FSGB Case: Employee’s Mental Health Issues and Performance

 

Via FSGB Case No. 2016-043:

The Department denies that grievant’s 2013 EER is factually inaccurate, falsely prejudicial, or biased, and cites a series of interviews with her supervisors, subordinates, and colleagues to dispute her contentions about the unfairness and inaccuracy of the EER. In response to grievant’s allegation that she was inadequately counselled on the deficiencies described in her EER, the agency contends, based on statements from grievant’s rating officer, that she was in fact counselled, both formally and informally, during the rating period. With respect to grievant’s claim that she was bullied, ostracized, and treated unfairly by the Embassy community, which she alleges triggered her trauma symptoms, the Department provided input from the Ambassador, grievant’s rating officer, and the General Services officer, all of whom disputed grievant’s allegations.

In response to grievant’s claim that she suffered from then-undiagnosed mental health issues (including anxiety, depression and trauma symptoms), the Department counters with quotes from grievant’s rating officer who stated that “from the time REDACTED arrived at post, she appeared unhappy and talked of being stressed.” The rater recalled that some of her stress “appeared to be related to prior postings (including REDACTED, REDACTED, and REDACTED),” and said that “upon arrival she talked to me about how stressful she had found the 6 months of FSI [Foreign Service Institute] REDACTED language training, and told me she urgently needed a break.” The Department was not persuaded that grievant’s poor performance resulted from the medical condition with which grievant was diagnosed after she left REDACTED. The Department put less credence in the medical statement grievant provided from her post-REDACTED therapist, stating “grievant has not provided medical documentation substantiating her alleged diagnosis. Nor does grievant’s counselor provide such documentation; the counselor merely states that ‘I believe PTSD is the primary diagnosis.’”

FSGB BOARD:

In all grievances except those involving discipline, the grievant bears the burden of proving that her claims are meritorious.3 This case turns on whether the grievant’s EER is falsely prejudicial, and, whether any documented underperformance can be attributed to the grievant’s post-REDACTED diagnosis of mental health disorders. The Board notes that the record in this case is, unfortunately, sparse with respect to a diagnosis of grievant’s mental health issues. While the Department is correct in noting that grievant’s counselor noted only that “I believe that PTSD is the primary diagnosis,” the Department provides no opposing medical information whatsoever, relying solely on the observation of grievant’s Foreign Service colleagues in REDACTED.  Grievant’s licensed mental health counselor did in fact provide a detailed listing of grievant’s problems in REDACTED, and concluded that grievant suffered mental health disorders as a result thereof. We note that grievant’s counselor saw the grievant regularly over a period of more than a year. On balance, therefore, the Board is obliged to find grievant’s medical evidence preponderant. After careful examination of the ROP, the Board concludes that grievant’s 2013 EER cannot stand, because her performance during that period was likely influenced by her depression, anxiety, and trauma symptoms. We base our conclusion largely on the detailed statement submitted by grievant’s Licensed Professional Counselor (LPC), with whom grievant had at least 38 therapy sessions between April 2014 and August 2015, and to whom grievant was referred by a prior therapist who had diagnosed her with anxiety, depression, and trauma symptoms. In the Board’s view, this statement, written by a mental health professional who knows the grievant well, is entitled to more weight in the decision process than that of grievant’s rating and reviewing officers, or her colleagues at post. We also note that the Agency provided no contradictory medical opinion, or any information of a medical nature.

In her August 18, 2015, statement, grievant’s LPC states, in relevant parts:

She was referred to my center, the National Center for the Treatment of Phobias, Anxiety, and Depression in Washington DC by a previous therapist who had diagnosed her with anxiety, depression, and Trauma Symptoms. She also sees REDACTED , MD for medications at this center. I believe PTSD is the primary diagnosis and the depression and anxiety are symptoms of the PTSD. REDACTED described primitive and unsanitary living conditions that caused her to feel unsafe. She reported unsanitary water in her apartment, unsafe electrical problems, and other living conditions that prevented sleep, peace and support. While in the workplace, she felt she was targeted, bullied and marginalized. Because of the combination of insecurity in her home, insecurity in her workplace, and the stress of an extremely stressful foreign environment, began to suffer from PTSD symptoms. She became depressed and hopeless, developed panic attacks, difficulty sleeping, developed nightmares, and generalized anxiety.

It is my understanding that her evaluations from this period faulted her for having strained relations with her subordinates, program participants, and peers in Washington, as well as difficulty making contacts in the REDACTED media and discomfort speaking to media on the record. I did not observe REDACTED during this period, so I do not have an opinion on the accuracy of these criticisms, but, if true, each would in my opinion be related to the various symptoms of her previously-undiagnosed and untreated anxiety, depression and trauma symptoms. 

I do not believe a patient can work with very seasoned therapists or psychiatrists and hide character issues as described in the accusations towards REDACTED. However, I do believe that it would have been difficult, if not impossible, for REDACTED , while suffering the effects of PTSD, to maintain a high level of diplomacy, an ability to connect well with co-workers, and to utilize PR skills to connect at work well with the media.

Nightmares, panic attacks, depression, extreme fear, feelings of hopelessness and helplessness and not feeling respected or supported would prevent most people from working at a level of excellence which, to my knowledge, had been true for REDACTED before her REDACTED posting. I believe REDACTED ’s behavior while in REDACTED was mischaracterized at most and misunderstood at the least. This is my opinion based on working with many patients who suffer from trauma-related symptoms. 

We find the foregoing LPC statement to be a detailed professional observation, based on relatively long-term (at least 16 months’) observation of grievant, and thus accord it more weight than we do the statements offered by the Department from non-medical providers (her rater, the General Services officer (GSO), the Ambassador, and grievant’s subordinates). While the statement does not contain a definite diagnosis of grievant’s symptoms, we note it is from a licensed medical professional, and is countered by the Department only with comments from non-medical co-workers and colleagues.

THE BOARD’S DECISION:

Grievant has shown by preponderant evidence that she suffered from the effects of then undiagnosed mental health conditions including anxiety, depression, and potential Post Traumatic Stress Disorder (PTSD) during her tour in REDACTED and accordingly, her Employee Evaluation Report (EER) for 2013 must be expunged and replaced in her Official Personnel File (OPF) by a standard gap memorandum. Grievant has shown that she suffered from these conditions and that they affected her performance in ways that contributed to the negative statements in her EER. If she is not promoted by reconstituted Selection Boards for the years 2014 -2017, her Time in Class shall be extended by one year.

One more: “as a general matter, an EER is inherently false, even though it accurately describes an employee’s performance, if that poor performance was the result of the employee’s serious illness.”

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No Comparator Case For DS Agent With PTSD — Failure to Follow Regs, Lack of Candor Charges Came 2 1⁄2 Years Late

Posted: 3:12 am  EDT
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This is a case of a DS Agent charged with lack of candor and failure to follow regulations for incidents that took place in 2010 related to his PTSD.   The State Department issued a final decision to  suspend the agent for 12 days.  According to the ROI, the deciding official at the agency level grievance “also considered the mitigating factors and gave grievant credit for having no past formal disciplinary record and a satisfactory work history. The deciding official also noted grievant’s potential for rehabilitation, while recognizing that grievant clearly was embarrassed by his diagnosis of PTSD, and feared that he might be stigmatized by the label, or that he might even lose his job with the Department.”

A couple things striking about this case.  Following grievant’s military service in Iraq in 2006, he started having panic attacks and severe anxiety, for which he was prescribed several medications – none of which he says worked very well. His symptoms became worse over time. In 2009 he was diagnosed as having Post Traumatic Stress Disorder (PTSD).  The incidents that ultimately led to the two charges occurred in November 2010; yet the Department did not propose disciplinary action until April 24, 2013 – a span of 29 months. The ROI does not explain the delay.

Grievant reportedly denied during the interviews with that he had been diagnosed with PTSD, saying instead that he had been treated for anxiety and panic attacks. And yet, according to the ROI, grievant avers that “he discussed his PTSD diagnosis in considerable detail with the DS investigators, and authorized release of his medical records.”

Grievant admits he did not comply with Department regulations requiring him to report that he had been prescribed psychiatric medications, but claims he was unaware of the policy requiring him to do so. He claims that he was not alone in being unaware of this requirement, as many other DS officers to his knowledge were also unaware of the regulation.

Since grievant is a DS agent, the Department has also cited 12 FAM Exhibit 023 2.5, its Deadly Force and Firearms Policy (which we can no longer read online, as it’s now behind the firewall). 12 FAM Exhibit 023 section 2.5 12 FAH-9 H-030 appears specific to prescription medication.  The State Department showed, and the FSGB agreed that there are no similar cases that presented the same set of circumstances as in this grievant’s case.

The Board held that grievance be granted in part and denied in part. The Board remanded the case to the Department to consider an appropriate penalty in view of their decision not to sustain two specifications of one of the two charges.

Summary:

Grievant faces two charges – Lack of Candor and Failure to Follow Regulations – that were leveled against him because of statements he made during a Department investigation about incidents that took place while he was in the U.S. on leave in 2010. He is a Diplomatic Security Special Agent who was admitted to the hospital on two occasions (on consecutive days) after he drank alcohol heavily and took an unknown quantity of prescription medications after he became upset about the breakup of his engagement to be married. The investigation revealed discrepancies between the information grievant gave to investigators and that found in his medical records. Records show that grievant suffers from PTSD and that he had not reported this fact to the Department. The investigation report claims that grievant denied during interviews that he had ever been diagnosed with PTSD or that he was ever in a treatment program to address the condition. His records also show that he had been prescribed several psychiatric medications, and contained no evidence that grievant had reported to the Department either the PTSD diagnosis, or the prescription medicines which are required to be reported under the agency’s Deadly Force and Firearms policy. The Department’s final decision provided for a 12-day suspension without pay.

Grievant denies the majority of the specifications cited in the charges. He claims to have discussed his PTSD diagnosis in detail with the investigators and avers that he responded candidly to all of the questions posed to him during two DS interviews. He admits that he did not report the prescription medicines, but argues that he was unaware he needed to do so. Grievant also claims that the charges are untimely, having been brought after a very long delay – nearly 2 1⁄2 years after the incidents, and that the delay has prejudiced his ability to present his case. He claims to have been particularly disadvantaged in that he is unable to find witnesses who could corroborate his positions or shed light on the quantity of medications he took prior to the 2010 incidents. He also argues that the proposed penalty, in any case, is overly harsh in light of penalties the Department has imposed for like offenses. He requests that those charges/specifications the Department is unable to establish should be overturned, and the 12-day suspension should be mitigated.

Click on the image or the link below to read ROI in pdf file. The file is redacted and originally published online by the Foreign Service Grievance Board.

2014-020 - 04-29-2015 - B - Interim Decision_Redacted-2-02

FSGB Case 2014-020 – 04-29-2015 – B |DS Agent – PTSD Case                         (click image to read in pdf)

2014-020 – 04-29-2015 – B – Interim Decision_Redacted-2

The regs apparently say that “a DSS Special Agent who is taking prescription medication to notify his supervisor and submit a medical certificate or other administratively acceptable documentation of the prescription … to the Domestic Programs Division of the Office of Medical Services immediately after beginning the medication.” We don’t know what happens to DS agents who self report as required by regulations.  Are their USG-issued weapons removed? Are they subject to reassignment? Is there a perception that this is an embarrassment?

Given that many Diplomatic Security personnel have now done multiple tours to war zones and high threat posts, is this really an isolated case of not self-reporting both the PTSD diagnosis and the use of prescription medication?

We sent this individual to Iraq in 2006. He came back with unseen wounds. And here he is in 2015, still fighting his battle.   What can the State Department do to make employees with potential PTSD less fearful of being stigmatized in coming forward and acknowledging they need help? What can the Bureau of Diplomatic Security do more for its agents? How can this be made into a less lonely fight?

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June Is PTSD Awareness Month — Let’s Talk Mental Health, Join Us at the Forum

Posted: 11:13 pm  EDT
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Join us at the forum today at http://forums.diplopundit.net, noon – 2pm, EST

I’ve blogged about mental health in the State Department for years now (see links below). I know that a mental health issue affecting one person is not a story of just one person.  It affects parents, spouses, children, siblings, friends; it affects the home and the workplace. It is a story of families and communities. While there is extensive support in the military community, that’s not always the case when it comes to members of the Foreign Service.

I once wrote about a former Foreign Service kid and his dad with severe PTSD. A few of you took the time to write and/or send books to the ex-FS employee incarcerated in Colorado, thank you.

I’ve written about Ron CappsRachel SchnellerCandace Faber, FSOs who came forward to share their brave struggles with all of us. There was also a senior diplomat disciplined for volatile behavior who cited PTSD, I’ve also written about Michael C. Dempsey, USAID’s first war-zone related suicide, and railed about suicide prevention resources.  The 2014 Foreign Service Grievance Board 2014 annual report says that eight of the new cases filed involved a claim that a disability, Post Traumatic Stress Disorder (PTSD), or other medical condition affected the employee performance or conduct that resulted in a separation recommendation.

With very few exceptions, people who write to this blog about mental health and PTSD do so only on background. Here are a few:

  • A State Department employee with PTSD recently told this blog that “Anyone outside of our little insular community would be appalled at the way we treat our mentally ill.”  The individual concludes with clear frustration that it “seems sometimes the only unofficially sanctioned treatment plan encouraged is to keep the commissaries well stocked with the adult beverage of your choice.” 
  • Another one whose PTSD claim from service at a PRT in Iraq languished at OWCP said, “I can assure you that OER and State Med have been nothing but obstructions… as a vet, I have been treated at VA for the past ten months, else I would have killed myself long ago.”
  • Still another one writes: “VA indicates the average time between trauma and treatment-seeking is eight years. The longer it is undiagnosed and treated, the more difficult to ameliorate. I have a formal diagnosis from VA but could not even get the name of a competent psychiatrist from DoS. The bulk of DoS PTSD claims are still a few years away (2008/2009 PLUS 8), with no competent preparation or process.”
  • A friend of a State employee wrote that her DOS friend was “deployed/assigned to a  war-torn country not too long ago for a year. Came back with PTSD and  was forced by superiors to return to very stressful/high pressure work  duties while also seeking medical attention for an undiagnosed then, but eventually diagnosed (took about 6 months) disease  triggered by environmental conditions where s/he was last posted.”
  • Another FSO said, “I actually thought State did a decent job with my PTSD. After I was subject to an attack in Kabul, the social worker at post was readily available and helpful. He indicated I could depart post immediately if I needed to (and many did after the attack). When I departed post I was screened for PTSD and referred to MED here in DC. After a few sessions here with MED, I was referred to a private psychologist who fixed things up in a few months.”
  • One FSO who suffered from PTSD assured us that “State has come a very long way since 2005” and that it has made remarkable progress for an institution. Her concerns is that PTSD is widespread in the Department in the sense that people develop it in a wide range of posts and assignments. She cited consular officers in particular, who evacuate people from natural disasters and civil wars and deal with death cases on a regular basis, and are particularly at risk.

 

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June is PTSD Awareness Month. We are hosting a forum at http://forums.diplopundit.net for an open discussion on PTSD.

It’s not everyday that we get a chance to ask questions from somebody with post traumatic stress disorder. On Monday, June 29, FSO Rachel Schneller will join the forum and answer readers’ questions  based on her personal experience with PTSD.  She will be at this blog’s forum from noon to 2 pm EST. She will join the forum in her personal capacity, with her own views and not as a representative of the State Department or the U.S. Government.  She’s doing this as a volunteer, and we appreciate her time and effort in obtaining official permission and  joining us to help spread PTSD awareness. Please feel free to post your questions here.

Rachel Schneller joined the Foreign Service in 2001. Following a tour in Iraq 2005-6, she was diagnosed with PTSD. Her efforts to highlight the needs of Foreign Service Officers returning from tours in war zones helped prompt a number of changes in the State Department, for which she was awarded the 2008 Rivkin Award for Constructive Dissent.

Prior to joining the U.S. Department of State, Rachel served as a Peace Corps volunteer in Mali from 1996-98. She earned her MA from the Johns Hopkins School of Advanced International Studies (SAIS) in 2001. We have previously featured Rachel in this blog here, and here.

The forum, specifically created for PTSD discussion is setup as an “open” forum at this time; readers may post questions without registration.  We’re hosting, same Privacy Policy apply.

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Below are some of our previous blog posts on mental health, PTSD, security clearance and the State Department’s programs:

What to do when different voices start delivering multiple démarches in your head?]

USAID’s First War-Zone Related Suicide – Michael C. Dempsey, Rest in Peace

State Dept’s Suicide Prevention Resources — A Topic So Secret No One Wants to Talk About It

Former Foreign Service Kid Writes About Dad With Severe PTSD  (Many thanks to readers who took the time to write and send books to Tony Gooch! We appreciate your kindness).

Ron Capps | Back From The Brink: War, Suicide, And PTSD

Rachel Schneller | PTSD: The Best Thing that Ever Happened to Me

Senior Diplomat Disciplined for Volatile Behavior Cites PTSD in Grievance Case, Fails

Pick the Long or Short Form, But Take the Post-Traumatic Stress Disorder (PTSD) Screening

On the Infamous Q21, PTSD (Again) and High Threat Unaccompanied Assignments

Ambassador Crocker Arrested for Hit and Run and DUI in Spokane

Quickie | Running Amok: Mental Health in the U.S. Foreign Service

Former FSO William Anthony Gooch: No Mercy for Broken Men?

Post-Traumatic Stress Disorder: The Ticking Bomb in the Foreign Service

Clinton issues note on mental health; seeking help a sign of maturity and professionalism

EFM shouldn’t have to see three RMOs, do a PPT presentation and wait 352 days for help

Join the Petition: Revised Q21 for the Foreign Service

State Dept’s WarZone Deployment Incentives, Programs, Training and Medical Support

DMW: Mental Health Treatment Still a Security Clearance Issue at State Department

Insider Quote: Returning to the Real World

What’s State Doing with Question 21?

 

Senior Diplomat Disciplined for Volatile Behavior Cites PTSD in Grievance Case, Fails

A Senior Foreign Service Officer with over 21 years of Foreign Service experience was serving as an Office Director when he was disciplined for repeated violations of the Department’s Policy on Violence and Threatening Behavior in the work place.  The FSO filed a grievance contending that the five-day suspension as unreasonable (also includes loss of pay, and a discipline letter being placed in his Official Personnel File for two years).

The FSO in his grievance filing also cites as one of the mitigating factors a link between his anger and inappropriate language at the workplace, symptoms of Post Traumatic Stress Disorder (PTSD) and adaptation disorder as a result of his service in a Provincial Reconstruction Team. The grievance appeal was denied.

Goya – The Disasters of War | Plate 65: Spanish: Qué alboroto es este? English: What is this hubbub? (wikipedia)

From FSGB Case No. 2011-004 dtd. August 19, 2011:

HELD: The Department carried its burden of proof in deciding to discipline grievant, a Senior Foreign Service Officer charged with inappropriate conduct, for five days. Grievant failed to prove that he suffered from Post Traumatic Stress Disorder (PTSD), which he asserted was responsible for his repeated violations of the Department’s Policy on Violence and Threatening Behavior in the work place.

SUMMARY: Grievant, a Senior Foreign Service Officer, was Office Director in the Bureau of [REDACTED] when he was charged with one count and seven specifications of inappropriate conduct in interactions with his staff and others. The charge and specifications include, for example, repeatedly referring to women as “bitches” and “hormonal,” yelling, banging on his desk and forcefully expressing his political views throughout the office.

A five-day suspension was proposed, to which grievant did not respond, and the Deciding Official sustained the specifications and penalty. Grievant filed a grievance, accepting full responsibility and expressing regret, but asserting, in mitigation, that his one-month suspension from duties (with pay) and the humiliation he suffered before his colleagues already constituted punitive action. He further claimed that, because the charged behavior was completely out of character, he sought mental health counseling and his clinical social worker identified a link between his behavior and PTSD as a result of his earlier service in [REDACTED]. Grievant also argued that a five-day suspension was not comparable to penalties imposed in other similar cases. The Department found no grounds for mitigation and grievant appealed to this Board.

The Board held that grievant knew or should have known the Department’s policy on threatening behavior. As a senior official, grievant did not justify a reduction in penalty based on case comparisons of lower level officers engaged in isolated incidents. Declarations by grievant’s subordinates and colleagues clearly demonstrated that he created a hostile and threatening work environment. Grievant made no claim to being unaware of his behavior and did not defend himself by raising the issue of PTSD or counseling until after the Proposing and Deciding officials issued their letters of discipline. His belated consultation with a clinical social worker to whom he described his behavior appears to be self serving. The social worker did not diagnose grievant with PTSD, but rather stated that based on grievant’s explanations, he was probably suffering from mild PTSD. For seven months after grievant’s return from [REDACTED] he served at the [REDACTED] apparently without incident. He presented no explanation about experiences in [REDACTED] that could have caused PTSD, or testimonials from others at the [REDACTED] or prior to his service in [REDACED] to support his claim that PSTD accounted for his “out of character” behavior afterwards. The Department presented overwhelming evidence that grievant violated its policy against threatening behavior. The penalty imposed by the Department was found to be within the realm of reasonableness.

The grievance appeal was denied.

Domani Spero