Before embarking for a new country, Canadians can easily check their risk of contracting an illness and arrange to be vaccinated against hepatitis, encephalitis, rabies or yellow fever. But there’s no vaccine for loneliness, anxiety or depression and their attendant health risks.
That’s not to say that employers can’t protect the mental and physical health of employees who undertake international moves. There are many steps that they can take. Ultimately, the best strategy is to anticipate the potential for distress and build in a cushion of linked supports to lessen the impact.
In a 2016 survey of academic literature on the subject of moving and mental health published in the journal Progress in Human Geography, researcher Tim Morris notes increasing evidence that just the act of moving “may have adverse effects on a wide range of health outcomes,” and that frequent relocation is linked to “poorer general mental health and wellbeing.” The signs of this can range from higher levels of depression and anxiety to an increase in tobacco, drug and alcohol use.
While frequent moves are hardest on children (who may demonstrate emotional and behavioural consequences in later life), adults are by no means immune. What is highly surprising, however, is that researchers have found that short-distance moves are generally associated with poorer health than longer-distance moves, writes Morris.
Why, exactly? Because long-distance moves tend to be part of a new and welcome life development. They are something an individual or family usually pro-actively embarks on, rather than the result of a situation forced upon them out of need. While “long distance moves may be more disruptive,” notes Harris, “they are less likely to be made under duress, and more likely to be related to labour market repositioning or other positive relocation.” In other words, the excitement and sense of achievement that accompany a distant work-related move go a long way towards mitigating the inherent stresses of the relocation.
The initial euphoria that often accompanies such a move does, however, dissipate when the reality of integrating into a new, foreign environment takes hold. “We find that there’s a honeymoon period – people are excited, everything is new – then there’s that realization that how to communicate, how to get around is more draining,” says Paula Allen, VP of research, analytics and innovation for Morneau Shepell, a global HR services and technology company headquartered in Toronto.
Allen says that companies can do a lot to manage the physical health concerns of employees relocating abroad. In the case of those with a chronic health condition, for instance, it may be possible to plan ahead for access to necessary treatments and medications. Harder to predict and manage are mental-health needs. And the mental-health impact in relocation is very real.
“The number-one thing is very basically that any type of change, especially a major change, is stressful, no matter how positively it’s viewed,” explains Allen. “The second part of it is that people underestimate the impact and all the stressors. For example, even if one moves between two very closely linked countries, like Canada and the United States, people may not accommodate for that ‘two per cent difference’ and start asking themselves ‘Why do I feel like a fish out of water?...’ What we’ve observed is that conflict tends to be high, and it might put pressure on a marriage or relationship. Sleep issues are [also] common.”
Allen highlights that social expectations and even day-to-day business customs differ so much between regions that the disconnect can be a continual, daily source of frustration, apprehension or anxiety. And like the pebble in the hiker’s boot, a small irritation can ultimately build into a crippling handicap. By way of example, Allen notes how in South America, the attitude toward starting times for meetings is far more casual from that in Canada. In Canada, casually walking into a meeting 20 minutes late would likely anger people; in South America, it might not.
In South America, “You may arrive for an 8:00 a.m. meeting and end up waiting for other people to arrive later – and they think that’s fine,” says Allen, who adds that if you don’t brush up on the differences, then you won’t understand the cultural implications of how people interact. “It really does take a long time to do that cross-cultural adjustment. Even if you’re a frequent traveller, you have to prepare for the cultural differences.” More importantly, you cannot let these differences upset you and raise your stress levels, which can then have negative health repercussions.
Of particular value within this framework is cross-cultural training. While it’s not exactly the first thing that comes to mind when one thinks of mental health, an ability to understand and accept cultural differences accelerates a feeling of connectedness, which in turn eases stress and its negative health impact. “If an organization is able to offer cross-cultural training, that will help,” Allen stresses.
Loneliness, isolation and homesickness are also culprits. “If you go anywhere, you’ve left somewhere. [So] you’re leaving friends and family,” says Allen. “You really do have to watch for the signs of isolation coupled with the signs of cross-cultural stress.” Nobody should wait for things to go wrong before taking action. Employees need to be advised of the possible health pitfalls and be taught in advance how to mitigate them if they do arise.
“Even before warning signs, [they need to] be prepared that they are going to go through a period of stress,” says Allen. “The first step is to recognize that this will happen and plan for it…. When you are overseas, very often it is the physical symptoms that come up before the mental health ones: the fatigue, the aches and pains. If anything feels different, then you can’t just ignore it.”
Transferees need to manage the frequent sense of isolation with a two-pronged approach. They can keep in touch with friends and family via LiveChat, Skype or a similar interface, while simultaneously actively pursuing activities and routines like café visits or fitness classes in their new locale.
If mental-health problems do arise, it is critical that transferees are able to access the help they need in a confidential manner. There is still quite a bit of stigma surrounding mental health, and not every employee is ready or willing to speak openly about it – especially those in senior positions. Employers need to bear this in mind.
“If you have business travellers on assignment, it’s important for them to have access to counselling and coaching in a very confidential way. Your highest-level employees are the ones most likely to have relocation assignments, and they’re the ones least likely to admit that they’re having difficulties,” says Allen.
In less developed and more remote locations, supports may be limited, so it’s especially important for employee assistance programs to be made available – locally if possible, remotely if not.
“The first step is counselling to help the adaptation and developing skills. Second is medical or psychological supports, which may include medications,” Allen emphasizes. “The third and last thing that you would want to do is actually repatriate someone.”
Fortunately, by taking the right steps, an employer can strongly minimize the likelihood of this happening.