Living and working overseas can both be stressful and present unique challenges and opportunities that are not experienced by Americans residing in the United States. I would like to describe some of the sources of help available and encourage folks to make use of these resources if needed.
The State Department Office of Medical Services has a variety of programs available to assist employees and their families who may need some help while serving abroad.
Regional Medical Officer – Psychiatrist (RMOP)
One of these resources is the Regional Medical Officer – Psychiatrist (RMOP) program, staffed by psychiatrists such as myself, assigned overseas and responsible to provide coverage in a geographic region adjacent to their home post.
The RMOP program was established around the time of the Tehran hostage crisis (1979-1981). It has now grown to twenty-four positions with the vast majority of these located at embassy health units. RMOPs are psychiatrists (medical doctors with additional training after medical school) who are able to provide consultation, medication support, and some psychotherapy. Because the RMOP travels to other posts in the region at least half the time, patients who would benefit from weekly counseling sessions are usually referred to local providers that have been cleared by the post health unit.
Patients requiring specialized care, such as children, may be referred to local providers who are trained and qualified to U.S. standards. RMOPs can assist with these types of referrals. They may be able to provide the majority of care, and they can arrange medical evacuations if needed. RMOPs do not typically provide long-distance management for individuals requiring ongoing treatment who do not reside permanently at post (such as adult children attending college on educational travel) but are available for any acute problems that may develop during these visits and will always be glad to meet to discuss the situation and possible referral options.
Employee Consultation Services (ECS)
Another program well worth knowing about is Employee Consultation Services (ECS). This office is based in the U.S. and is the official State Department employee assistance program. ECS is staffed by qualified Licensed Clinical Social Workers and provides telephone or video teleconference consultations with employees and families overseas. They are particularly helpful in providing advice on curtailments, elder care, and family problems. They can help with individual, couple and group interventions. Unlike consultation with RMOPs, contact with ECS does not generate an entry into the medical chart with discussions being highly confidential and protected.
For more information, visit the ECS information page on the State Department website: http://www.state.gov/m/dghr/flo/c21952.htm.
Alcohol and Drug Awareness Program (ADAP)
The State Department also has a program to help individuals with substance abuse concerns. The Alcohol and Drug Awareness Program (ADAP) provides services to all eligible U.S. Government employees and their family members having health unit privileges overseas. ADAP provides education and consultation, initial assessment and treatment referrals, case management for individuals in treatment and recommendations to MED clearances. This program is highly confidential and nothing shared with ADAP personnel will be disclosed to anyone without written, informed consent. ADAP records are kept fully segregated from the regular electronic and paper records systems in order to protect confidentiality.
ADAP has a page on the State Department Intranet and their phone number is (202) 663-1904.
Deployment Stress Management Program (DSMP)
In awareness of the unique challenges faced by individuals assigned to high stress posts such as those in Pakistan, Iraq and Afghanistan, a congressionally mandated program, the Deployment Stress Management Program (DSMP), was created. DSMP can be a helpful source of assistance to those who are serving or have served in these types of environments. DSMP provides services throughout the deployment cycle from pre-deployment through reintegration. Services include prevention, intervention, assessment, treatment, counseling, education, and referral services associated with deployment-related psychological health issues before, during, and after deployment. DSMP provides services to help build psychological resilience, reduce stress associated with deployments, and overcome the stigma associated with seeking mental health care when the need arises.
For more information please visit the DSMP web page on the State Department website: http://www.state.gov/m/med/dsmp/
Child and Family Program
Last but certainly not least, the most recent program established in the Office of Medical Services is the Child and Family Program. The mission of this office is to work with parents to assure children’s mental health and special educational needs are identified and appropriately assessed and that an effective treatment and educational plan is established in advance of and during overseas assignments. Team members assist families with arranging evaluations for problems including speech difficulties, motor coordination difficulties, learning disabilities, attention deficit disorder, and emotional problems. Comprehensive evaluations can include psychological, educational, speech/language, occupational therapy and psychiatric assessments.
For more information, please visit the Child and Family Program page on the State Department website: http://www.state.gov/m/dghr/flo/c22458.htm
Dr. Paul Beighley is the Regional Medical Office Psychiatrist (RMOP) in Vienna, Austria. He has previously served in Washington, DC, Cairo, Egypt, and Accra, Ghana.
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