Disclaimer: The views and opinions expressed in this article are solely those of the author and do not necessarily reflect the official policy or position of WERC.
Relocating abroad represents a significant life transition that can impact mental health in many ways, and companies spend considerable resources on expatriate assignments. Despite this substantial investment, many organizations fail to adequately prepare employees and their families for the psychological challenges of international relocation. This oversight contributes to concerning statistics: Up to 40% of expatriates return early due to difficulties adjusting or dissatisfaction with their overseas assignment. The cost of a failed assignment could be as high as $1.25 million per assignee.
Understanding the Mental Health Challenges of Expatriation
Research has consistently identified several mental health concerns associated with expatriate experiences. Studies show that expatriates face elevated risks for:
- Depression and anxiety disorders
- Sleeping difficulties
- Poor concentration and focus
- Substance abuse issues
- Occupational anxiety
- Cultural issues resulting in friction at work
- Physical health complications
Key findings from this research indicate that:
- Expatriates who struggle to adjust to everyday life and a new job environment experience higher psychological distress.
- Strong support systems—having someone to discuss homesickness or loneliness with—significantly improve adjustment to work and host culture.
- Effective company support should be tailored to the individual’s specific needs rather than based on assumptions about what might be helpful.
Cultural Perspectives on Mental Health
Understanding how different cultures approach mental health is crucial for successful expatriate transitions. Cultural attitudes toward mental health vary dramatically across regions. Below are just a few examples from specific countries.
Sweden
Sweden has a social approach to mental health care and treatment. Employers are encouraged to focus on employees’ mental wellness by providing a healthy work-life balance, and businesses are refunded for wellness activities, including offerings like acupuncture and yoga.
Due to the cultural focus on comprehensive health, mental health is much less stigmatized than it is in other countries. Mental health conditions, including stress-related disorders and burnout, are covered by the country’s sickness benefits, and Sweden has strong laws protecting from discrimination.
Singapore
Despite being one of Asia’s most developed nations, Singapore still grapples with a stigma around mental health; 75% of individuals who self-report mental illness avoid treatment. As with most Asian countries, stigma continues to surround mental health issues.
There is some progress occurring. Singapore became the first Asian city to host the global “Together Against Stigma” conference in 2019, and government initiatives have eliminated requirements for job seekers to declare mental illnesses on applications. However, socially, the topic remains somewhat taboo, especially among older generations.
United Arab Emirates and Saudi Arabia
In the United Arab Emirates (UAE) and Saudi Arabia, mental illness remains heavily stigmatized, though both countries have launched national well-being initiatives to address these issues. The UAE’s National Strategy for Wellbeing 2031 specifically targets mental health improvement.
In Saudi Arabia, younger generations are gradually becoming more comfortable discussing mental health openly, while women have historically faced barriers to treatment due to cultural expectations around privacy.
South Africa
South Africa faces high rates of depression and PTSD linked to the high rate of violence and other social determinants, yet the percentage of those receiving the care they need can be as low as 10% for some disorders.
Traditional African medicine and indigenous healers, usually older women, continue to play important roles in mental health treatment, not just in rural areas, but in urban centers like Cape Town and Johannesburg. These traditional approaches have reported success with treating psychosis, substance abuse, and brain disorders.
The South Africa Federation for Mental Health has launched outreach programs to raise awareness and battle stigma. As in many countries, wealthier citizens with more resources are more likely to pursue treatment.
Brazil
Despite the wide range of available services for mental health in Brazil, seeking treatment is still stigmatized. While the country lacks specific mental health discrimination laws, the Brazilian Law on the Inclusion of Persons with Disabilities provides some protections for workers with certain conditions. The law, which went into effect in 2016, defines a person with disability as “someone with any long-term physical, mental, intellectual, or sensory impediment.” While there is some uncertainty as to whether a mental disability, as defined in this law, is inclusive of mental illness, it is generally seen as a positive step for the country’s civil rights advancement.
Best Practices for Supporting Expatriate Mental Health
Organizations can implement several strategies to better support expatriate mental health.
Comprehensive Intake Interviews
Intake interviews are a good way to open a dialogue with employees. Foster an environment that encourages employees to be honest about any mental health or substance abuse concerns. By doing so, employers can help them proactively develop personalized coping strategies, find educational and occupational stability, and make plans for maintaining connections with home country support systems.
Overseas Mentorship Programs
Peer-based mentorship programs, different from supervisor relationships, can significantly reduce isolation and disconnection while creating a sense of community. These programs tend to offer high returns with relatively low costs.
Confidential Employee Assistance Programs (EAPs)
Access to mental health professionals from the employee’s home culture can eliminate additional stressors related to language and cultural differences in therapy. Modern teletherapy platforms make these services accessible regardless of location.
Mental Health Training Workshops
Even experienced expatriates benefit from location-specific mental health training. In-person workshops provide opportunities to normalize experiences, answer questions, and develop community among relocating employees to help with assimilation.
The ROI of Proactive Support
While international assignments offer exciting opportunities for personal and professional growth, they also present unique psychological challenges. By implementing proactive mental health support strategies, companies can significantly improve expatriate success rates while protecting their substantial investments in global talent.
The benefits of these comprehensive approaches extend far beyond organizational outcomes to positively impact employees and their families throughout the entire relocation experience, ultimately creating more resilient global professionals and healthier international communities.