When an American working in the Persian Gulf region committed suicide in February 2017, it highlighted the mental health needs of expatriates, or expats. From being disconnected from support networks back home, to adjusting to new languages, cultures and work responsibilities, expats face a number of challenges that can lead to mental health issues if left unchecked. Added to which, individuals living and working abroad can be too proud or ashamed to seek treatment, or unsure how to access appropriate services.
In a whitepaper published by Aetna International in May 2017 called, “Expatriate mental health: Breaking the silence and ending the stigma,” the health benefits and services partner calls for better mental health education and preventative measures for expats, employers, insurers and medical professionals. The organization believes this could lead to increased awareness, better outcomes for individuals, and their families and employers, and could ultimately end the stigma associated with mental illness.
The World Health Organization ranks depression as the third top chronic disease. The depression rate continues to rise and will likely overtake heart disease and cancer to become the single most common chronic disease by 2030, according to the American Psychological Association.
Analysis of Aetna International’s global member claims data revealed that more women than men sought mental health treatment between 2014 and 2016. The analysis also revealed member prevalence for mental health increased in the Americas, Europe, Middle East and Africa and Southeast Asia during the same period. The data points to a growing global issue of mental health.
The white paper details recent studies of expats conducted by Aetna International and illustrates factors that can make a person working in a foreign country depressed or anxious. In addition, the organization reports findings that 94 percent of expats are unprepared for the mental health issues associated with relocating abroad. As a possible solution, employers could conduct cultural training and assessing candidates or their accompanying family members for their suitability for an overseas placement, before committing to the assignment. During the overseas placement, employee assistance programs, which offer phone support to employees dealing with many issues, and programs and policies that support work-life balance can help reduce employee stress and provide workers access to resources if they need it.
“We believe that employers should be taking a more preventive approach to mental health issues, introducing solutions such as employee assistance programs. At best, these not only tackle mental health concerns when they arise, but encourage broader employee wellness, and address conditions before they escalate,” said Dr. Mitesh Patel, a medical director for Aetna International. “Expats relocating independently should also consider preparing for the challenges they may face, and consider seeking support before and during their move. Increasing knowledge around mental health issues and the support available can change attitudes towards those with mental health, and the behavior of those coping with issues.”
Aetna International also states that proactive programs and education can help identify those who may be suffering emotionally, and can change wider perceptions of mental health issues. Mental Health First Aid is the flagship program of the National Council for Behavioral Health and trains people on how to identify emotional distress and how to offer initial support until professional care is available.
Telepsychiatry services, delivered through digital health care services such as Aetna International’s virtual health, or vHealth, not only provide individuals with an opportunity to connect with a medical professional, possibly even one from back home, but also increase access to tailored treatment and support.
And data mining can also help identifying those at risk of experiencing mental health issues. As part of Aetna International’s In Touch CareSM program, clinicians use predictive analytics to find, engage and help members with acute and chronic conditions and mental health concerns.
“Our In Touch Care offering has been designed to offer one-to-one support to vulnerable members and provide ongoing support, ensuring that wherever they are in the world they have quick and easy access to the help they need,” Patel said. “Since this service launched for our Americas’ members, we have seen a decrease in mental health claims costs per member, suggesting that our support may have reduced the frequency of their visits to mental health treatment providers.”
There isn’t a single solution to mental health issues affecting expats, but Aetna International believes a collaborative approach to addressing the issue is crucial. An approach of this nature could not only break the silence, but end the stigma – and ensure that tragedies, like the death of the unnamed American in the Gulf, do not happen elsewhere.