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Human Resources

Looking after your expat employees’ mental health

Published 8 December 2021 in Human Resources • 6 min read

An expat assignment can prove challenging for the mental health of employees and their families.  Companies that provide the right emotional support will help them deal with transition challenges more smoothly.


Jenny moved from New York City to The Hague with her husband, Jared, and their 10-year-old daughter, Sonia. Before the move, she worked as a legal counsel for a media company and Jared was a human rights lawyer with the United Nations. He got an offer to work at the International Criminal Court, and they decided to take it and move to the Netherlands as a family. Jenny quit her job. 

Anchored in his new job, with a built-in support system, Jared adjusted quickly. Jenny spent the first few weeks after the move getting Sonia settled at home and school, getting to know her way around, and starting to learn Dutch. Jenny didn’t know anyone in The Hague. During her first weeks there, she felt homesick and isolated. Her only contact with others was talking to her family and close friends back in New York City. She was spending too much time on video calls and not enough time getting out of the apartment and talking to people locally.  

Then, there were days when she didn’t have the energy to get out of bed. She thought it was because of the darkness outside and getting used to the Dutch winter – not the initial symptoms of depression. It took her several months of suffering before she sought professional help. Her depression lasted for almost a year. 

Jenny is one of many expats who struggle with mental health issues. A recent survey by health care provider William-Russell found that one in four of the expats surveyed reported the experience of living and working abroad as either ‘negative’ or ‘significantly negative.’ An earlier survey of globally mobile individuals by health benefits provider Aetna International highlighted a substantial increase in mental health claims. Between 2014 and 2016, claims increased by 33 percent in Europe, 28 percent in the Middle East and Africa, 26 percent in the Americas and 19 percent in Southeast Asia. With a reported 50 percent increase, depression was the most prevalent conditionfollowed by anxiety at 28 percent. 

The pandemic has made things worseespecially for expats. According to the William-Russell survey, more than a third of expat participants reported a decline in their mental health because of the coronavirus crisis. Twelve percent said their mental health had gotten ‘significantly worse.’ These numbers should come as no surprise. Expats have had to navigate the challenges of a pandemic away from their support networks. Restrictions on travel and socialising have left them isolated, unable to build a social circle or explore and feel at home in their new host countries. Dealing with a situation that threatentheir health and well-being in an unfamiliar environment is stressful, to say the least. 

Woman standing in a field with umbrella

Three kinds of challenges to expat mental health 

What is it about being an expat that increases the risk of depression and anxiety? To a great extent, it’s the lack of support and connection. Expats must manage the practical and emotional challenges of relocation away from family and friends and without support system (at least initially). This makes them more susceptible to developing feelings of isolation, stress, anxiety, even depression. Three common relocation challenges can jeopardize expats’ mental health: 

  1. Adapting to a new environment and culture. Some expats struggle to adjust. The unfamiliar environment, the language barrier, the inability to understand or fit into the culture can damage their confidence and increase their anxiety.
  2. Building a new support systemand social network. Having to build a support system from scratch, struggling to make new friends, and feeling homesick often make expats feel overwhelmed, isolated, sometimes even depressed. 
  3. Recreating a professional identity.Expat partners who move abroad to follow their partner’s career may have difficulty finding fulfilling work, building connections, or finding a sense of purpose – in addition to all the ‘regular’ challenges of expatriation. They may end up having an identity crisis, which may affect their mental health and damage their relationship. 

Sometimes, the stresses of relocation and adjustment can overlap with other challenges, creating a ‘perfect storm’ that triggers or worsens mental health issues. An expat spouse may have just had a baby and struggle with postpartum depression right around the time that culture shock hits. The family’s teenage daughter may be having challenges integrating into her new high school and miss her friends and family at the same time that she’s going through puberty. Add to that the struggles expats often face in navigating unfamiliar health systems to get the support they need. 

Beyond their impact on well-being, mental health issues can impair assignees’ productivity and work performance to the extent that they jeopardise the overall success of the assignment.

The role of employers 

Companies have a substantial stake in helping their expat assignees deal with transition challenges and avoid mental health issues. Beyond their impact on well-being, mental health issues can impair assignees productivity and work performance to the extent that they jeopardise the overall success of the assignment. Unaddressed mental health issues may result in early return and assignment failure, which is costly for companies. This is true whether the mental health issues affect the assignees, their families, or both. 

The right emotional support can make or break an expat assignment, but unfortunately, mental health does not receive as much attention in the workplace as physical health. In some circumstances, admitting that one has mental health issues carries a stigma. There are also wide discrepancies when it comes to the mental health support provided in different countries. The pandemic has further eroded the health services in many places and severely curtailed the availability of mental health professionals. 

How can employers help? 

Here are some ways that companies can design a robust approach to anticipate and, ideally, prevent mental health challenges when it comes to their expat employees and their families: 

  1. Think ahead and be proactive about supporting the general well-being of their expat employees. To help prevent mental health issues from arising in the first place, focus employee assistance programs on areas such as well-being and work-life balance. 
  2. Design support options informed by an in-depth understanding of the mental health challenges expats and their families face. Support can include, for example, access to counselling, therapy, or coaching with a qualified professional who speaks their language. 
  3. Provide support that is targeted and personalised. People experience transitions differently and therefore need different resources to cope. Tailor support to the unique challenges confronting individual expats and their families. 
  4. Offer support before, during, and after the relocation. The pace of adjustment to transition varies widely among individuals. Also, it’s hard to anticipate every challenge beforehand, so companies should plan to provide at least some ongoing support (for example, continuing for the first year after the move). Such support can include access to cross-cultural training, transition coaching, career development assistance for expat partners, mentoring, therapy/counselling, and introductions to local social and professional networks. 
  5. Raise employee awareness of the support resources available to them, including at the local level. Often, expats either don’t know what kind of mental health support is available, don’t know where to look for it locally, or don’t find what they need in their host country. Raising awareness should also help make mental health less of a taboo issueboth for those facing it and those around themthus encouraging people to ask for help rather than suffer in silence. The goal should be to tackle mental health issues early, ideally as soon as they arise. 

Our awareness of expat mental health challenges has increased substantially in the past few years, highlighting the need for companies to be proactive in understanding and effectively supporting the mental health needs of expat assignees and their families. 



Katia Vlachos

Katia Vlachos

Coach and author

Dr Katia Vlachos is a certified coach and author of A Great Move: Surviving and Thriving in Your Expat Assignment. She supports the globally mobile as they navigate international moves, career changes, reinvention, and identity issues to design a thriving life abroad. A researcher and policy analyst by training, she has a Master’s from the Harvard Kennedy School and a PhD from the RAND Corporation. She has written for Harvard Business Review and Huffington Post, and been featured in the Financial Times and the New York Times.


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