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Youth Mental Health in the Foreign Service  


Childhood and adolescence are critical periods for development and mental health is an important component in overall health and well-being. While most youth cope with life's challenges, effective and timely treatment can help reduce the impact of emotional struggles on an adolescent's life.

It is normal for children and youth to experience various types of emotional distress as they develop and mature. But if problems persist, young people will benefit from professional assistance. Children and adolescents may suffer from depression and anxiety, eating disorders, self-harming behaviors, suicidal feelings and thoughts, impulsive or risk-taking behaviors, delinquency, and substance abuse. More severe mental health conditions are expressed in mental confusion, dangerous behavior, explosiveness, and extreme swings in mood.  Youth exposed to traumatic events such as violence, abuse, disasters, or accidents may be especially prone to anxiety, depression, and problems with sleep. Peer relationships and school functioning can be adversely impacted by such exposure. Children with special educational needs are at higher risk than their peers for mental health conditions and may be prone to depression and anxiety. LGBTQ+ youth may also experience elevated risk and associated negative health outcomes.  Mental health support for all children and youth should be as focused and routine as for any other health condition.

Children and adolescents benefit from the presence of adults in their lives who can be engaged should the child or teen feel the need. Trusted adults can include teachers, coaches, guidance counselors, school psychologists or social workers, clergy, and in the Foreign Service world, the Community Liaison Officer (CLO), the FS Nurse Practitioner, the Regional Medical Officer or the Regional Medical Officer-Psychiatrist. There can sometimes be a need for one or more meetings with a mental health professional, such as a psychologist, professional counselor, clinical social worker, or psychiatrist.

While particular aspects of Foreign Service life must be acknowledged as potential stressors, there are many very positive and protective factors. Third Culture Kids (TCK's) or "globally mobile" youth are those who spend significant parts of their young lives outside of their parent's culture. Whether they spend only a little time or nearly their whole lives as expatriates, TCK's accumulate experiences and develop perspectives that are unique. The experiences that TCK's have abroad can lead to a sense of confidence in managing complicated situations, like navigating an international airport. TCK's learn to interact with peers from many cultures and thereby develop a strong sense of cultural competence. TCK's learn to adapt to changing circumstances, like laws and cultural norms that vary from country to country. TCK's often develop patience and flexibility due to the unpredictability of life in foreign countries.  The lives of TCK's are enriched by the many places visited and sites seen. Their tastes in music, food, and art are broadened by exposure to art, food and music of different cultures.

TCK's may have more in common with youths from other countries who are also TCK's, than they do with their U.S. - based peers. It may be for this reason that many children and teens of the Foreign Service report that re-entry into the U.S. to attend school or university is often the most difficult time in their lives.

A growing body of research about TCK's reveals some common challenges that need to be recognized by parents. These include:

·         The effects of frequent relocations and school changes

·         Loss of friends

·         Difficulties fitting into new cultures and new schools

·         Extended separations from parents during unaccompanied tours or frequent TDY's

·         Separation from extended families

·         Separations from nannies

·         Exposure to poverty, crime and danger in foreign countries

TCK's serve in foreign countries alongside their parents and are exposed to the same opportunities, dangers, and difficulties that come from living abroad. Acknowledging these challenges and the possible impact these have on children, youths and families is important. We should also help TCK's themselves learn to recognize, express and work to resolve any problems that accompany this lifestyle.

Check out the  Digital Library for additional mental health resources.

FSYF offers the following resources to assist families in promoting mental wellness.

If you are in crisis -  please reach out for help
U.S. Suicide and Crisis Hotline: call 988 (

Crisis Text Line: text HOME to 741741 (

International Resources

Resources for FS Youth and their Families

FSYF Peer-Recommended Providers and Resources

Youth Mental Health and Wellness Guide (originally prepared for Arlington County residents but includes 

many resources in the DMV area as well as national resources).

U.S. Department of State

Bureau of Medical Services

Regional Medical Officer-Psychiatrists: provide patient care, community education and assist leadership.  Appointments can be made via post Health Units.

 Child and Family Program Office:  a small team of dedicated multidisciplinary providers who work to complete post-specific educational and mental health clearance recommendations for those children with identified needs. The office also adjudicates the Special Needs Education Allowance (SNEA) for those children that meet eligibility criteria for educationally required services and supports.

Employee Consultation Services:  offers free, confidential counseling with professional clinical social workers to State Department employees and family members.  They can assist with job stress, marital and relationship problems, parent and child problems, single parent and blended family concerns, depression, anxiety, and other emotional problems, financial concerns, life transitions, new career/retirement issues, and pre or post-departure and re-entry concerns.  Visit their SharePoint site for calendar of multiple support groups.  Contact or 202-634-4874 with questions.

Foreign Service Institute Transition Center

provides security and life skills training, post-specific bidding and assignments materials, resilience education and training, and retirement planning courses for U.S. government foreign affairs employees and family members.

   See especially these courses:

  • Going Overseas for Families with Children (MQ210) | Course Details
  • Going Overseas: Preparing for Your Move for Families with Children (MQ230) | Course Details
  • Ready Set Return to the United States (MQ897) 
  • Young Diplomats Overseas Preparation (MQ250) | Course Details

See also Zines and Guided Journal for children under Publications and Online Resources.

Foreign Service Institute Center for Excellence in Foreign Affairs Resilience

provides resilience training, education, and support for U.S. government foreign affairs agencies.  Resilience is the capacity to adapt successfully to risk and adversity, and the ability to bounce back and move forward from setbacks, high stress crisis and trauma. 

See especially this course:  Encouraging Resilience in your Foreign Affairs Child (MQ500) | Course Details | Email

Global Community Liaison Office

In addition to the global network of Community Liaison Officers at posts, GCLO's Internet site provides a number of resources on important life events, including these Counseling Resources and Referral Services.

WorkLife4You (WL4Y) is the Department of State’s 24/7 comprehensive and confidential resource and referral service for employees and their family members. WL4Y provides free 24/7 education, and referral services that help Department of State employees and family members find the programs, providers, information, and resources they need to manage personal and professional responsibilities. Counselors will help determine what services are needed and available and refer to appropriate providers. Call them for 24/7 personalized assistance, read articles and educational guides on their website, order topic related kits, engage in monthly live talks, watch webinars and listen to audios or ask for a free in-person elder care assessment from a qualified Professional Care Manager.  Department of State, both Civil Service and Foreign Service employees and family members are eligible to use WorkLife4You.

Visit GCLO’s List of Federal Agencies’ Employee Assistance Programs (EAP) webpage or contact for help with contacting your agency’s EAP.

** Employees of agencies other than the Department of State should check with their headquarters for guidance pertaining to their contracted Employee Assistance Program.

 USAID Staff Care

USAID Staff Care ensures the wellbeing and work-life balance of USAID’s total workforce (all hiring categories) and their dependents through a range of programs and services. USAID has partnered with Federal Occupational Health (FOH) to deliver a secure, confidential Staff Care website that provides a central location to access the Employee Assistance / Employee Resilience Program (EAP/ERP), Wellness, Work-Life, and Child Subsidy Programs. Services are available 24/7. Contact at or 877-988-7243 (877-98USAID).


Transition to College: Supporting Third Culture Kids’ Mental Health by Megan Norton, Foreign Service Journal

Mental Health Support for Foreign Service Children: Parents Weigh In Editorial, Foreign Service Journal

What About Our Kids? by Kim DeBlauw, Foreign Service Journal

Raising Foreign Service Kids by John Naland, Foreign Service Journal

Promoting Your Child's Emotional Health by Rebecca Grappo, Foreign Service Journal


Third Culture Kids 3rd Edition: Growing Up Among Worlds by Ruth Van Reken

Letters Never Sent: A Global Nomad’s Journey from Hurt to Healingby Ruth Van Reken

Belonging Everywhere and Nowhere: Insights into Counseling the Globally Mobile by Lois Bushong

The Global Nomad's Guide to University Transition by Tina Quick

Misunderstood: The Impact of Growing Up Overseas in the 21st Century by Tanya Crossman

Safe Passages - How Mobility Affects People and What International Schools Should Do About It by Douglas Ota

Raising Global Nomads: Parenting Abroad in an On-Demand World by Robin Pascoe 

Emotional Resilience and the Expat Child: Practical Storytelling Techniques That Will Strengthen the Global Family- by Julia Simens

Raising Global Teens: A Practical Handbook for Parenting in the 21st Century by Dr. Anisha Abraham

Raising Up a Generation of Healthy Third Culture Kids: A Practical Guide to Preventive Care by Lauren Wells 

Belonging Beyond Borders: How Adult Third Culture Kids Can Cultivate a Sense of Belonging by Megan Norton

Arrivals, Departures and the Adventures In Between by Christopher O’Shaughnessy

Here Today, There Tomorrow: A Training Manual for Working with Internationally Mobile Youth by Elizabeth Parker 

Foreign Service Youth Foundation

P.O. Box 50663

Arlington, VA  22205


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