Transcript Expatriate Wellness and Mental Well

Global HR News Conference
October 7, 2008
Intercontinental Chicago
International Employee
Assistance for Expatriates and
Families
David A. Sharar, PhD
Managing Director
Chestnut Global Partners
(309) 820-3570
[email protected]
Agenda
• Rational for an “EAP like” model for expats
and families.
• Determinants of expat family adjustment
• The “intervention” model
• Measuring effectiveness
"Before they relocate,
couples tend to focus on
the externals like where
they will live, what schools
their children will attend or
where to buy groceries.
They understandably
ignore the internal
challenges, so many of
which are key to
successfully relocating.
They are in denial about
the changes which lie
ahead for their marriage or
family life".
--Dixie Wilson, EAP Manager,
ConocoPhillips
Why focus on the "internals"?
• There is "risk" in denial (hope for the best but plan
for the worst)
• Make "coaching" or even "clinical counseling"
available and acceptable
• Counteract the perception of company "indifference"
when the "blues" or "stress" kicks-in
• Children "pick up" on parent stress & conflict
• "Work-Life" balance is felt more acutely in the expat
world (where the interdependence of work & family is
profound)
Hardships that impact expatriate health &
wellness
•
•
•
•
•
•
•
•
Isolation and loneliness (lack of social support)
Cross-cultural adjustment and culture shock
Unreliable means of communication/transportation
Difficult living conditions/harsh environments/pollution
Reduced access to medical and professional services
Exposure to suffering, violence, insecurity, poverty
Risk of infectious disease
High expectation of self-sufficiency
Culture shock is a stress-induced
reaction. This stress can increase risky
behaviors or situations:
• Unsafe driving (motor vehicle accidents is #1
risk among humanitarian expats)
• Increased alcohol and cigarette consumption
• Increased use of prescription sedatives/other
substances
• Unprotected sex
• Irritable bowel syndrome/digestive disorders
• Intentional violence/threats of violence
Maintaining a fitness schedule and sensible diet
will enhance the body's reaction to the stress of
culture shock.
Sources of Expat Failure
Spouse/family’s inability to adjust to
cultural/physical environment
Expat's inability to adjust to cultural
environment
Other family related problems
Lacks skills necessary to conduct
business in host country culture
Personality or emotional maturity
Inability to integrate job expertise with
larger responsibilities of assignment
Inability to adapt to changing business
priorities or organizational realignment
Lack of technical competence
Source: ERC 1993/1996 international Survey of 162 companies
0%
10%
20%
30%
40%
50%
60%
70%
Rates of mental health problems
U.S. nationals vs. expatriates
50.8%
50%
40%
30%
17.5%
20%
12.7%
7.7%
10%
3.2%
3.7%
0%
Alcohol use disorders
Depression
Adjustment disorders
U.S. nationals National Comorbidity Study, 2006
Expats, Valk, 2002
Anxiety
3.4%
GAIN Short Screener (GSS) used with an
Expat Population (N=450)
• A scientifically valid, 20 item (3-5 minute) behavioral
health screener for use in general populations to
identify who needs a brief intervention or more
specialized behavioral health care
• Identifies over 90% of the people with a behavioral
health disorder and rules out over 90% of those who
do not.
• It can further classify the likely type of problem into
one or more of four areas: internalizing disorders,
externalizing disorders, substance disorders.
• It can also be used to measure change and document
who has had problems in the past but is now in
remission.
Website:
http://www.chestnut.org/LI/gain/GAIN_SS/index.html
GAIN SS Data among Expats (n=450)
Source: Collected as part of a health risk assessment; Total Disorderscreener is based on 14 of 20 GSS items (one item n the internal not asked, and the
violence and crime screener w ere not asked).
72%
Substance Use Disorder
20%
8%
Tried to Hide A OD use
Family/co -wo rkers co mplain abo ut use
Used A OD weekly
Kept using tho ugh go t yo u in tro uble
spent alo t o f time getting/using A OD
External Disorder
77%
18%
Hard time paying attentio n
Hard time listening
Threatened o ther peo ple
Yo u lied o r co nned to get things
Have y o u hit so meo ne
Internal Disorder
43%
36%
21%
Significant pro blems sleeping
Feeling trapped, lo nely sad
Feeling anxio us, nervo use
Distressed/upset by memo ries
Low
Moderate
High
5%
3 determinants of expatriate family
adjustment (Alietal, 2003)
1. Personality traits
2. Family characteristics
3. Work-life
Personality Traits
•
•
•
•
•
Cultural Empathy
Open-mindedness
Social Imitative
Flexibility
Emotional Stability
Family Characteristics
• Family Cohesion
• Family Adaptability
• Family Communication
Work-Life
• Expatriate work satisfaction
• Support from the international company
• Other social supports
Theory of Expatriate and Spousal Adjustment
(adaptation of Caligiuri model)
Personality Traits
- Cultural Empathy
- Open-mindedness
- Social Initiative
- Flexibility
- Emotional Stability
Family Characteristics
- Family Cohesion
- Family Adaptability
- Family Communication
Work-Life
- Expatriate Work Satisfaction
- Support from the international
company
- Other Social Support Networks
Intercultural Adjustment
- Psychological Adjustment
- Sociocultural Adjustment
- Work
- Family
- Culture
Are we doing enough?
Relocation
Vendor
• Relocation
• Policy
• Vendor Mgt.
• Exception
Mgt.
Spouse career
consultation
Destination
services
• Spousal
career support
and resume
writing – US
Domestic only
• Housing
• Some
destination
services
•Orientation to
local area
• Schooling
• Settling- in
• Referrals
Training
• Cultural
training
Family
Support
• Personal
Support
•Language Trg • Assessment,
• Follow up
counseling,
training
referrals
Historically, we have not focused heavily on the “softer,”
personal side of an Expat assignment.
• Proactive
outreach and
support – pre,
during and post
assignment
Why are traditional EAPs inadequate to serve
expatriate populations?
1.
Most EAPs are U.S. centric and do not fully
account for local and cultural needs.
2.
Expatriates & families tend not to use traditional
EAPs.
3.
Many EAPs are passive.
4.
Delivering consistent EAP services globally has
proven complicated.
5.
Traditional EAP alone is not sufficient to meet the
complex needs at each stage of an expatriate
assignment assignment.
4 key elements in Expatriate EAP
1.
2.
3.
4.
Proactive Outreach (by phone and e-mail) to all
new & existing expats and spouses to lend support
and identify any issues
Intervention (face-to-face or phone) with "incountry" professional coach or counselor (up to six
visits)
Educational Support facilitated teleconferences,
webinars, and web site
Pre-Departure Meeting Meet with new expats and
spouses prior to departure to prevent or anticipate
problems
Expatriate Employee Assistance Program (EAP)
The EAP is. . .
EAP
 Confidential
 Proactive and strategic
 Free of charge to the expatriate
families
 Ultimately voluntary
Case examples
1.
Spouse - isolated and afraid to leave the house in
Mexico
2.
Child - not fitting in at school in the U.K.
3.
Expat employee - extramarital affair in China
4.
Expat employee - drinking excessively in Brazil
Delivery Model Options for Expatriate Support
1. U.S. based
telecounseling and
online services
2. Home country
professionalperiodic expat
“check ups”
3. Placement of
home country
professional in
host-country
4. Face-to-face with
local provider
“Think
Global
Act
Local”
“Think
Local
Act
Local”
Global Partnerships
Multi-local Approach
 Local, in-country providers have an
intimate knowledge of the host country
 “High touch,” local presence with quick
responses
 Greater acceptance and integration by
local management
 Local providers can blend cultural issues
with “personal problems”
Social support is a buffer against
extreme stress
Ann Copeland's research (Boston University) indicates
that expat spouses who interact with host country
nationals "seem to be more content and satisfied than
spouses with no such contact".
Try to avoid living exclusively in the
Survey Data
“How has your personal life been affected while living
abroad?” Percent reporting a “negative” impact.
49% decrease
Pre IAP
1 year follow up
Survey Data
Percent who have considered early repatriation
Pre IAP
1-year
follow up
Considered early repat
due to personal problem
Considered early repat
due to work problem
Family considered early
repatriation
Survey Data
Percent reporting dissatisfaction with . . .
Emotional state
Social
relationships
Marital
relationships
Pre IAP
Family
relationships
Job
After first year of IAP
Kids'
educational
experience
Survey Data
Percent reporting dissatisfaction with . . .
Prior to IAP
Support with
policy
Overall HR
support
After first year of IAP
Support finding
Level of
healthcare
personal support
Survey Data
Percentage reporting more than 4 days absent “due
to a personal or emotional problem.”
39% decrease
Pre IAP
1 year follow up
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