Healthy Responses Amid Turmoil: Medical Diplomacy and Citizen Protest

Quid pro quo and impeachment politics have dominated topline news in the United States. For federal employees, including foreign and civil service officers in the U.S. diplomatic community, it is challenging to remain nonpartisan and defend policy that is constantly changing or being undermined. Concern is rising about low morale. How do practitioners navigate such churn? Are there any parallels with stress management amid civil society uprisings around the globe?

U.S. foreign service officers (FSOs), civil servants and embassy military personnel serving around the world usually endure job-related stress on their own. But, if it becomes too burdensome, they can turn to the Mental Health Services team of the Department of State. Recently, I learned a bit more about the work of these doctors, including the public diplomacy component and how it may just help them cope, too. 

On October 26^th, Stephen A. Young, M.D., State’s Mental Health Services Director, was the keynote speaker at the annual meeting of the American Academy of Psychiatry and the Law. Dr. Young painted an inspiring picture of his daily routine, treating patients and managing staff in high-demand, politically unstable environments across the globe. The audience of fellow professionals and citizens heard about the work of the 22 regional medical officers/psychiatrists, who treat patients, raise awareness of mental health concerns in embassy and local communities, and support embassy leaders in managing staff morale and other challenges. Dr. Young addressed questions from those considering whether to apply to serve on the Department’s Mental Health Services team. He was enthusiastic about opportunities to engage with host country nationals on mental health issues at schools, hospitals and public agencies, as well as in intelligence and military settings. Clearly, interacting with local residents and officials is a primary source of Young’s professional fulfillment.

As a civil servant with an academic exchanges portfolio at the United States Information Agency, I visited overseas posts only briefly. Coordinating exchanges of scientists was a part of that work, but only now have I had occasion to more closely consider the embassy mental health team’s public diplomacy function. The efforts of Dr. Young and his team have deepened my appreciation of the multifaceted, challenging roles of the diplomatic corps. It is both challenging and beneficial for them to take the time for public diplomacy while attending to the mental health of embassy personnel and their dependents.

Participatory, inclusive citizen engagement, fulfillment of basic human needs and diplomacy comprise a peaceful approach for generating political will to reform. 

Civil society protesters across the globe also cope with stress and other mental health challenges. Since mid-October in Lebanon, more than one million protesters have been demanding a transformation from the corrupt, sectarian and fiscally strapped government. These conditions have increased poverty, causing landfills and waterways to overflow with garbage and erratic availability of electricity, to mention just two failures in basic public service delivery due to weak governance that have enraged citizens and residents. They succeeded in blocking a usurious tax on calls with WhatsApp and other voice-over internet protocols and have removed the prime minister from office. The protesters have been tempering their street protests, intense dialogues, tire burnings, road blockades and occasional violence with yoga, music and face-painting. Volunteer psychiatrists are also said to be on hand to help reduce anxiety.

These peaceful acts, expressions of freedom and humanity, are among the salutary influences of the Lebanese women participating in, if not leading, the uprising. Their holistic approach to political change is fostering understanding and patience needed to facilitate a transition to an interim government of nonsectarian technocrats who can keep the country’s economy afloat while maintaining a strong Lebanese National Army and independent media outlets.

Empathic U.S. medical officers engaging as public diplomats.

A million Lebanese integrating recreation, art and therapy in what is claimed as the country’s most inclusive uprising in recent history.

State Department psychiatrists and Lebanese artists, performers and yogis mediating tensions and contributing to organizational and community well-being.

All responding to physiological stress triggered or intensified by political turmoil.

Will these sites of psychiatrist-diplomats serving embassy personnel, as well as host communities and citizens protesting tragic injustice while providing mental health care, increase compassion among the U.S. and other global stakeholders to help heal domestic divisions and failed governance abroad? As with the Ebola and Zika epidemics, human resources and persuasive soft power, committed first responders, and collaborative public diplomacy and development programs addressing health crises and other societal ills, will increase the likelihood of prosperity and peace.

Though political tensions in the United States, Lebanon and around the world differ in scale and source, political will is essential to relieving them all, with the addition, in Lebanon’s case, of sufficient international assistance. Participatory, inclusive citizen engagement, fulfillment of basic human needs and diplomacy comprise a peaceful approach for generating political will to reform. Otherwise, the status quo or military conflict may well result. Either would be a most unhealthy and entirely preventable outcome, the antithesis of the will of the Lebanese people.