Living and working in Hong Kong can lead to stresses associated with the lifestyle and environment of the city. For example, global research by Swiss banking group UBS has found that Hong Kong residents clocked up the longest working hours anywhere – at 50.1 per week, accompanied by just 17 days of annual leave.
As well as the stresses of working life, there can also be a whole set of domestic challenges in adapting to what will be a very different culture for many people – potentially affecting all family members.
“When you consider that starting a new job and moving house are known to constitute some of life’s greatest stresses, it’s easy to see why being an expat can sometimes be so difficult,” explains Karin Sieger, a London-based psychotherapist who works with expats.
“They are literally having to undergo what would normally be individual experiences all at once. And that’s not counting the impact that taking your children abroad may have – or even choosing to give birth in a foreign country.”
Having previously worked in Hong Kong herself, Sieger, who is accredited and registered with the British Association for Counselling and Psychotherapy, now runs dedicated workshops for expats on the emotional challenges of either coming from or moving to other countries.
Seattle-based therapist Anita Colombara, who spent four years working in Cambodia with an NGO, adds: “Sometimes these challenges can negatively impact an expat’s emotional wellbeing and their relationships with family and friends – or lead them to develop unhealthy behaviours to cope with it all.”
Understanding the issues Expat life: managing stress
While people who may have had problems in the past should think about their wellbeing, Sieger recommends that people who do not usually consider their mental health should also contemplate the probable stress once they make the move.
“People can burn out a lot quicker when they’re living abroad, and expats need to realise that they might not be able to access the same level of support that they could expect at home – even if they’re working for the same employer.”
Colombara, who faced her own mental health challenges when working in Cambodia, realised she was not alone, and set up Remote Access Mental Health on her return to the US – which allows expats to undertake therapy via video conferencing, wherever they happen to be.
Having a support network in place is an integral part of maintaining good mental health, according to Sieger, who underlines that the transient nature of expat life means that it’s essential to keep in touch with a good base of people back home.
“It’s not uncommon for people to want to put a brave face on, in front of what is usually a limited community,” she says, “often for fear of being gossiped about or things getting back to their employer. That makes it all the more important that they maintain some sort of outlet.”
Colombara adds that seeking therapy in such a tight enclave can be awkward.
“Even if there is a professional therapist available, it is very likely they are already acquainted,” she points out, “making professional boundaries difficult to establish. The intimacy of an expat community can also make privacy challenging. However, I would say that the biggest barrier to getting therapy is really the denial that there are issues that need to be addressed.”
Tips for managing stress
Siegel recommends several self-help measures for any expat’s mental wellbeing, while online resources can also help:
- Preserving continuity: If there’s something you enjoy doing – a sport, or certain hobby, for example – then keep doing it!
- Establishing a daily routine: Having something that is known and familiar makes us feel good.
- Learning something new: Try to find a fun activity or pastime that has a direct link to the country you’re in. It will help you feel a connection to the place you’re in and to bring something new to your life.
- Setting some ground rules: Time differences can make it easy to fall into working out of hours. Don’t be tempted just to try and fit in – establish some firm time boundaries, stick to them and keep some quality ‘me’ or family’ time.
- Consider using online counselling, and joining expat forums for tips, advice and contacts for potential support networks.
Available treatments for Expat life: managing stress
If you would like to seek guidance about any mental health issue, Sieger’s advice is to find a therapist who will look at what you want to achieve and outline the processes that you use.
As a rule of thumb, counselling tends to be short- to medium-term, whereas psychotherapy is used for people over a longer time frame.
“In large, cosmopolitan cities such as Hong Kong, mental health services are not normally difficult to access as long as people take the initiative to seek them out,” Colombara says. “My suggestion is to ask an international hospital or primary care doctor for mental health resources. There are also some well-resourced international churches or expat forums that could probably provide some good referrals.”
Expats should also check whether their health insurance policy includes cover for mental health services, to help with access to any professional services and treatments.
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