Lea Iodice was delighted to hear that the Peace Corps had accepted her application and was sending her to Senegal as a community health care worker. He shares the good news with his roommates, his family and his favorite professor and daydreams about his last day at his job, managing a gym called SnapFitness.
He was devastated, about a month later, to receive a letter from the Peace Corps Office of Medical Services saying that his offer had been revoked because he was being treated for anxiety. Although she is in therapy to manage occasional panic attacks, she has never taken any psychiatric medication, been hospitalized or engaged in any type of self-harm.
“The reason for the medical nonclearance is that you are currently diagnosed with an undiagnosed anxiety disorder,” read the letter, which appeared on his online application portal. “You indicate that your anxiety symptoms of increased heart rate and dizziness recur during periods of stress, which are likely to occur during service.”
Searching online, Ms. Iodice said her experience was unusual. For years, comparing notes under anonymous screen names, Peace Corps applicants have shared stories of being disqualified because of a history of mental health, including common ailments like depression and anxiety.
Training is the subject of a case filed this week in federal court, accusing the Peace Corps of discriminating against applicants with disabilities in violation of the Rehabilitation Act, which prohibits discrimination in programs that receive federal funds.
The lawsuit, which seeks class-action status from the US District Court for the District of Columbia, includes accounts from nine people whose Peace Corps invitations were revoked for mental health reasons. The suit alleges those decisions were made without considering reasonable accommodations or making individualized assessments based on current medical knowledge.
In a statement, a Peace Corps official said he could not comment on pending litigation, but added that “the health, safety and security of Volunteers is the Peace Corps’ top priority.”
“The agency has a statutory responsibility to provide necessary and appropriate medical care for Volunteers during service,” said Jim Golden, acting associate director of the Office of Health Services, in a statement. “Many health conditions – including mental health care – that are easily managed in the US may not be addressed in areas where Peace Corps Volunteers are stationed.”
He said each candidate’s medical history is assessed individually to determine if the agency can support the individual’s needs.
The three plaintiffs in the case were not identified by name in court filings. But other Peace Corps applicants described the rescinded offers as a major blow at a difficult time in their lives, casting doubt on post-college plans and forcing them to explain to family, friends and supporters that they denied due to a mental health condition.
“It’s really heartbreaking to be dismissed like that,” said Ms. Iodice, now 26, who is not a party to the lawsuit. “It took a lot of processing to get over that initial feeling of unworthiness.”
The The Peace Corps medically examines accepted applicants before sending them overseas to ensure they do not face health crises when they are in locations where specialized care may not be available. Similar screenings are used in the State Department and the military.
But those policies are coming under pressure from legal activists. Earlier this year, the State Department agreed to pay $37.5 million to settle a class-action lawsuitfiled 16 years ago, challenging a hiring requirement that an applicant must be able to work at any State Department overseas post without requiring ongoing medical treatment.
In recent years, the Peace Corps has deployed about 7,000 volunteers to more than 60 countries, according to recent figures from the Congressional Research Service. A review of the medical clearance system found that, in 2006, approximately 450 applicants were medically disqualified from service.
“I was surprised, at first, how broad and outdated some of these policies are,” said Megan Schuller, legal director of the Bazelon Center for Mental Health Law, which, along with Bryan Schwartz Law, represents the plaintiffs.
A party to the lawsuit filed Tuesday, Teresa, 22, who asked to be identified by her middle name out of concern that the stigma would harm her job prospects, was hired this past January for a voluntary position in Mexico working on climate change awareness.
In March, before his planned departure, he was told he had failed his medical clearance due to his history of treatment for anxiety and depression. He appealed the decision but was denied.
Like many undergraduates, he suffered during the isolation of the pandemic and attended therapy and took an antidepressant drug in 2020, never considering that these treatments could disqualify him from serving in Peace Corps, he said.
“There’s a part of me that thinks, This can’t be happening,” he said. “I didn’t know a single person in my entire college experience who didn’t struggle with their mental health.”
The letter informing him of his nonclearance cited “active symptoms of anxiety, increased heart rate, inability to sit still, inability to say no,” all symptoms his therapist noted in 2021, he said. He spent weeks at the end of college explaining, over and over again, that he wasn’t going to Mexico.
“It’s really embarrassing to tell people you got in and then get rejected because of your mental health,” said Teresa, who is now training to be a paralegal.
Another party to the case, Anne, 34, who also asked to be identified by her middle name out of concern for stigma, was offered a Peace Corps position in Mongolia teaching at the university level.
On his medical clearance forms, he shared that he had made two suicide attempts at the age of 15, he said in an interview. Since then, however, he has lived abroad as an exchange student and worked for more than a decade as a public English teacher without a recurrence of suicidal behavior.
His rejection letter, which came in November, said he was assessed as a high risk for repeating suicidal behavior. He tried to appeal the decision but was denied.
“When you get rejected based on something from half your life ago, it’s like a punishment for being honest, and it’s like a part of your past that you can’t escape,” says Anne, who teaches a high school. “I’m very disappointed. I’m confused and I’m trying to figure out how to do this – to save this dream.”
Complaints about the policy have simmered for years in online forums and have been the subject of a petition on Change.org in 2019 and coverage this year in Worldview magazine, a news site for the National Peace Corps Association.
Applicants are increasingly forthcoming about discussing their medical clearance experiences, said Jade Fletcher-Getzlaff, 33, who outlined her own denial and successful appeal to a YouTube video in 2019.
In each wave of deployment, he said, he receives between five and 10 inquiries from applicants who have been disqualified because of mental health conditions.
“As more people seek therapy, and more openly talk about these issues, I think it comes up more often,” he said in an interview from Japan, where he now teaches, after serving as a Peace Corps volunteer in Cambodia.
Rates of anxiety and depression among US youth have risen dramatically in recent years.
In 2020, found a study by the Centers for Disease Control and Prevention that 63 percent of adults aged 18 to 24 years reported mental health symptoms, compared to 31 percent of all adults. Young adults also expressed a greater need for mental health treatment, with 41 percent of adults 19 to 25 reporting unmet needs, compared to 26 percent of all adult.
Kirstine Schatz, 24, currently serving as a Peace Corps volunteer in Morocco, said she was initially denied medical clearance because she had been taking sertraline, a common antidepressant, for six months at the recommendation of her primary care doctor. .
He stopped medication seven months before applying and never received any mental health diagnosis, he said, but was told he was denied medical clearance because the stressful environment of the Peace Corps could trigger a relapse.
Ms. appealed Schatz appealed the decision, emphasizing that he had been off medication and had been stable for six months, and reversed the decision. He urged the agency to change its screening policy. “They’re missing out on so many amazing people because of the outdated mind-set they have on mental health,” she said. “It’s 2023. They need to know it.”
As for Ms. Iodice, she did not appeal her initial rejection and is still at SnapFitness, where she is the general manager. He says he has no regrets about receiving therapy, even though it may have prevented him from serving in the Peace Corps in Senegal.
“If I had applied before I went to therapy, I might have gotten there, but I would have been a worse worker, in my opinion,” he said. “In my perspective, I am a stronger person. I know myself better. I know how to deal.”