Misunderstood: The impact of growing up overseas in the 21st century -  By Tanya Crossman

Childhood and adolescence are critical periods for development and mental health is an important component in overall health and wee-being. While most youths cope with life's challenges, the National Alliance on Mental Health (NAMI) states that one in five teenagers lives with a mental health condition, such as depression or anxiety, which can impair functioning at home, school or in the community. Half of all chronic mental health problems begin by age 14 and 75% by age 24. Effective and timely treatment can help reduce the impact of emotional struggles on an adolescent's life.

It is normal for children and youths 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 (like cutting on one's skin), 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. Youths 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. They can be especially prone to depression and anxiety. Support for children with special educational needs should be as focused and routine as for any other health condition.

All children and adolescents benefit from the presence of adults in their lives who are sensitive to their and who can be engaged should the child or teen feel the need. Examples are teachers, guidance counselors, school psychologists, school social workers, clergy, and in the Foreign Service world, a Community Liaison Officer (CLO), the FSMP, the RMO, and the RMO/P. However, 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.

There are some particular aspects of Foreign Service life that should be acknowledged as potential stressors and some aspects that can be viewed as very positive and possibly protective.

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 youths 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 where rain might shut down major roads and the electricity is unreliable or where they may have to wait in long lines for a train ticket or haggle for an item purchased in a marketplace.

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 limited, but 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 who take unaccompanied tours and frequent TDY's
  

• Separation from grandparents, uncles, aunts, cousins and their extended families
  

• Separations from nannies
  

• Exposure to poverty, crime and danger in foreign countries
  

TCK's truly 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. Helping TCK's themselves learn to recognize, express and work to resolve any problems that accompany this lifestyle is important.