Potential Decrease in Mental Health for the Vulnerable Post COVID-19

Since the declaration of the Covid-19 pandemic, life seemed as if it ceased to exist for the majority of us. The same daily activities that we took for granted seemed no less than huge feats. Walking to the park, going to the gym, embracing someone, and as little as seeing a person’s face seems like a distant memory. The material impacts of this pandemic, such as the inability of going to the office, losing hours at work, isolation, closure of small businesses, being laid off, and for some not being able to put food on the table has deeply impacted our psyche. The unpredictability, uncertainty, lockdown, lack of physical movement and inability to see loved ones have all led to people in increasing their vices such as alcohol, cigarette, online gambling, and drug consumption.

Needless to say, every country has been affected. Frontline workers such as doctors, nurses, supermarket and retail employees, and mail delivery services have been among those who have been hit the worst, not particularly owing to the loss of jobs but due to the amount of labour they have to do.

A recent study comprising of 1,257 doctors and nurses in China revealed that when the virus was at its apex, half of the population reported depression, 45 per cent reported anxiety and about 34 per cent were diagnosed with insomnia (Jianbo Lai, 2020). The general population in France saw an increase in their smoking consumption by 27% and around 51% reported an increase in alcohol Consumption (Sante Publique France, s.d.). In the United States, 40.9% of respondents reported that they faced at least one adverse mental or behavioural health condition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of trauma- and stressor-related (TSRD) owing to the pandemic (26.3%), and have had started or increased substance use to cope with stress or emotions related to COVID-19 (13.3%) (Czeisler MÉ, June 24–30, 2020).

Until a sustainable solution that seems feasible enough comes through, it seems like we must find new ways to adapt. While telecommunication has been used before, it has reached newer levels now. Many enterprises have tried to implement new and innovative ways of working outside the office. However, it is not always an option.

Companies are decreasing their capital for employing expats throughout the world, but sometimes companies need somebody whom they can rely on in the host country, who possess a level of communication with the senior management and senior leaders back in the HQ. These employees that have been living abroad during the pandemic have been unable to travel owing to the restrictions in mobility.

Being away from family, friends, and their original countries may cause anxiety and depression. Isolation is not the only factor that comes into play in causing dysfunction for expats. Lack of language, lack of social support, and reasons for moving- all affect one’s adaptation within a new environment.

I have been working in the mental health field as an expat myself for over a decade. Working throughout these years with people who have moved from all over the world has shown similarities in the way that people deal with immigrating. Expatriates who may be predisposed to certain vulnerabilities could be in even more trouble during this pandemic.

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As immigrants, parents and children can live in horizons with different cultural contexts, which can be regarded as a source of parent-child arguments and conflicts about friendships, dating, marriage, gender roles, and career choices (A, 2001). Whatever the reason was for moving, there were always certain things in common. I have discovered what I call the “5 Stages Of Transplantation For Expats”. Each stage comes with potential negative consequences.

Excitement stage:

This stage can start before even leaving your country of original residence. People become elated and excited about moving to a new country, depending on the reason for immigrating.

Negative consequences that might appear:

• Not preparing material things before departure i.e packing well, saying goodbyes.
• Learning the local language, finding accommodation in a new country.
• Overwhelmed with the reason for departure i.e falling in love, new job, packing.
• Having preconceived notions about the new place.

Fear/Anxiety Stage:

This stage is after the excitement wears off, the expats start to feel the reality of their situation. They might not have been as prepared for the move as they thought they were. Approximately 3 months – 1.5 years.

Negative consequences that might appear:

• Fear of leaving their homes because of the unknown geographical location.
• The anxiety of speaking to people in another language because of their lack of host country’s language.
• Not being able to understand social graces.
• Not performing well in the new job.
• Tensions with partner/ marital issues.
• Extreme dependency on the partner.
• Lack of social network.
• Increase in drinking, drugs, smoking, eating.

Anger/Resentment:

This stage the expat no longer feels excitement. They still have some anxiety but starts to display anger. Feeling angry about how things function in their new host country. Comparing it to their original country. Lasts approximately from 1.5 to 3 years.

Negative consequences that might appear:

• Having work problems; being unable to complete tasks, socialize with colleagues; compare how things functioned in their last employment.
• Being unable to connect to people in the new culture.
• Having resentment towards their partner for bringing them to a new country.
• Having resentment towards their partner because they are completely dependent on you.
• Criticizing the way the new country functions in bureaucratic, economic, social ways.
• Feeling homesick and wanting to leave. Being hostile, pessimistic, and negative about life

Acceptance and Integration:

The expat is obligated to embrace foreign cultures as equal, even when they conflict with the values and traditions of the original culture. At this stage, the expat has learned enough of the local language to be able to function.

Negative consequences that might appear:

• Feeling lost or homesick.
• Feeling like you are not quite fitting into your new country or you’re old.
• Try to push your opinions or way of life on to others.
• Accepting how things function in new culture and what that means for you.

Assimilation:

At this stage expats accept the ways of their host and become a full part of the community.  Assimilation implies that immigrants, through education and experience, can earn their way into the host culture and be seamlessly accepted as full members of their new community.

Negative consequences that might appear:

• ‘How do I retain my identity?’
• Partner is in a different stage and causes conflict.

There hasn’t been much research published and while it might be too early to predict anything yet, it doesn’t take a genius to say that certain vulnerable groups during the post-Covid-19 era are probably suffering even more. There have been political movements in countries to implement mental health programs but they have been falling short. The Department of Health & Human Service in the United States (SAMHSA) recognizes the challenges posed by the current COVID-19 situation and is providing guidance and resources to assist individuals, providers, communities, and states across the country.

It is important to not neglect mental health. Be it the little things in life like doing yoga, going to the gym, seeing a therapist, trying and finding the small pleasures in life is important.