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EEOC Finds @StateDept Liable Under the Rehabilitation Act in US Embassy Kabul Medical Clearance Denial

Posted: 12:21 am ET

 

This is a case where an FSO previously diagnosed with rheumatoid arthritis was granted a Class 2 medical clearance for an assignment at the US Embassy in Kabul, Afghanistan.  While at post, the FSO developed pericarditis and was hospitalized in Kabul in 2013; she was subsequently medevaced to Texas. The FSO was later told by State/MED that she retained her Class 2 Medical Clearance, but it was not Kabul-approved.  In August 2013, the FSO filed an EEO complaint alleging that the State Department discriminated against her on the basis of disability. The State Department’s decision  notes that in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  It held “that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.”  It also concluded that MED“improperly denied Complainant a Class 2 medical clearance (Kabul-approved).”  The FSO on appeal asserted that she was not provided with full relief, including reasonable attorney’s fees and costs. In response to that appeal, the State Department noted that its final decision was, get this — “erroneously issued.”

Summary of Case via EEOC:

In September 2011, Complainant was assigned to work as an Administrative Officer at the Agency’s Embassy in Kabul, Afghanistan.  Complainant had been diagnosed with ongoing rheumatoid arthritis since 1999. In conjunction with her assignment to Kabul, Complainant was reviewed by the State Department’s Office of Medical Services (State/MED) for a medical clearance.  Complainant was granted a Class 2 (Kabul-approved) medical clearance 2 and she started her duties in Kabul.  While on leave from Kabul in the United States in June 2012, Complainant saw a doctor and was prescribed a new medication for her arthritis called Leflunomide. At the time, Complainant did not report that she was taking this new medication to Agency medical officials.

In April 2013, Complainant developed pericarditis which led to her hospitalization in Kabul.  At that time, her physicians at the hospital advised her to stop taking Leflunomide and she did so.  Upon her release from the hospital, Embassy medical officials made the decision to send Complainant back to the United States for an evaluation by her own physicians. On May 7, 2013, Complainant departed Kabul for El Paso, Texas.

Upon her return to El Paso, Complainant was examined by her own physician (“Complainant’s Physician”) for clearance to return to Kabul.  She provided documentation to the Agency’s Office of Medical Services indicating that her physician had no concerns with her return to Kabul. On May 31, 2013, Complainant was initially informed by the Agency’s physician (“Agency Physician”) that her medical clearance for Kabul would be renewed.

However, on June 3, 2013, the Agency Physician informed her that she retained her Class 2 Medical Clearance, but was not Kabul-approved.  Complainant was told that the reason for the denial of her clearance to return to Kabul was her use of Leflunomide, a drug banned by the Department of Defense for use by personnel assigned to Afghanistan.3  As Complainant had stopped using the medication since her April 2013 hospitalization, she appealed the denial of her medical clearance for Kabul.  Her appeal was denied by the Agency’s Medical Review Panel on the grounds that her cessation of Leflunomide was too recent. The Panel indicated that Complainant needed to show a period of at least 12 month of “clinical stability” before she could return to Kabul.  The Panel defined clinical stability as “the absence of systemic clinical manifestations of pericarditis and rheumatogic problems.”  There was some speculation that, because Leflunomide reduces resistance to infection, Complainant’s pericarditis may have resulted from its use.  Complainant then requested an Administrative Waiver to allow her to return to her position in Kabul.  That waiver was also denied on June 19, 2013.  Since May 2013, Complainant has been working from the Agency’s El Paso, Texas, Intelligence Center.

On August 22, 2013, Complainant filed an EEO complaint alleging that the Agency discriminated against her on the basis of disability (rheumatoid arthritis) when her “Return to Post Authorization” was not reinstated and she was prevented from returning to work at the U.S. Embassy in Kabul.

At the conclusion of the investigation, Complainant requested a hearing before an EEOC Administrative Judge (AJ).  However, on March 10, 2014, the Agency issued a final decision pursuant to 29 C.F.R. § 1614.110(b). In its decision, the Agency conceded the Complainant was an individual with a disability as defined by the Rehabilitation Act.  The Agency further determined that Complainant was an otherwise qualified individual with a disability, as she had been performing in the position in question in Kabul for the preceding two years, and had the requisite knowledge, experience, skill, and education to perform the position.

The Agency’s decision then noted that Complainant was denied a Class 2 Medical Clearance (Kabul-approved) because of the perceived risk of harm she posed to herself due to her recent use of the drug Leflunomide. As a result of this determination, Complainant was prevented from returning to her previously-approved assignment in Kabul.  The Agency’s decision went on to conclude that, in denying her clearance, its medical officers failed to conduct a sufficient individualized assessment of the risk posed by Complainant’s medical condition and its impact on her ability to return safely to Kabul.  Specifically, Agency held that there was no evidence that the medical officers and Medical Review Panel took into account the duration of the risk, the nature and severity of the potential harm, and the likelihood that the harm will occur or the imminence of the potential harm, as required by the law.  The Agency decision noted that medical opinions that supported Complainant ability to safely return to Kabul were improperly given little weight during the medical clearance determination.  Accordingly, the Agency’s final decision concluded that it improperly denied Complainant a Class 2 medical clearance (Kabul-approved).

Based on its finding that Agency medical staff had failed to provide Complainant with an individualized assessment, the Agency ordered the Office of Medical Services to go forward and actually conduct the required individualized assessment of Complainant’s medical condition and her ability to return to the Administrative Officer position at the Agency’s Embassy in Kabul without posing a significant risk of substantial harm to herself or others.

This appeal followed.  On appeal, Complainant did not challenge the findings by the Agency, but asserted that she was not provided with full relief, including reasonable attorney’s fees and costs.

In response to the appeal, the Agency noted that its final decision was erroneously issued in light of Complainant’s previous request for a hearing.  As such, the Agency argued that the final decision should be voided.  In response, Complainant argued that the final decision should not be considered void and the matter should not be remanded for a hearing.

EEOC ANALYSIS AND FINDINGS: Violation of Rehabilitation Act

As an initial matter, we find that Complainant’s statement on appeal constitutes a withdrawal of her earlier hearing request.  As such, we deny the Agency’s request to void its final decision.

In that decision, the Agency found that its medical staff failed to conduct a proper individualized assessment as required by the Rehabilitation Act when Complainant was prevented from returning to work at the U.S. Embassy in Kabul.  Complainant does not challenge the Agency’s findings in its final decision.  As such, we affirm the Agency’s specific findings.  However, the Agency did not expressly state that its actions constituted discrimination in violation of the Rehabilitation Act.

As evidenced by the Agency’s final decision, there is no dispute that Complainant is an individual with a disability who was otherwise qualified for the position in she had previously held in Kabul. In other words, she met the skill, experience, education and other job requirements to perform the duties of the position in Kabul, apart from the Agency’s decision to retract her medical clearance for work in Kabul.

The Agency noted in its findings in its own decision that Complainant’s Physician provided medical documentation that Complainant was no longer taking Leflunomide, the drug of concern, had not had flare-ups of her medical condition, and had embarked on a healthier lifestyle. However, the Agency conceded that Complainant’s supporting medical documentation was improperly “given little if any weight.”  The Agency also admitted in it decision that the denial of the Class 2 Medical Clearance was due to the “perceived risk of harm she posed to herself or others” and not on an actual risk.  Based on the record including the medical evidence provided by Complainant’s Physician, we find that Complainant has shown that she was qualified for the position in question in Kabul and was only prevented from doing so based on the Agency’s perception that she posed a safety risk.  This moves the burden of proof squarely to the Agency to prove that there is a significant risk of substantial harm. Massingill v. Dep’t. of Veterans Affairs, EEOC Appeal No. 01964890 (July 14, 2000).  See also, Branham v. Snow, 392 F.3d 896 (7th Cir. 2005) (“employer’s burden to show that an employee posed a direct threat to workplace safety that could not be eliminated by reasonable accommodation”); Hutton v. Elf Atochem N. America, 273 F.3d 884, 893 (9th Cir. 2001) (direct threat affirmative defense).

Here, as already noted, the Agency’s own decision concluded that Complainant was denied a Class 2 Medical Clearance because of perceived risk of harm she posed to herself or others.  Our regulations permit the Agency to deny job assignments on the basis of disability where such an assignment would pose a direct threat. See 29 C.F.R. § 1630.2(r). A “direct threat” is defined as a “significant risk of substantial harm” that cannot be eliminated or reduced by reasonable accommodation. Interpretive Guidance of Title 1 of the Americans with Disabilities Act, Appendix to 29 C.F.R. Part 1630, § 1630.2(r); Echazabal v. Chevron U.S.A., Inc. 536 U.S. 73 (2002); 29 C.F.R. § 1630.2(r).

The issue in finding direct threat is “not…whether a risk exists, but whether it is significant.” Bragdon v. Abbott, 524 U.S. at 649. A direct threat must be based on an individualized assessment of the individual that takes into account: (1) the duration of the risk, (2) the nature and severity of the potential harm, (3) the likelihood that the potential harm will occur, and (4) the imminence of the potential harm. Interpretive Guidance on Title I of the Americans With Disabilities Act, Appendix to 29 C.F.R. § 1630.2(r). The individual assessment must be based on a reasonable medical judgment that relies on the most current medical knowledge and/or on the best available objective evidence. Id. A determination of significant risk cannot be based merely on an employer’s subjective evaluation, or, except in cases of a most apparent nature, merely on medical reports.

The Agency held in its final decision that it “failed to conduct a sufficiently individualized assessment of the risk posed by Complainant’s medical condition, and its impact on her ability to return safely to Kabul.  There is no evidence that the following factors were taken into account: 1) the duration of the risk; 2) the nature and severity of the potential harm; 3) the likelihood that the potential harm will occur; and 4) the imminence of the potential harm.”  Based on the record and the Agency’s own findings in its decision, we determine that the Agency has not met its burden of establishing that Complainant’s return to Kabul would have posed a direct threat.  Accordingly, the Agency’s defense to denying Complainant the Class 2 Medical Clearance was not established, and the Agency is liable under the Rehabilitation Act.

As a result of this violation of the Rehabilitation Act, Complainant is entitled to make-whole relief, which the Agency did not provide her in its final decision.  First, the Agency should offer Complainant the assignment in Kabul if she chooses to return. See Nathan v. Department of Justice, EEOC Appeal No. 0720070014 (July 19, 2013) (awarding the complainant the position for which he applied following a determination that the agency violated the Rehabilitation Act when it medically disqualified him without an individualized assessment). In addition, Complainant correctly argues that she should be awarded reasonable attorney’s fees and legal costs for processing her EEO complaint, as well as the opportunity to support her claim for compensatory damages. Also, we find that the Agency provide training to relevant management highlighting the Agency’s obligations with respect to the Rehabilitation Act.

The EEOC concludes the case with a modification of the State Department’s  final decision and remanded the matter to the agency with the following order signed by Carlton M. Hadden on October 25, 2016.  The EEOC case file notes that compliance with the Commission’s corrective action is mandatory.

The Agency is ordered to take the following remedial action:

1. Within 60 calendar days from the date this decision is issued, the Agency shall offer Complainant an assignment in Kabul substantially similar to the one she lost. If Complainant rejects the offer of the assignment, the Agency shall use the date of rejection for purposes of back pay calculations as noted below.  If Complainant accepts the assignment, the Agency shall use the date Complainant assumes the assignment for purposes of back pay.

2. The issue of compensatory damages is REMANDED to the Agency. On remand, the Agency shall conduct a supplemental investigation on compensatory damages, including providing the Complainant an opportunity to submit evidence of pecuniary and non-pecuniary damages. For guidance on what evidence is necessary to prove pecuniary and non-pecuniary damages, the parties are directed to EEOC Enforcement Guidance: Compensatory and Punitive Damages Available Under § 102 of the Civil Rights Act of 1991 (July 14, 1992) (available at eeoc.gov.) The Agency shall complete the investigation and issue a final decision appealable to the EEOC determining the appropriate amount of damages within 150 calendar days after this decision is issued.

3. The Agency shall determine if Complainant is entitled to an award of back pay as a result of the denial of her return to her assignment in Kabul.  The Agency shall determine the appropriate amount of back pay, with interest, and other benefits due Complainant, pursuant to 29 C.F.R. § 1614.501, no later than sixty (60) calendar days after the date this decision is issued.  The Complainant shall cooperate in the Agency’s efforts to compute the amount of back pay and benefits due, and shall provide all relevant information requested by the Agency.  We note that the Agency should consider if there would have been a difference in locality pay and benefits to Complainant including but not limited to promotions or other incentives for an assignment in Kabul, Afghanistan.

If there is a dispute regarding the exact amount of back pay and/or benefits, the Agency shall issue a check to the Complainant for the undisputed amount within sixty (60) calendar days of the date the Agency determines the amount it believes to be due.  The Complainant may petition for enforcement or clarification of the amount in dispute.  The petition for clarification or enforcement must be filed with the Compliance Officer, at the address referenced in the statement entitled “Implementation of the Commission’s Decision.”

4. Within sixty (60) days from the date this decision is issued, the Agency is ordered to provide at least eight (8) hours of training to the responsible officials covering their responsibilities under the Rehabilitation Act. The training shall cover the Agency’s obligations regarding the provision of reasonable accommodation, as well as its obligation to conduct an individualized assessment pursuant to the direct threat defense.

5. If Complainant has been represented by an attorney (as defined by 29 C.F.R. § 1614.501(e)(1)(iii)), she is entitled to an award of reasonable attorney’s fees and costs incurred in the processing of the complaint, including this appeal.  29 C.F.R. § 1614.501(e).  The award of attorney’s fees shall be paid by the Agency.  The attorney shall submit a verified statement of fees to the Agency — not to the Equal Employment Opportunity Commission, Office of Federal Operations — within sixty (60) calendar days of this decision is issued.  The Agency shall then process the claim for attorney’s fees in accordance with 29 C.F.R. § 1614.501.

The State Department was also ordered to post this order within 30 days of the date of the decision for a duration of 60 consecutive days.

The Agency is ordered to post at its Washington D.C. facility copies of the attached notice.  Copies of the notice, after being signed by the Agency’s duly authorized representative, shall be posted both in hard copy and electronic format by the Agency within 30 calendar days of the date this decision is issued, and shall remain posted for 60 consecutive days, in conspicuous places, including all places where notices to employees are customarily posted.  The Agency shall take reasonable steps to ensure that said notices are not altered, defaced, or covered by any other material.  The original signed notice is to be submitted to the Compliance Officer at the address cited in the paragraph entitled “Implementation of the Commission’s Decision,” within 10 calendar days of the expiration of the posting period.

 

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@StateDept Task Force For New Sexual Assault FAM Guidance – An Update

Posted: 12:57 am ET

 

We’ve written about nine blogposts on sexual assaults and/or lack of clear sexual assault reporting guidance in the Foreign Service since August this year (see links below).   On November 22, the State Department finally directed a task force to create a new section in the Foreign Affairs Manual for sexual assault (see U/S For Management Directs Task Force to Create New Sexual Assault FAM Guidance).

Mindful that there are 35 days to go before a new administration takes office, we requested an update on the task force convened by “M” to craft the sexual assault guidance in the FAM.

A State Department spox sent us the following:

“The Department is committed to the work the taskforce is doing to create a sexual assault section for the FAM, work that will continue past inauguration day. Currently, the Department has policies and procedures relating to sexual harassment and workplace violence. Employees and their family members can receive assistance and advice from MED, DS and S/OCR on these issues.

 The taskforce is initially focused on establishing FAM definitions and will then build out the program, communications and training. The group has met with Peace Corps and will soon meet with DOD to understand what each has done on this issue. Both of those agencies dedicated several years to building their programs.

The taskforce includes members from MED, HR/ER and HR/DGHR, M staff and M/PRI, DS/DO/OSI and DS front office, S/OCR, and L. The group has also heard from a number of diplomatic community members at post who were eager to contribute ideas and offer feedback throughout the process. The group welcomes this contribution and feedback.”

 

So 35 days to go but we already know that the new guidance will not be ready until after January 20. We are pleased to hear that the taskforce is consulting with both DOD and Peace Corps who each has its separate reporting mechanism.  We are certain that the bureaucracy will continue to grind despite the transition but we do not want this to fall through the cracks.  If you are a member of the Foreign Service who provided feedback to this taskforce, and if you are a member of the FS community who considers an assault on one as an assault on all, you’ve got to keep asking until this gets done.

The Department’s Anti-Harassment Program is managed by the S/OCR, an office that reports directly to the Secretary of State. It conducts inquiries into allegations of sexual and discriminatory harassment in the Department.  It is not the appropriate office to handle sexual assault crimes. To initiate the EEO complaint process, regulations require that employees contact S/OCR or an EEO counselor within 45 calendar days of the alleged discriminatory act in order to preserve the right to file a formal complaint of discrimination with S/OCR. Email: socr_direct@state.gov.

The Department’s policy on workplace violence is governed by 3 FAM 4150, last updated in April 2012.

workplacev

Under Employees’ Responsibilities, the FAM provides the following guidance:

In the event of an immediately threatening or violent situation, all Department of State employees should:

(1) If the incident takes place in the United States, call 911 when there is an injury or an immediate risk of injury in the workplace;

(2) Alert the appropriate law enforcement or security office at his or her location when there is risk to his or her safety or the safety of others, injury, or immediate risk of injury. In the Washington, DC area dial extension 7-9111 or the appropriate telephone number for the law enforcement or security office at his or her location;

(3) Immediately report threatening or violent behavior to supervisors after securing emergency medical assistance as needed;

(4) Move to a safe area away from the individual(s) making threats or exhibiting violent behavior. Do not confront the individual or individual(s); and

(5) Take all threats and acts of violence seriously.

A close reading of this section on workplace violence, makes one think that perhaps the drafters were thinking of an employee “going postal”. This certainly provides no guidance for victims of sexual assault.  “Take all threats and acts of violence seriously,” of course, doesn’t make sense when one contemplates about a colleague who is also a rapist. It’s important to note that approximately 3 out of 4 of sexual assaults are committed by someone known to the victim; that “friend” or “buddy” is not going to threaten you that he’s going to assault or rape you before he commits the crime.

The workplace violence section has more guidance on what to do with an employee exhibiting violent behavior than what to do with the victims. Immediate actions recommended include review of “whether an independent medical exam should be offered” to the violent employee. Short-term and long-term responses include administrative leave; counseling from supervisor or higher management official; appropriate disciplinary action, up to and including separation; curtailment; and/or medical evacuation. All focused on the perpetrator of workplace violence.

Yes, the Department has policies and procedures relating to sexual harassment and workplace violence; and you can see that they are sorely lacking when it comes to addressing sexual assaults.

 

Sexual Assault Related posts:

 

 

 

U/S For Management Directs Task Force to Create New Sexual Assault FAM Guidance

Posted: 5:08 pm PT

 

The message below addressing sexual assault was sent to all State Department employees on November 22, 2016.  Several copies landed in our inbox.  The State Department sent us a note that says they want to make absolutely sure that we have seen this, and gave us an “officially provided” copy.

 

A Message from Under Secretary Pat Kennedy
November 22, 2016

Sexual assault is a serious crime.  It can traumatize victims and have a corrosive effect on the workplace.  The Department is determined to do all it can to prevent sexual assault, and, if it does occur, to support victims and bring the perpetrators to justice.  We are committed to effectively and sensitively responding to reports of sexual assault and to ensuring victims are treated with the care and respect they deserve.

The Department has policies and procedures relating to sexual harassment and workplace violence.  We recognize these policies may not address all issues specific to sexual assault and that sexual assault is more appropriately dealt with in its own FAM section.  At my direction, an inter-bureau taskforce is in the process of creating this new FAM section.  Among the issues the taskforce will take up are reporting processes, confidentiality, sexual assault response training, and potential conflict of interest issues.

As we work to complete a stand-alone sexual assault FAM section, it’s important to note that there are and have been policies and procedures in place to help employees and their family members who are sexually assaulted get the medical care they need and to bring perpetrators to justice.

Medical services are available at post, and personnel from the Bureau of Medical Services (MED) can also provide advice from Washington, DC.  Post’s Health Unit healthcare providers are the first responders for medical evaluation and treatment overseas and will abide by strict patient/provider confidentiality.  An employee or member of the Department community who has been sexually assaulted may also report the incident to MED’s Clinical Director (currently Dr. Behzad Shahbazian) at 202-663-2976 during business hours.  After hours and on weekends/holidays, victims may contact the MED Duty Officer at 202-262-9013 or via the Operations Center at 202-647-1512.

For reported sexual assaults that are committed by or against members of the Department community or occur within a COM facility or residence, RSOs serve as the law enforcement first responders.  Every reported sexual assault is handled as a criminal matter that may be prosecuted in the United States under federal extraterritorial laws.  For more guidance on the handling of such cases, see 16 STATE 56478.

If a victim overseas wants to report a sexual assault to law enforcement authorities, but prefers not to report it at post, he or she can contact the Office of Special Investigations (DS/DO/OSI), via telephone at 571-345-3146 or via email at DS-OSIDutyAgent@state.gov<mailto:DS-OSIDutyAgent@state.gov>.  The DS/DO/OSI duty agents are available 24 hours a day, seven days a week and can investigate an allegation independent of post management.  OSI agents have been trained to handle such cases and will work with the victim and can also provide information about the Victims’ Resource Advocacy Program available at vrap@state.gov<mailto:vrap@state.gov>.

Victims may also report sexual harassment directly to the Office of Civil Rights<http://socr.state.sbu/OCR/Default.aspx?ContentId=6666> (S/OCR) at http://snip.state.gov/f5h or via phone at 202-647-9295 and ask to speak with an Attorney-Adviser.  Pursuant to 3 FAM 1525, S/OCR oversees the Department’s compliance with anti-harassment laws and policies and conducts harassment inquiries.

The working group developing the new FAM section is consulting with other agencies about best practices in such areas as communication, training, and post-attack medical and mental health support and will integrate appropriate elements of these programs to ensure that the Department’s policies on sexual assault are victim centered and effective.

The Department’s position is clear: there is zero tolerance for any form of violence, including sexual assault, within our Department community. We understand these are sensitive and difficult situations, but we strongly encourage victims to come forward so the Department can take the appropriate steps to ensure the victim’s safety and bring the perpetrator to justice.

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Sexual Assault Related posts:

First Person: I did everything right. I filed a report the next business day … #FSassault

Posted: 12:55 am  ET

 

I did everything right. I filed a report the next business day with RSO. The accused was removed from post shortly thereafter. 

My victimization didn’t really begin until I sought assistance 6 months later from MED when I arrived at my next post. MED sent me on a MEDEVAC to DC from my post to a facility that didn’t treat trauma and required I take a $60 taxi each way daily from Oakwood Falls Church where most of my colleagues from my unaccompanied post were staying due to long term training. 

MED refused to discharge me for weeks despite requests for relocation and a new treatment plan. I finally found my own providers online when the State Department didn’t provide a list of referrals prior to my discharge. 

Then, the MEDEVAC team advised me of their recommendation for a Class 5 medical clearance (domestic only) without ever speaking to my psychiatrist and without providing a reason. 

I filed appeals of my medical clearance without success all the way to the Director General. 

MED refused to assist with my PTSD claim for worker’s compensation despite the reported incident occurring at the U.S. Embassy in a warzone where we can’t leave the compound. 

My out of pocket medical expenses (therapist/ psychiatrist/medicine) would not be covered once my MEDEVAC ended. My housing was paid for at my post and my children were enrolled in the international school. We didn’t receive our HHE for 6 months after having someone else pack out our goods. 

Without access to the State Department system, it was nearly impossible to secure an onward assignment. I didn’t have contact information for my 360s and no access to my employee profile. I went house shopping in DC with a realtor and was advised there was no suitable housing for a family of my size at an amount I could afford. Washington, DC has bedroom occupancy regulations which made it difficult to accommodate. 

The State Department sent me to the brink of financial ruin. I took a huge pay cut, lost my paid housing, my kids lost their prestigious school, and my spouse lost job opportunities available at post all because I was a victim and sought assistance from MED.

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The account above is an unsolicited email from a Foreign Service employee who did not want us to use her name but wanted to share her story. She said she previously served in Israel, Iraq, Colombia, Venezuela, Georgia, and Afghanistan, all with a Class 1 medical clearance, meaning “worldwide available” for Foreign Service assignments. She told us she was also last promoted in 2015. 

According to her, Diplomatic Security asked if she wanted to go to the medical unit but she declined. Regarding the perpetrator, she said, “I have no verification that he is overseas with his family, but he is listed on the GAL [global address list] and so is his wife.”  She added, “He had also destroyed government property ✂️ and was highly intoxicated in the middle of the night when he was subdued by security. It apparently had no effect on his security clearance or medical clearance as he had the ability to serve overseas at his next post with his family.” 

She said that she chose to stay at her post in the warzone until the end of her tour so she would not lose her onward assignment. She arrived at her onward post in Europe and was  subsequently medically evacuated (MEDEVAC) after she contacted MED.

She told this blog, “I was never hospitalized. I was never a threat to myself or others. It is hard to believe that this is my life. The biggest issue I have is that I was never provided a reason as to why my clearance was denied other than a generic “best care is available in the U.S.” 

The post she was evacuated from is a European post with high level of medical care including English speaking therapists and psychiatrists. Post has a resident regional medical officer (RMO) and a resident regional medical officer/psychiatrist (RMO/P).

The FS employee told us she is on leave without pay and believed that her OWCP claim (Office of Workers’ Compensation Programs) for PTSD was one of the factors in the downgrading of her medical clearance.

She shared with us an OCWP letter in which “Under Accepted Event(s) That Are Factors of Employment” is this:

“– That while assigned to the US embassy in ✂️ from 2014-2015. you were sexually harassed and assaulted by a colleague who was under the influence of alcohol after checking on him at his room.” 

We hope to have a follow-up post on the MED – OCA – OCWP mess.

 

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Foreign Service Members Offer Candid Views of @StateDept Mental Health Services (via FSJ)

Posted: 3:04 am EDT

 

The January issue of the Foreign Service Journal is out. The issue is focused on mental health care for the Foreign Service.  Dr. Samuel Thielman,  a recently retired regional medical officer/psychiatrist for the Department of State writes about how MED’s mental health program has grown and evolved over the years to address the unusual needs of FS employees and their families serving overseas in The Evolution of State’s Mental Health Services. Chantay White, the chief of the Employee Assistance Program with the State Department Employee Consultation Services and Paulette Baldwin, a Licensed Clinical Social Worker write about Mental Health and ECS—What You Should Know. Dr. Stephen A. Young, the director of Mental Health Services for the State department since September 2015, writes about The Face of Mental Health Services Overseas.

One part of the bureaucracy that is glaringly missing here is, of course, Diplomatic Security.  A majority of these comments express concern about DS and security clearance. The most instructive part is probably the section on MED/MHS Checkup: Foreign Service Members Weigh In that offers very candid views from people in the field.

The FSJ writes that the compilation includes 45 responses from FS members in Washington, D.C., and overseas, some entry-level and a few retired, from the foreign affairs agencies, primarily State and USAID. The gender split was about even. “Due to the sensitive nature of the topic, and known concerns about privacy, we took the unprecedented step of offering to print comments without attribution,” the editors write.

Some excerpts below, each paragraph selected from a separate FS member response.  The last one It’s No Joke is in full; the contributor appears to be part of US Mission Libya following the 2012 attacks. The full comments are available to read here.

“Dealing with the bureaucracy after having sought mental health treatment is itself enough to cause PTSD.”

“Senior officers, in particular, need to set the example by ensuring that their employees understand that a mental health issue, like any ailment, is best addressed early. Until they do, we will all still sign notes like this as… Anonymous.”

“During a rough patch in a relationship, my partner and I sought couples counseling. When my security clearance was up for renewal, I was grilled by the investigator regarding this counseling. I had to defend myself for wanting counseling, and the harsh and critical tone she took for me wanting to do what I needed for my relationship was upsetting. I got the clearance, but it was a stressful process.”

“After service in Iraq, there is no doubt in my mind that I suffered from PTSD. Now (several years later), I see my symptoms as both classic and obvious. At the time I was suffering, however, I hid my symptoms out of fear that knowledge that I suffered from PTSD would harm my career. That concern was heightened by the intense questioning I endured by a Diplomatic Security agent conducting a security clearance update when I was serving in Iraq. When it became known that I had sought mental health care, I was hassled and forced to repeat the content of a private discussion with a mental health professional to a DS agent with zero mental health training. I found the entire episode both distasteful and inappropriate.”

“My mistake—I was told by MED that I’d be given a Class 2 because of seeking continued therapy. I thought that showing that I’d made arrangements for my mental health would ensure a Class 1, but instead that’s what gave me the Class 2. Geez, why be honest with MED—it could have cost me my assignment.”

“I met with a therapist who told me he never wrote anything down because all of his FS clients were terrified of getting caught seeking assistance for their stress-related problems. It’s sad. Concerns about security clearances have a big effect on whether or not I seek mental health care.”

“I feel that if I had declared myself an alcoholic I would have gotten more attention from MED than when I was traumatized and sat in my office working, feeling like an isolated zombie.”

“Once I joined the Foreign Service, I could easily understand why there is an impression that the Service has an alcohol abuse problem—it’s self-medication that is easy to hide from a clearance process. I find that distressing and disturbing and extremely unsupportive.”

“Despite former Secretary of State Hillary Clinton’s message a few years ago telling employees that their clearance will not be affected by seeking mental health treatment, that is not what happens in practice. DS investigators zero in on this, considering it a red flag, as if mental health were any different than physical health.”

“No matter what management says about the importance of mental health, if there are no real changes, then the Foreign Service will continue to be an ineffective and unsupportive mental health environment.”

“You also do not know who the regional psychiatrist’s client really is: you or the State Department? Does a psychiatrist see you as a patient who needs help or just a problem for the Foreign Service best remedied by removing you from post?”

“The mandatory out brief improved between the time I returned from Afghanistan in 2007 and 2012, when I returned from Iraq. However, both times I was told that the symptoms in the PTSD questionnaire are normal for six months and not to worry unless they persist. (And I was offended when taken aside after the briefing and asked how pervasive I thought infidelity was in Baghdad.)”

“During the onward assignments process, MED refused to consider my needs as identified by my therapist, instead assigning me to a post where there was no one in-country who could serve as an appropriate psychiatrist. There, I raised an issue of concern with the health unit nurse, who in turn shared it with the management officer, who then told my supervisor that I was “nuts.” This was not only a violation of my privacy; it reflected total ignorance on the management officer’s part of what PTSD and its symptoms are.”

“I would rate the mental health support at 3 out of 10, with 10 being the best. Working in a high-stress post that was not a “high-threat” post, my colleagues and I were given limited support in a time of crisis.”

“I am grateful for the mental health assistance available to me. If it weren’t for grief counseling, I would have qualms about seeing the RMO/P, because I’d need to disclose this in the five-yearly security update. And while that disclosure might not affect my security clearance, I still think there’s a stigma attached to the fact that I needed mental health assistance.”

“As a veteran of two priority staffing post (PSP) tours—one in Iraq (2007–2008) and the other in Afghanistan (2013–2014)—my experience with transition support has been abysmal. Just getting authorization to attend out briefings and to access mental health services was impossible.”

“I am not concerned about medical and security clearances as they relate to mental health care. Most people have seen a therapist at one time or another, and I don’t think it would affect a security clearance. But corridor reputation is a concern. Even when people need to talk to a mental health professional, they’re more worried about their corridor reputation and often won’t seek help due to the stigma of being “weak.”

“In my final post, when I had finally had enough bullying from my fourth bully boss (three of whom were DCMs and one a GS-15), I worked with the regional psychiatrist who prescribed two anti-anxiety/anti-depressants and a sleeping pill to help me cope. I sought assistance from the ombudsman, but received no help, so I resigned.”

“I had discussed my mental health with the regional psychiatrist during his visits, but he just gave me Xanax and told me panic attacks were normal. He asked me about work-related stress, but reported the results of our meetings with post leadership, contributing to my stress.”

“When State does not actively intervene in cases of abusive behavior, managers are given the impression that they have carte blanche to do whatever they want. Even if victims get mental health care afterwards, the damage has been done. From what I hear, the problem is getting worse and more widespread. It doesn’t have to be this way. Instead of sending out feel-good cables on workplace atmosphere and bullying, put policies in place that have real teeth. A zero-tolerance policy for workplace bullies, administered neutrally and enforced by D.C., would lead to an instant decrease in unacceptable behaviors and the resulting damage they cause.”

It’s No Joke

The first MED-directed mental health intervention that was provided in Tripoli after the Benghazi attacks on Sept. 11, 2012, was a video conference in April 2013, conveniently less than a week before the Director General arrived for a visit to Libya. Prior to that, the only service provided was a discussion with the nurse about “fostering resiliency” several months after the attack…hardly a useful assist.

The half-day course for those returning from hardship posts is a joke. I took it after my first (!) unaccompanied tour (UT), and both the instructor and some of the other students made fun of me for enrolling, since at the time my tour was seen as one of the “cupcake UTs,” without an active war going on outside the embassy walls. I refused to take the course after my second UT. No one from HR or my bureau asked if I’d taken it or even how I was doing after the second UT.

An RMO/P made fun of some of my coworkers in a high-stress, high-threat post that happened to be a popular destination for American tourists. He told them that they had no idea what serving in an actually difficult post was like, comparing it to the regional city where he was based. Never mind the fact that almost every person at that highly desirable but still challenging post got there via a tour in Iraq or Afghanistan.

I have neither respect for nor faith in MED’s mental health efforts. As long as MED is staffed with people who see mental health as an inconvenience, supported by State leadership (from the very top down) who barely pay lip service to mental health and a work-life balance, there’s no hope for anyone who suffers in the aftermath of an emotionally catastrophic tour abroad. At least there is solidarity among those who survived terrible times abroad.

Read in full the candid views from the filed via the Foreign Service Journal.

 

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Killer Air in China: Pollution Kills an Average of 4,000/day x 365 = 1,460,000

Posted: 4:18 am EDT

 

Berkeley Earth released a study showing that air pollution kills an average of 4,000 people every day in China, 17% of all China’s deaths. For 38% of the population, the average air they breathe is “unhealthy” by U.S. standards. According to the study, the most harmful pollution is PM2.5, particulate matter 2.5 microns and smaller.  This penetrates deeply into lungs and triggers heart attacks, stroke, lung cancer and asthma.

“Beijing is only a moderate source PM 2.5 ; it receives much of its pollution from distant industrial areas, particularly Shijiazhuang, 200 miles to the southwest,” says Robert Rohde, coauthor of the paper.

“Air pollution is the greatest environmental disaster in the world today,” says Richard Muller, Scientific Director of Berkeley Earth, coauthor of the paper. “When I was last in Beijing, pollution was at the hazardous level; every hour of exposure reduced my life expectancy by 20 minutes. It’s as if every man, women, and child smoked 1.5 cigarettes each hour,” he said.

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Perhaps it’s time to revisit this Burn Bag submission?

“Why are we still downplaying the enormous health impact to officers and their families serving in China? Why are State MED officers saying ‘off the record’ that it is irresponsible to send anyone with children to China and yet no one will speak up via official channels?”

Embassy Beijing and the five consulates general in China house one of the largest U.S. diplomatic presences in the world (no presence in Kunming and Nanjing).  Service in China includes a hardship differential (when conditions of the environment differ substantially from environmental conditions in the continental United States) for poor air quality among other things, ranging between 10-25% of basic compensation.

According to the 2010 OIG report, more than 30 U.S. Government agencies maintain offices and personnel in China; the total staff exceeds 2,000 employees. Consulates General Guangzhou and Shanghai are as large as many mid-sized embassies, each with more than 250 employees. Consulates General Chengdu and Shenyang are smaller but serve the important western and northern parts of the country respectively. Consulate General Wuhan, opened in 2008, is staffed by one American. Mission China is a fully accompanied post; we have no numbers on how many family members, including children are present at these posts.

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Related posts:

High Risk Pregnancy Overseas: State/MED’s SOP Took Precedence Over the FAM? No Shit, Sherlock!

— Domani Spero

 

The Foreign Affairs Manual says that it is the general policy of the Department of State “to  provide all medical program participants with the best medical care possible at post. In a situation where local medical facilities are inadequate to provide required services, travel to locations where such services can be obtained may be authorized.” (see 16 FAM 311).  Elsewhere on the same regs, the FAM says  that “a pregnant patient who is abroad under U.S. Government authorization is strongly encouraged to have her delivery in the United States. The patient may depart from post approximately 45 days prior to the expected date of delivery and is expected to return to post within 45 days after delivery, subject to medical clearance or approval.” (see 16 FAM 315.2 Travel for Obstetrical Care).

A grievance case involving a high risk pregnancy of a Foreign Service spouse was recently decided by the Foreign Service Grievance Board (FSGB).  This is one case where you kind of want to bang your head on the wall. The FAM gets the last word in the Foreign Service, but in this case (and we don’t know how many more), the State Department  ditched the relevant citation on the Foreign Affairs Manual in favor of a longstanding practice on its Standard Operating Procedure (SOP). Specifically, the Department’s Office of Medical Services (MED)  SOP. So basically, MED relied on its interpretation of the regulations contained on its SOP instead of the clear language included in the FAM.

No shit, Sherlock!

Excerpt below from FSGB Case No. 2014-007.

SUMMARY: During grievant’s tour in his spouse became pregnant. She had had five previous pregnancies, none of which resulted in a viable birth. The post medical team (FSMP) and the State Department Office of Medical Services (MED) both agreed that this was a very high-risk pregnancy and that the preferred option was that the spouse return to the U.S. as soon as possible for a special procedure and stay under the care of a single obstetrician specializing in high-risk care for the remainder of her pregnancy. Although MED authorized a 14-day medical evacuation for the procedure, it advised grievant that, under its longstanding practice, it could not authorize further medical evacuation per diem under 16 FAM 317.1(c) prior to the 24th week of gestation. MED instead directed grievant to seek the much lower Separate Maintenance Allowance (SMA).

Grievant claimed that the regulation itself stated only that per diem for complicated obstetrical care could be provided for up to 180 days, and therefore permitted his spouse to receive such per diem beginning in approximately the 10th week of pregnancy, when she returned to the U.S. for treatment. He also claimed that he was entitled to have his airline ticket paid for by the agency as a non-medical attendant when he accompanied his wife back to the U.S., since her condition precluded her from carrying her own bags.

The Board concluded that the agency’s regulation was not ambiguous, and that any clarification meant to be provided by the agency’s longstanding practice was both plainly erroneous and inconsistent with the agency’s own regulations, and arbitrary and capricious. We, therefore, did not accord any deference to the agency’s interpretation of its regulations by virtue of this practice, and relied instead on the language of the regulation itself.

Here is the FAM section on Complicated obstetrical care:

16 FAM 317.1(c):  If the Medical Director or designee or the FSMP [Foreign Service Medical Provider] at post determines that there are medical complications necessitating early departure from post or delayed return to post, per diem at the rates described in 16 FAM 316.1, may be extended, as necessary, from 90 days for up to a total of 180 days.  

More from the Record of Proceeding:

When FSMP contacted MED in Washington, DC, they were given the response that MED does not medevac for obstetrical care until after the 24th week of gestation. The 24th week of gestation is when the medical world deems a fetus viable outside of the womb. Grievant claims both FSMP and the post’s Human Resources (HR) reviewed the FAM and other MED documents to determine how MED handles high risk pregnancies at a hardship post and could not find any reference that limited a high risk pregnancy to the 24 weeks claimed by MED.

Grievant claims he contacted the head of MED and asked for an explanation as to why MED was not following 16 FAM 317.1(c), which allowed for medevac for high risk pregnancies. M/MED/FP responded with the following in an e-mail dated August 27, 2013:

This issue of how early a woman can be medevac’d for delivery comes up regularly. So does the situation of cervical cerclage – up to 80,000 procedures are done in the U.S. per year. While not in the FAM, MED has a long standing internal SOP that the earliest we will medevac a mother for obstetrical delivery is at 24 weeks gestation. 

Grievant claims that his spouse’s pregnancy was high-risk enough to qualify for medical evacuation prior to the 24 weeks’ gestation. Grievant also argues that every medical professional in and in Washington, including MED staff, agreed. Grievant argues that MED’s justification for how they choose which pregnancy to deem OB-medevac-worthy for high risk is ambiguous. Grievant takes issue with MED imposing internal rules that are not published in the FAM. Grievant claims that the alternatives offered by MED were not in accordance with 16 FAM 317.1(c).

What was the official State Department position?

The agency asserts that grievant’s wife was medevac’d to Washington, DC, to receive obstetrical care. MED did not believe there were medical complications necessitating early departure from post or delayed return to post. Thus, the agency claims, 16 FAM 317.1(c) does not apply to her situation.

Did it not matter that the FSO’s wife “had had five previous pregnancies, none of which resulted in a viable birth?”  The Department also made the following argument:

The agency further argues that, in any event, although not compelled by law, the Department’s Office of Medical Services (MED) has a longstanding internal Standard Operating Procedure (SOP) that the earliest MED will authorize a medevac of a pregnant woman for delivery, even in the case of complicated pregnancies, is 24 weeks’ gestational age. This SOP, MED asserts, is based on the medical community’s widely accepted recognition that the gestational age for fetal viability is 24 weeks. 

Ugh!

The ROP states that MED personnel communicating with both grievant and the post FSMP repeatedly relied on the SOP that no medevac would be provided prior to the 24th week of pregnancy as the basis for their guidance. They did not cite grievant’s wife’s particular medical circumstances as the rationale for denying an earlier continuous medevac.

You might remember that the last time MED failed to use common sense, the State Department ended up as a target of a class action lawsuit.

Here is the Board’s view:

It is the Board’s view that 16 FAM 317.1(c) is not ambiguous. It provides for the Medical Director or designee or the FSMP at post to determine if there is a complication requiring early departure or a delayed return, and authorizes up to 180 days’ per diem when such a determination is made. The entire context of the provision is to define what benefits are provided when based upon medical needs, and the provision appears to reflect the individualized medical decision making required in the case of complicated obstetrical care. Although the preceding provision, 16 FAM 317.1(b),8 places a set 45-day limit for per diem both before and after an uncomplicated pregnancy and birth, that limit is also, by all appearances, based on medical analysis of normal pregnancies and deliveries, which lend themselves to such generalizations. Airlines do not allow pregnant women to travel less than 45 days before birth, because of the risks involved. 16 FAM 317.1(b) recognizes and incorporates that medical evaluation under the circumstances of a normal pregnancy. Although not stated explicitly in the record, we assume that the 45 days of per diem permitted after delivery also reflects a medical assessment of recovery times under normal circumstances, which, because they are normal, can be generalized.
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In the Board’s view, the longstanding practice is also arbitrary and capricious and an abuse of discretion. As stated by MED, the rationale for the 24-week practice is that a fetus is generally not considered viable before the 24th week of pregnancy. It is not based on, and does not take into consideration, whether the mother’s need for medical care can be provided safely at post prior to the 24th week, or whether the medical care needed by any fetus of less than 24 weeks to come to full term as a healthy baby can safely be provided at post. It is difficult to see any link at all between the rationale offered by State/MED with the recognition of medical needs established in the regulations.

It is the Board’s conclusion that 16 FAM 317.1(c) is not ambiguous, and that any clarification meant to be provided by the Department’s longstanding practice of requiring the 24-week waiting period in cases of complicated pregnancies is both plainly erroneous and inconsistent with the Department’s own regulations, and arbitrary and capricious. We, therefore, do not accord any deference to the Department’s interpretation of its regulations by virtue of this practice, and rely instead on the regulation itself.

To the extent that the agency is arguing that the SOP is freestanding and applies by its own terms, apart from 16 FAM 317.1(c), again, we conclude that the agency is in error. By the same analysis as outlined above, the SOP conflicts with the provision of the published regulations of the agency. An SOP may not take precedence over a regulation with which it is in conflict.

The Board’s conclusion, based on the record, is that this was a high-risk pregnancy, with risks to both the mother and the fetus, and that the necessary obstetrical care was in the U.S. Under these circumstances, medical evacuation per diem should have been authorized beginning upon the return of grievant’s wife to the U.S., and continuing for 180 days.

Doesn’t it makes you wonder how many high risk pregnant women on USG orders overseas were affected by this longstanding internal Standard Operating Procedure (SOP)?  If planning on getting pregnant overseas, read the redacted ROP below:

 

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EEOC Affirms Class Action Certification For Disabled Applicants to the U.S. Foreign Service

— Domani Spero

 

In October 2010, we blogged that the Equal Employment Opportunity Commission (EEOC) has certified a class action brought on behalf of all disabled Foreign Service applicants against the U.S. State Department.  (see  EEOC certifies class action against State Dept on behalf of disabled Foreign Service applicants).

Related items:

Meyer, et al. v. Clinton (Department of State), EEOC Case No. 570-2008-00018X (September 30, 2010) (certifying class action based upon disability discrimination in State Department’s Foreign Service Officer hiring)

This past June, the EEOC affirmed the class certification for applicants to the Foreign Service denied or delayed in hiring because of their disabilities, based upon the “worldwide availability” policy.  (see Meyer v. Kerry (Dept. of State), EEOC Appeal No. 0720110007 (June 6, 2014)).

The State Department Disability Class Action now has its own website here.  Bryan Schwartz in San Francisco and Passman & Kaplan in Washington represented the class. The State Department’s Office of Legal Advisor and Office of Civil Rights represented the department.

Below is an excerpt from the class action website:

The EEOC decision found that the Class Agent in the matter, Doering Meyer, has had multiple sclerosis (MS) in remission for decades, without need for treatment, but was initially rejected outright for State Department employment anywhere in the world because the Department’s Office of Medical Services perceived that her MS might cause her problems in “a tropical environment.” This was notwithstanding a Board Certified Neurologist’s report approving her to work overseas without limitation.
[…]
The Department challenged the judge’s initial certification decision because, among other reasons, Meyer eventually received a rare “waiver” of the worldwide availability requirement, with her attorney’s assistance, and obtained a Foreign Service post. She is now a tenured Foreign Service Officer, most recently in Croatia, and being posted to Lithuania. Meyer’s attorney argued to the EEOC that she was still delayed in her career growth by the initial denial in 2006, and missed several posting opportunities over the course of an extended period, losing substantial income and seniority. The EEOC agreed with Meyer – modifying the class definition slightly to include not only those denied Foreign Service Posts, but those “whose employment was delayed pending application for and receipt of a waiver, because the State Department deemed them not ‘worldwide available’ due to their disability.”

Schwartz indicated that the case may ultimately have major implications not only for Foreign Service applicants, and not only in the State Department, but for all employees of the federal government abroad who have disabilities, records of disabilities, and perceived disabilities, and who must receive medical clearance through the Department’s Office of Medical Services. He noted that he has already filed other alleged class cases, also pending at the EEOC – one on behalf of applicants for limited term appointments (who need “post-specific” clearance, but are also denied individualized consideration), and another on behalf of employees associated with people with disabilities, who are denied the opportunity to be hired because of their family members who might need reasonable accommodations (or be perceived as disabled).

The Commission had also received an “Amicus Letter” from a consortium of more than 100 disability-related organizations urging the Commission to certify the class.

Read the full ruling at (pdf) Meyer v. Kerry (Dept. of State), EEOC Appeal No. 0720110007 from June 6, 2014 where the State Department contends that since this complaint was filed, the Office of Medical Services has changed many of its procedures in assessing “worldwide availability.”It also suggested that “many of those individuals who were found not worldwide available in 2006 maybe currently worldwide available under new definitions and procedures.”

The Commission, however, says that it “is not finding that changes made to the Medical Clearance process subsequent to the filing of the instant complaint have remedied any alleged discriminatory policy.”  

The order states (pdf): “It is the decision of the Commission to certify the class comprised of “all qualified applicants to the Foreign Service beginning on October 7, 2006, who were denied employment, or whose employment was delayed pending application for and receipt of a waiver, because the State Department deemed them not “world-wide available” due to their disability.”

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State Dept Regional Psychiatrist William Callahan, 53, Dies in Cape Town

— Domani Spero

We previously posted about the December 12 death of a U.S. Embassy Accra employee while visiting Cape Town, South Africa. (See US Embassy Accra Employee Falls to Death on South Africa’s Table Mountain). We subsequently learned the identity of the employee but decided not to publish his name as we could not confirm independently that the family back in California has been notified.  His hometown newspaper had since identified him in a news article as William E. Callahan Jr., 53, a prominent psychiatrist in Aliso Viejo, California.  He was the State Department’s Regional Psychiatrist covering West Africa. Below is an excerpt from OCRegister:

Callahan had left his private psychiatry practice in California last year to join the U.S. State Department as a Regional Medical Officer and Psychiatrist based out of the U.S. Embassy in Accra, Ghana, said Kenneth Dekleva, Director of Mental Health Services at the U.S. Department of State in Washington, D.C.

Dekleva said the news came as a shock to him and his department last Friday when he found out Callahan’s body had been recovered by South African authorities near the Table Mountain Range.

“His death has touched many people: my phone hasn’t stopped ringing since Friday…we lost one of our own,” Dekleva said. “It’s a huge loss for our organization. He represented the best in psychiatry in my opinion. We’re very proud to have known him and to have had him as part of our team.”

Dekleva said that the investigation surrounding the circumstances of Callahan’s death is ongoing in South Africa.

Memorial services are planned in Accra on Wednesday. Services in Greenfield, Mass. and Laguna Beach will occur in early 2014, the State Department said.

 

Dr. Callahan joined the State Department in July 2012.  Our source told us that “he was an avid outdoorsman and in great shape.  He was well-liked in Accra and at the other embassies he covered in West Africa.”

According to his online bio, he was a Special Forces flight surgeon turned psychiatrist.  “With the constant deployments in my military unit on clandestine missions, I observed how stress in a family member can jump from person to person and lead to physical illness as well.  After 5 years of active duty and 9 of total service, I left the military to get the training to become a board certified psychiatrist.”

He was previously the president of the Orange County Psychiatric Society.  For 15 years prior to joining the State Department, he  provided a two hour a week, free, open-to-the-public group for families dealing with a mental illness called Interactive Solutions.

Dr. Callahan’s service in the military included a general surgery internship at David Grant Medical Center at Travis AFB, CA followed by assignment to the 8th Special Operations Squadron as a flight surgeon, at Hurlburt Field, FL.  He served in both the First Gulf War and Panama Wars,  and received two Meritorious Service Medals. He was the 1988 Flight Surgeon of the Year within the First Special Operations Wing.

He graduated from Deerfield Academy (1978), Tufts University (1982), Tufts Medical School (1986) and did General Surgery Internship at Travis AFB, CA (1987), and his Residency in Psychiatry at UC Irvine (1994).

R.I.P.

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