Supporting Young People’s Mental Health in the Foreign Service
Raising children is complicated enough. Raising them while regularly moving countries, changing schools, leaving friends behind, navigating unfamiliar cultures, and starting over adds an entirely different layer of complexity.
Earlier this year, I joined Susie Brown on the Big Purple Blob Podcast to talk about something I don’t think we consider enough: young people's mental health in the Foreign Service. If you’d rather listen than read, you can do so here.
Our children have opportunities that many people can only dream about. They experience different cultures, travel the world, and learn how to adapt to new environments. They also move. A lot. They leave friends, schools, teachers, and communities behind. They are repeatedly asked to adapt to new homes and new versions of what "normal" looks like. And sometimes, they struggle.
Susie and I covered a lot of ground, from the broader mental health challenges young people are facing to finding care overseas, navigating transitions, and thinking honestly about what our children need from us. I wanted to share some of the biggest themes from our conversation here.
Yes, young people are struggling, but I also have hope.
We are living through a difficult time. We are experiencing a "loneliness epidemic" and surviving one "unprecedented event" after another, with climate change and war thrown into the mix. Given all of that, it’s no wonder there is so much existential anxiety. The world is dealing with some very real problems, and frankly, I would be more concerned if nobody was worried about the kids.
Young people are growing up with an enormous amount of information at their fingertips. They are exposed to violence and distressing events in ways previous generations simply were not.
But they are also exposed to something positive: mental health is becoming more visible.
Young people are hearing conversations about therapy. They're learning about emotional regulation. They're seeing mental health professionals online and beginning to understand that support is available. In some ways, I think our kids are becoming more emotionally aware while the world around them is still struggling to catch up. That can create conflict, but it can also create hope.
The stigma around mental health support is slowly beginning to loosen. When I was younger, many people didn't even know that asking for therapy was an option. And if they did ask, they were often told they were fine or that they didn't need it.
More young people today know that they can ask for help, and it’s important that we give it to them.
Don't let fear prevent you from seeking support
One of the biggest concerns I hear from people in the Foreign Service is whether seeking mental health support will affect their medical or security clearance. That fear is understandable, but it is also one of the reasons I want people to have accurate information rather than making decisions based on fear.
I have worked specifically with Foreign Service clients for years, and I’ve signed dozens of medical clearance forms. Not once has MED contacted me for more information, and none of my clients have experienced issues getting their clearances renewed. Getting appropriate mental health support is almost never something that puts someone's career at risk. Truly, unless you have lost touch with reality, cannot keep secrets, or are actively a risk to others’ safety, you should be fine. Check out the technical guidance about clearances from an RMOP/big MED in this other guide I wrote.
Getting help for depression, anxiety, adjustment difficulties, marital conflict, or family challenges is not the same thing as being unable to serve. Even mental health medevacs rarely impact clearance, including when it is the officer seeking care, as long as the issue is appropriately addressed.
Please do not allow fear about your career to prevent you or your family from getting the care you need.
Prevention matters, especially when you're living overseas
One of the things I feel most strongly about is preventative care. Don't wait for everything to fall apart before you start thinking about support.
Finding the right mental health professional while living overseas can be challenging. Not every therapist based in the United States understands the Foreign Service lifestyle, and many are not willing or able to work with clients internationally.
Fortunately, there are licensed EFMs and other professionals whose practices specifically serve the Foreign Service community. Finding the right person may take some work, and finding the right fit may take even more, but it is worth it. Here’s a link to my referral list if you are looking for someone. Big MED has also released a list of providers who have theoretically been vouched for by someone.
If you are preparing to move overseas, or if you know that your family will be moving regularly, think about establishing relationships with appropriate providers before there is a crisis.
This can be especially important for children because they experience therapy differently from adults. Children learn and process through play, creativity, and interaction. Online therapy can be useful in certain circumstances, but children generally do not experience it in the same way adults do.
If your child already has a relationship with a trusted therapist before moving, that continuity can become incredibly valuable. And if your child doesn’t already have a therapist, you don't have to wait until there is a problem to introduce them to one. Sometimes establishing the relationship itself is the preventative care.
If your child is struggling, take it seriously
Sometimes the resources available at post will be excellent. Sometimes they won't. And sometimes they may simply not be the right resources for your child. Sometimes the schools can work with a child’s different learning needs and sometimes they can’t. A child may discover they are gay/lesbian/bi/queer/trans at a Post where being LGBTQIA+ is illegal or stigmatized. Or maybe you thought there was enough support, but it turns out there isn’t or your child is continuing to struggle.
If your child is struggling and doesn’t improve in 2 months (or if they ever say they don’t want to live/wake up any more) it’s time to get real help. Contact your RMOP immediately. It’s possible enough help can keep everyone at Post, but it’s also possible a MEDevac or curtailment may be necessary. I know these decisions are complicated. Careers, finances, and family logistics are real considerations. I'm not suggesting there is always one simple answer, but I do think we need to be willing to ask ourselves difficult questions about what we are prioritising.
In my experience, MED evacs (even mental health ones) do not impact the medical/security clearances of family members or even officers as long as the issue/crisis is resolved. BUT, even if it did, restrictions exist for a good reason, so that people don’t end up in resourced situations. I also have seen many curtailments and every single one of those families went right back out on another assignment (when they were ready). Again, even if they didn’t, isn’t your family’s health and sanity more important than your job? If you are refusing to leave Post even with a suicidal child in the mix (yes, I’ve seen it), what does that say about what is important to you?
Your children are always watching
Parents are their children's most important teachers. There will be mistakes, hurt feelings, and moments when we get things wrong, but children are constantly learning from us. They learn from the things we say, but they also learn from what we do. If they see you consistently prioritising your career over your health, they learn something from that. If they see you avoiding emotions or refusing to ask for help, they learn from that too.
If they see that a sibling’s mental health concerns are a “problem,” “too much,” or something that “stresses out” the parents, they will take that into consideration when they are struggling. They may decide not to “burden” you with their own difficulties.
And if they see you take care of yourself, invest in relationships, and seek support when you're struggling, they learn from that as well. If a parent has to return with a sibling on a medical or mental health evacuation, the other children learn that sacrifices will be made to keep each family member safe and healthy.
Children are always watching, and one of the most important things we can give them is the experience of being seen.
Make transitions a conversation
Moving is difficult, even when you love the Foreign Service lifestyle. We may love the opportunities, adventure, and experiences that come with this life, but packing up your home and starting again is still stressful. For children, particularly adolescents, those transitions can be significant. I encourage parents to think about transitions long before senior year of high school.
One of the best things families can do is intentionally talk about what each move has been like. You don't necessarily need a therapist to begin those conversations. You can start around the kitchen table.
One exercise I mentioned during the podcast is called Roses, Thorns and Buds. Talk about the roses: What was good? Talk about the thorns: What was difficult? And talk about the buds: What might grow from this experience? What are you taking with you? What are you hoping for next?
These conversations give children language for their experiences. They also give parents an opportunity to hear things they might otherwise miss.
Create your family culture intentionally
What does your family value? Love? Adventure? Financial security? Health? Achievement? Safety? Connection? These things influence our decisions whether we talk about them openly or not. I encourage families to name their values, talk about them, and use them when making decisions. Most importantly, let your children participate in the conversation.
Your children may not ultimately get to decide where your next post will be, but they can still be stakeholders in the family. They can give feedback. They can tell you when they don't think a decision fits with what your family has said is important. That doesn't mean they always get their way. It means they know their voice matters.
Connection is the foundation
At the heart of everything Susie and I discussed was connection.
Your child needs to know that you are listening. They need to know that they can bring difficult things to you. They need to know that their experiences matter and that you will help them. For Foreign Service families, so much of a child's external world can change. Homes change, schools change, countries change, friends change. The relationship they have with their parents can become one of the most important sources of consistency in their lives. That doesn't require perfection. It does require attention, listening, and a willingness to have conversations that may feel awkward.
Sometimes supporting your child also means recognising that you need support yourself. Parents do not have to have all the answers, and seeking help can be one of the most powerful things you model for your children. If you need advice or coaching on parenting, reach out to Susie or one of the many other fantastic parenting coaches out there. If you think it’s your own history or “stuff” that’s getting in your way, consider talking to a therapist yourself so you don’t pass that “stuff” on to your kids.
At the foundation of parenting and family in general is a very simple message:
I see you. You matter to me. We will figure this out together.
Listen to the full conversation
Susie and I covered so much more in the full episode, including navigating mental health care overseas, finding appropriate resources, preparing for transitions, and supporting children and families through difficult situations.
If you are raising children in the Foreign Service, supporting a young person through a difficult transition, or simply trying to be more intentional about your family's wellbeing, I hope you'll listen to the full conversation.
dr. fae
has a Ph.D. in Counseling Psychology. She lives abroad and offers online therapy & clinical supervision. In her individual therapy practice, she specializes in depth work, value alignment, existential questions, decision making, and general coping to increase overall life satisfaction.
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