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WASHINGTON – U.S. diplomats suffering from the unexplained “Havana Syndrome” used a tense meeting with Secretary of State Antony Blinken this month to voice growing dismay over continuing stigma and disbelief within the U.S. government about their injuries, more than four years after the incidents began.

In his first meeting with the cohort of State Department staffers affected in Cuba and China, Blinken spent more than an hour offering reassurances and fielding questions, with most affected staffers joining remotely by phone. His message: Those suffering must be believed, and that the administration is doing all it can to investigate and provide care.

Yet, the assurance from America’s top diplomat stood in stark contrast to the profound challenges that affected diplomats say they’re still facing in getting proper medical care, evaluation and benefits — and the skepticism about their injuries they say is pervasive even among some high-level government officials.

July 20, 202101:20

“It’s just incredibly sad. It’s the worst part of bureaucracy,” one of the diplomats said, describing the call as “identical to so many other phone calls” where they’re told about protocols in place to ensure proper treatment. “It’s so maddening because those protocols aren’t in place — not the way they think they are.”

NBC News spoke with more than half a dozen people who participated in the Sept. 10 call. They described a yawning gap between the government’s public, official message and the situation in reality, and said the administration’s refusal to describe the incidents as “attacks” is fueling continued skepticism among their colleagues.

In 2017, when the incidents in Cuba first came to light, the Trump administration described them as “targeted attacks.” But in recent years, the government stopped calling them attacks, with the Biden administration preferring the term “unexplained health incidents,” or UHIs.

Several individuals affected by Havana Syndrome in Cuba or China said the State Department’s Bureau of Medical Services originally told them their symptoms were due to stress, or attributed their cognitive symptoms to simply getting older.

“It’s those sorts of sickening statements that perpetuate this disbelief,” one of the diplomats said, adding that staffers fully understand the government can’t share with them all the details of the investigation. “We get it, it’s classified information. But if you’re seeing stuff, don’t act like it’s nothing. Don’t call it freaking UHIs. Don’t talk about our stress levels.”

Others described being put through an endless chain of bureaucratic hurdles that they said have prevented them from obtaining benefits authorized by recent legislation to address Havana Syndrome, such as lost wages for workers whose brain injuries forced them into early retirement or prevented them from progressing professionally.

A senior State Department official, responding to questions about Blinken’s call with the diplomats, acknowledged that there’s “frustration” among the group about a perceived stigma or lack of empathy by their colleagues, but said it did not extend to those at the top.

“That’s certainly not the case with the secretary and the senior leadership,” the official said in an interview. “Everyone is taking it seriously as a real issue that is affecting people who are experiencing real symptoms.”

Aiming to defuse the skepticism, multiple U.S. agencies including the State Department and the Pentagon have encouraged their employees to report any incidents of concern or symptoms to be evaluated. Last month, the Office of the Director of National Intelligence issued a rare public statement describing the stepped-up investigation as a “top priority,” and vowing to support those affected “to ensure they are believed, heard and respected.”

Since 2017, at least 200 U.S. diplomats, spies and other government employees have come forward to report potential symptoms of what officials believe are most likely directed energy attacks, possibly using microwave technology. The first incidents discovered were in Havana, but later incidents have emerged on every continent except Antarctica, including cases in the U.S.

Late last month, suspected incidents in Vietnam just before Vice President Kamala Harris was scheduled to visit led her to delay her trip by several hours. On Monday, NBC News reported that a CIA official traveling with CIA Director William Burns to India this month reported symptoms and is receiving treatment.

Some of the workers have reported hearing bizarre high- or low-pitched sounds, or feeling strange sensations before developing symptoms, which include cognitive and memory problems, balance issues, and hearing and visual changes. Doctors enlisted by the U.S. government to treat them have diagnosed traumatic brain injuries.

Yet, more than four years after the U.S. government started investigating, the intelligence community still has not formally identified a cause or culprit.

The Biden administration, which inherited the unsolved investigation in January, appointed a senior official at the White House National Security Council to oversee the response, which now includes new task forces involving scientific and medical experts who have access to classified information.

“It’s confounding and puzzling to everyone who works on this that we have not been able to determine the cause or attribution,” the senior State Department official said. “’Attacks’ implies that we know what has happened and what is causing this and implies there’s a state actor. Obviously, that’s the theory that people have that’s not been ruled in or ruled out.”

Some of the initial diplomats affected in Cuba received formal letters from the FBI saying they were victims of a crime, awards from the secretary of state for being injured in the line of duty, or both.

But the FBI, which traveled multiple times to Havana to investigate, later issued a report that found no evidence of an attack and determined the staffers were most likely suffering from mass psychogenic illness, or mass hysteria. Diplomats have bristled at the fact the FBI did not directly interview the diplomats affected.

On the Sept. 10 call, when Blinken asked how the department could reduce the skepticism, at least one diplomat encouraged the State Department to publicly refute that report.

Diplomats told NBC News they were dismayed that Ambassador Pamela Spratlen, tapped by the Biden administration to oversee the State Department’s response, declined to conclusively rule out the mass hysteria theory.

“The FBI study is one I have actually read,” she told the diplomats, according to notes from the call. “We know not a lot of people are referring to that now, but we heard what you have said about it and we have your view, and we will definitely take that into account as we think about next steps in dealing with that issue.”

One diplomat on the call described that response as “invalidating and inconsiderate.” Another said that Spratlen was “very clearly saying that she has not ruled out that we’re crazy.”

“In the end, we were interrupting Spratlen to try to get people in” to speak, a third diplomat on the call said. “It was ugly.”

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