'Expatriate Life': Research Highlights Main Drivers for Employee Mental Health Outcomes on Assignment - AXA Global Healthcare
- Written by: iPMI Global
The latest findings from AXA Global Healthcare's World of Work series highlight where organisations can focus their efforts to close the gap between how they support assignees, and the experience reported by people they send abroad.
The third edition in the World of Work series draws on insights from 689 HR decision-makers and 641 non-native assignees across ten markets, examining what is needed for organisations to keep internationally mobile employees performing their best on assignment. As the expectations of assignees continue to evolve, with demand for personalised, flexible support growing alongside shifting motivations for taking placements, the in-assignment period has become the most complex and consequential stage of the assignment journey.
In-assignment support: the most complex stage of the journey
Once an assignee arrives, a new set of considerations comes with them. For many, the experience is as rewarding and enriching as they’d hoped, yet beyond the logistical pressures of settling in, other challenges can emerge. Strain on the family unit, feelings of isolation and other mental health pressures can develop as assignments progress – and these instances are harder for organisations to plan for and even trickier to spot. Assignees need both preventative support to reduce the likelihood of these pressures taking hold, and personalised, responsive provision to address them if they do. As Sebastian Judez, Head of Proposition and Medical at AXA Health International, notes: "The in-placement stage of the assignment journey is not static. It shifts as people settle into new environments, navigate challenges and build lives abroad, and the most effective support responds to these changes.".
How benefits are structured is one area where responsiveness can be sharpened. One in five assignees are still on a fixed benefits package with no ability to adapt what they receive, and 45% say that benefits vary by seniority rather than need. This points to a clear gap between flexible, needs-based provision and what many assignees currently experience. Closing that gap may require a more individual approach.
The frequency of benefit reviews can impact effectiveness here, too. Those reviewed every six months are linked with notably better wellbeing outcomes, with 88% of assignees in that group reporting positive wellbeing compared to 69% of those reviewed annually. Regular reviews are not just an operational consideration; they are a way organisations can demonstrate that their support is genuinely responsive.
The same opportunity for individual tailoring shows up in how assignees experience mental health support. Three in four describe their employer's policies as proactive and innovative - yet two thirds still believe more could be done. The research points to a consistent difference between what HR decision-makers say they provide and what assignees say they receive, with differences up to 21 percentage points in cases such as the availability of expat support groups and buddy systems. This suggests the opportunity lies less in adding provision, and more in ensuring that support is personalised and accessible for those receiving it.
That need for personalisation carries through to how support is delivered. For many assignees, virtual mental health provision works well, and 86% of HR decision-makers are planning to increase investment in this area over the next two years.
However, two thirds of assignees still prefer in-person support, particularly those on long-term placements. That preference is significant given that 37% say hybrid working has contributed to feelings of loneliness and disconnection. For an assignee already navigating isolation, the value of face-to-face support should not be underestimated. The strongest provision is that which gives people the choice.
The role of family in assignee wellbeing
Of all the factors that shape mental health on assignment, the family situation is often the most significant. The research shows that those living apart from their loved ones pay a higher price in terms of their wellbeing. These assignees are 47% more likely to suffer with their mental health than those who relocate with their families. This is a direct causal relationship, and one that makes family provision as much a mental health consideration as a logistical one.
The personal health toll of separation extends further still:
- 46% say separation has strained their relationships, a 15% rise since 2020
- 35% say their overall wellbeing has been affected
- 27% report their physical health has worsened as a direct result of living away from family
As with mental health support more broadly, the picture on family provision points to an opportunity to do more. Only 38% of organisations extend family wellbeing support to all assignees. There is also a 22% gap between what assignees expect in terms of family support and what they currently receive. And where support does exist, awareness remains low: over half of HR decision-makers say they provide travel costs home and extended leave to see family, yet only two in five assignees know these options are available.
Closing these gaps is made harder by the nature of the challenge itself. Unlike the practical difficulties of family relocation, which are visible and easier to plan around, the strain of separation tends to be hidden and managed privately. Without regular, personalised engagement, what begins as an invisible strain can escalate into something that takes a real toll on the individual, which can ultimately affect performance or prompt an early return.
There is a clear business case for getting this right. With the average cost of an international assignment having risen 58% since 2017, organisations that treat the family dynamic as a performance variable and design their support accordingly are the ones best placed to protect that investment. But the human case is just as compelling. Behind every assignment is a person navigating an experience often as demanding as it is rewarding, and the support they receive should reflect that.
Sebastian Judez said: “Keeping people brilliant on assignment does not happen by accident. It happens when employers treat that stage of the journey with the same strategic focus they bring to their many other commercial objectives. In return, organisations will see stronger retention, higher performance, and a greater return on the considerable investment that every international assignment now represents.”
