program of care for U.S. diplomats and their family members, currently encompassing more than 250 U.S. embassies and consulates worldwide. Such an approach has allowed for rapid delivery of high-quality care in collaboration with regional medical officers, nurse practitioners, physician assistants, nurses, and local assets. Data from the past three decades indicate that the program has had low rates of medical evacuation and repatriation and low rates of mortality. Building from its roots in disaster and crisis response, the program now offers integrated mental health care in a geographically distributed, worldwide program to address the general medical and behavioral health needs of an expanding U.S. diplomatic presence in increasingly remote, challenging, and dangerous environments.

Mental health of diplomatic personnel: scoping review

“…However, evidence from the UK suggested that diplomats reported low rates of psychiatric morbidity and fared better psychologically than other occupational groups whose work involved frequent international travel [ 12 ], although more poorly than their spouses. Evidence from the USA suggested diplomats who benefited from the US Department of State’s mental health service for diplomats fared better psychologically (in terms of post-traumatic stress disorder [PTSD] and suicide rates) than both military and civilian populations [ 10 ]. A study of diplomats in Iran [ 9 ] found that occupational stress was low overall, but significantly higher for staff who had musculoskeletal disorders; the same study found that burnout was higher in staff who smoked and staff with higher occupational stress.…”