The U.S. Department of State's mental health services: A model for integrated care

Since it was established in 1979, the U.S. Department of State's mental health service has functioned as a unique program of care for U.S. diplomats and their family members, currently encompassing more than 250 U.S. embassies and consulates worldwide. Such an approach has allowed for rapid delivery of high-quality care in collaboration with regional medical officers, nurse practitioners, physician assistants, nurses, and local assets. Data from the past three decades indicate that the program has had low rates of medical evacuation and repatriation and low rates of mortality. Building from its roots in disaster and crisis response, the program now offers integrated mental health care in a geographically distributed, worldwide program to address the general medical and behavioral health needs of an expanding U.S. diplomatic presence in increasingly remote, challenging, and dangerous environments.