— By Domani Spero
On September 5, Gordon Lubold writing for Foreign Policy reported on USAID’s first known war-zone-related suicide and asks if America is doing enough to assist its relief workers. Excerpt below:
On Aug. 15, the U.S. Agency for International Development announced that one of its employees had died suddenly. The agency didn’t mention that Michael C. Dempsey, a senior field program officer assigned as the leader of a civilian assistance team in eastern Afghanistan, killed himself four days earlier while home on extended medical leave. However, the medical examiner in Kent County, Michigan, confirmed to Foreign Policy that Dempsey had committed suicide by hanging himself in a hotel-room shower. His death is USAID’s first known suicide in a decade of work in the war zones of Afghanistan and Iraq. And what makes the suicide particularly striking is that it came a year and three days after Dempsey’s close friend and colleague was killed in an improvised-explosive-device attack in Afghanistan.
- State Dept’s Suicide Prevention Resources — A Topic So Secret No One Wants to Talk About It | JUNE 18, 2013
- US Mission Afghanistan: USAID Officer Ragaei Abdelfattah, Four Others Killed, Two Wounded in Suicide Attack in Kunar | AUGUST 10, 2012
- Post-Traumatic Stress Disorder: The Ticking Bomb in the Foreign Service | JUNE 25, 2012
- Quickie | Running Amok: Mental Health in the U.S. Foreign Service | JUNE 29, 2012
- Rachel Schneller | PTSD: The Best Thing that Ever Happened to Me | JUNE 27, 2012
- Senior Diplomat Disciplined for Volatile Behavior Cites PTSD in Grievance Case, Fails | JUNE 22, 2012
- Clinton issues note on mental health; seeking help a sign of maturity and professionalism | SEPTEMBER 10, 2010
- On the Infamous Q21, PTSD (Again) and High Threat Unaccompanied Assignments | JULY 29, 2010
- Join the Petition: Revise Q21 for the Foreign Service | JANUARY 8, 2009
- On the Infamous Q21, PTSD and the Wholeness of People in the Foreign Service | May 2008
More from Mr. Lobold’s A Death in the Family:
Shah left unspoken the issue of suicide that USAID must now confront. With Dempsey’s death as the first known suicide from either of USAID’s Afghanistan or Iraq programs, the suicide forces the agency to deal with an inescapable problem: how to help its employees who deploy to the same war zones as the military but who don’t always have access to the same kind of assistance. Civilian culture may not have the military’s taboo against seeking mental-health assistance, but unlike the Defense Department, which has struggled to arrest the vast suicide problem within its ranks, civilian agencies such as USAID and the State Department are governed by different privacy rules that hamstring those agencies as they try to help employees who may be suffering from post-traumatic anxiety, depression, or worse.
USAID has deployed more than 2,000 “direct hires” through Iraq and Afghanistan since 2003. Many of them, like Dempsey, are considered “foreign service limited” (FSL) officers. That means they enjoy many of the same benefits of Foreign Service officers, but can’t be promoted or moved to other offices or departments. About 150 FSL officers are in Afghanistan currently. After each deployment, each one gets a “high-stress outbrief,” but due to privacy concerns, USAID isn’t able to contact any of them after they leave federal service to ensure that they aren’t suffering from deployment-related issues or other maladies, like alcohol abuse or depression. After a deployment, supervisors may only hear about those kinds of problems unofficially, through the bureaucratic grapevine, because of the way privacy regulations govern civilian agencies. And even then, if a problem is identified, USAID, unlike the Defense Department, can’t force an employee to undergo treatment.
* * *
Something about that “each one gets a “high-stress outbrief,” but due to privacy concerns, USAID isn’t able to contact any of them …” seem odd.
According to the State Department, Foreign Service and Civil Service employees from the State Department and USAID who have spent more than 90 days in Afghanistan, Iraq, Pakistan, Yemen, or Libya are required to attend its High-stress Assignment Outbriefing Program. Any State employee serving at any high stress post is also highly encouraged to attend.
However, a review of the program by State/OIG in July 2010 indicates that fewer than 60 percent of returnees from Iraq and Afghanistan for whom this is mandatory attend the High Stress Assignment Outbrief. Apparently, very few employees from other high stress posts for whom it is voluntary take it. State/OIG also stated that “If efforts to increase attendance fail, the Department will need to adopt stronger measures and a follow-up mechanism.” Now, why would State/OIG propose the adoption of stronger measures to increase the Outbrief attendance if there were “privacy concerns?”
In any case, the Outbrief is mandatory but more than 40% of returnees mandated to attend it do not take it. FSI’s Transition Center admits that “compliance remains a difficult issue:”
“Compliance remains a difficult issue. While the program has received support and validation from a number of internal and external stakeholders, the unique requirement of a post-deployment “de-brief” coupled with a cultural reluctance in the workforce to deal with mental health or stress related issues mitigate against full participation. Since the essence of the program is to provide help to returning employees – and their family members – more rigorous measures to ensure compliance were seen as undesirable (e.g., holding up onward assignments or limiting or temporarily suspending clearances) and counterproductive.”
In a recent document published in conjunction with a solicitation for a High Stress Assignment Outbrief provider also states that the Outbrief “is a two-way educational program” and it is “not a clinical session or intervention.” Asked by potential provider about “sources/citations for the interviewing methodologies utilized in the High Stress Assignment Outbrief”, the official response is as follows:
“The interview methodology was developed by trainers and psychiatrists working for the Foreign Service Institute and the Office of Medical Services of the Department of State. The interview protocol is not designed as a therapeutic intervention; it’s purpose is to have participants reflect on their experiences, offer advice to the Department, and to provide a conduit for such aggregated information for Department decision makers.”
The Outbrief implementation guide posted by FSI’s Transition Center at fbo.gov also states that “the Department is responsible for keeping track of compliance” and that there is a need (for the selected provider) to make sure that “accurate records are kept of who attended, when, and where.”
In short —
The Outbrief is not/not a clinical session.
It is not/not a therapeutic intervention.
It is mandatory but not everyone attends it.
The Department kept accurate records of who attended it, where and when.
But due to “privacy concerns” USAID isn’t able to contact any of them to ensure that they are not suffering from deployment-related issues.
Also a new contract was awarded to a new Outbriefer in May 2013 for $46,400 (Base and Option Years Estimate).
You know, I’ve lost my brain today. I just don’t get this. If you’ve been through the Outbrief session would you kindly write me and help me understand how this is helpful to returnees from high stress-high threat assignments.
- A USAID Worker’s Suicide Raises the Flag on a Troubling Issue (truthdig.com)
- Report: USAID Wasting Millions in Taxpayer Dollars in Afghanistan (freebeacon.com)
- PTSD and Suicide Risk (everydayhealth.com)
- In Afghanistan, troop drawdown hems in US diplomats who oversee development (stripes.com)