State Department foreign-service officers serving in "high-stress" areas may not avail themselves of the department's mental health services for fear of adverse effects on their career, according to a review by the Department's Office of Inspector General (OIG).

The review grew out of the OIG inspection of Embassy Baghdad in February/March 2009 but included personnel who had served in Afghanistan, Pakistan, Saudi Arabia, Lebanon, Sudan, Yemen, Chad, and other high-stress posts. It was based in part on a survey of about 1,200 Foreign Service and Civil Service personnel who had served in these posts since September 2007. Approximately 400 officers replied (75 percent of the respondents had served in Iraq, Afghanistan, or Pakistan).

More than 90 percent of the respondents reported an unusual amount of stress, with danger being the most-cited cause, followed by separation from families, workload, leadership, and management support. Yet the review also found that "employees believe there is still a significant stigma attached to seeking mental health assistance" and that few people availed themselves of the High Stress Assignment Outbrief, a screening tool for mental health problems.

The OIG submitted the following recommendations:

The recommendations in the report are posted at <http://oig.state.gov/documents/organization/145424.pdf>.