Loss and grief in Australian cross-cultural missionary aid workers on re-entry: A mixed method study

Re-entering cross-cultural aid workers experience reverse culture shock with over 40% suffering psychological distress and of these, 80% suffering depression. General Practitioners (GPs) are often the first point of contact for their care in Australia and the UK, The aim of this study is to explore the issues of loss and grief on re-entry for these workers.

Surveys and semi-structured interviews were undertaken with adult Australian cross-cultural workers (n=15) who were missionaries in non-Western countries for two or more years and who had re-entered Australia.

Nine out of fifteen participants experienced grief and all experienced disenfranchised grief. Grief and depression scores were associated. Multiple varied losses, disenfranchised grief and re-activation of past grief were significant themes. Doka's five types of disenfranchised grief and Kauffman's self-initiated disenfranchised grief were represented in the sample. A sub-type of self-initiated disenfranchised grief was described. Theories were generated about the linkage between these themes, the occurrence of psychological distress and the role of the GP.

Psychological distress in the re-entry adjustment of cross-cultural workers is a significant problem. GPs need to have knowledge of their loss and grief issues to manage and prevent complications and to make appropriate referrals.