One in four: mental health is becoming the next major employer challenge in the Dutch Caribbean

Aruba, Bonaire and Curaçao are known for sunshine, tourism and hospitality. Behind that image, a less visible reality is growing: mental health problems are becoming more common, and a growing number of employers are dealing with them directly. What was long considered a private matter for the employee is quickly becoming a factor that affects teams, organisations and entire sectors.

One in four adults

Regional figures leave little room for doubt. According to the Caribbean Public Health Agency (CARPHA), approximately one in four adults in the Caribbean will experience a diagnosable mental health condition at some point in their life. Depression and anxiety disorders are the most common diagnoses. At the same time, a large proportion of people who need help go untreated: an estimated 60 percent receive no appropriate care.

Mental health conditions are therefore not a marginal issue, but a significant part of the regional burden of disease. This affects not only individuals and their families, but also economies that rely on human contact, services and tourism.

Bonaire as a concrete example

On Bonaire, the effects are already clearly visible. Mental Health Caribbean, which is responsible for mental healthcare in the Dutch Caribbean, reports that the number of clients on the island has risen from approximately 250 in 2018 to 1,021 in 2023. That amounts to roughly five percent of the population. According to the organisations involved, this increase is linked to demographics, social issues and the fact that people are becoming better at finding their way to care.

The demand for help is also increasing among young people. Caribisch Netwerk previously reported that more young people on Bonaire are independently seeking help for mental health problems, and that an estimated 250 young people are in need of mental healthcare. This group is on the threshold of the labour market or has only just entered it.

Youth research: little optimism

A regional study by CARICOM and UNICEF on mental health among children and young people confirms this picture. More than 1,500 young people from 17 Caribbean countries and territories completed a questionnaire on depression, anxiety and wellbeing. Of these, 58 percent report feeling little optimism about the future. More than half report persistent worry, low mood or depressive feelings.

For the Dutch Caribbean islands, with their small labour markets and heavy dependence on young workers, these are telling figures. Employers will increasingly encounter young employees who are motivated on one hand, but who are starting out with greater mental vulnerability than previous generations on the other.

Tourism and the service sector under pressure

The very sectors that dominate Aruba, Bonaire and Curaçao place high demands on people. Tourism, hospitality, retail and public services run on flexibility, customer-friendliness and emotional labour: smiling at the front desk, staying calm on the phone, dealing with impatient or angry customers. Research in the region shows that job insecurity, irregular schedules and tensions with guests are associated with higher levels of stress and depression among employees.

On small islands, there is an added practical problem. Teams are small and good staff are hard to replace. When someone is absent, the extra pressure falls directly on colleagues and managers. As a result, mental health problems can spread through an organisation like an oil slick, even before there is any formal long-term sick leave.

Culture and Brua: a different language for the same complaints

Beyond the figures, culture plays an important role. Research into Brua, the Afro-Caribbean religious and healing tradition on the ABC islands, shows that a significant proportion of patients do not view psychological complaints solely as a medical problem. In an exploratory study, over 70 percent of the patients examined said they believed in Brua, and approximately one third attributed their own complaints partly to it.

Many people are reluctant to discuss this with healthcare providers, for fear of being misunderstood. In daily life, mental health problems are often described differently: heavy thoughts, pressure in the head, poor sleep, quick to anger, or simply being "tired of everything". For employers, this means complaints can remain invisible for a long time, hidden behind short-term absences, conflicts or declining performance.

What employers are noticing

All of these developments converge in the workplace. For employers in Aruba, Bonaire and Curaçao, this means concretely that mental health is no longer a side issue. Psychological complaints increase the risk of absenteeism and staff turnover, put pressure on the quality of services, and place extra demands on colleagues who have to take over tasks. This is particularly true for small organisations, where every absent employee is immediately felt.

Added to this is the fact that employees will not always express their problems in medical terms. Those who only look for the label "burnout" or "depression" will miss the signals that precede them: someone who becomes quieter, is more frequently absent for short periods, becomes more easily irritated, or conversely becomes noticeably withdrawn.

The workplace as the first line

Meanwhile, the islands are working to strengthen the care side. In 2024, the Dutch Caribbean Mental Health Federation was established, in which Respaldo (Aruba), GGZ Curaçao and Mental Health Caribbean collaborate on improving care and sharing knowledge. But the front line remains the workplace itself: hotels, schools, government, shops, healthcare institutions and transport companies.

That is where problems first become visible, where work pressure, personal worries and financial stress collide, and where early intervention is possible if there is room for an honest conversation. Those who take this seriously look not only at production figures and schedules, but also at what those figures do to the people who carry out the work day after day.

No longer a question of whether, but when

Regional figures show that one in four adults in the Caribbean will experience a mental health condition, and that the demand for help on Bonaire has risen sharply in a short period of time. Combined with the outcomes of the CARICOM–UNICEF study among young people, the conclusion is clear: virtually every employer in the Dutch Caribbean already has mental vulnerability in their team, or will soon.

The question is therefore no longer whether employers need to take mental health into account, but how quickly they recognise that it is part of good employership and business continuity. Those who act in time are more likely to retain staff, prevent absenteeism and maintain service quality. Those who wait until something goes wrong often find that the resilience of their team has already been exhausted.

About the author

Harald Linkels is an organisational psychologist with over thirty years of experience in the field of personnel and labour on the Dutch Caribbean islands and in the wider region. He is co-founder of the Caribbean Institute of Psychology, which focuses on the further professionalisation of psychological care and research in the Caribbean.