By Lara Farrar

Almost half of new expatriates leave China early because they have difficulty adjusting to the lifestyle, a consultancy firm said.

China Transition Institute (CTI) president David Israel-Rosen said most foreigners are unprepared for what life will be like when they arrive in China. "It is moving from the West to the East," he said. "It is not like moving from Chicago to Denver."

"If you look at the literature, between 30 percent and 50 percent of expats go home early. The failure rates are astonishing."

Alan Kahn, vice president of marketing and communications for United Family Healthcare, said identity loss and depression are more widespread than many people realize.

"These are very real issues and they do have a significant impact," Kahn said. "It is very hard to ever fit in fully and that can cause lots of serious problems," he said.

Jessa Parkman, a 28-year-old nurse who recently arrived in Beijing from Baltimore said she misses her family and is worried about losing job skills she spent years acquiring if she cannot find a similar position here in Beijing.

"It is very debilitating to be at home and not be so independent," Parkman said. "I just feel very helpless at times and very dependent on other people. It is a struggle to get my bearings."

Last Saturday, Parkman and her husband attended expat boot camp, which is run by the CTI, and offers basic survival training for expatriates.

Cheryl Smith, a psychologist with International SOS China, said spouses of executives who have been assigned to China can have the hardest time adjusting.

"They feel a big emptiness and imbalance," Smith said. "I see a lot of alcoholism with expat women. I see a lot of depression. I see anxiety disorders and lots of marital issues."

"There are many who have marital issues," Smith said. "They don't have enough time with their partner and there are also lots of infidelity issues that I see."

Jasmine Keel, managing director of Inspired, a Beijing-based life and transition support company, said it is important to find an outlet for frustrations.

"It is hard when the spouse used to have a very strong professional identity. Maybe she was working so she had a professional world. Maybe she also had a very strong circle of friends so basically when she moved a lot of the world that she had disappeared," she said.

Helen Zhang, co-author of "Think Like Chinese," which explains Chinese thought and business culture from a Chinese perspective, said: "When you communicate with the Chinese, if you are open-minded and observant, there are clues you can pick up".

"There are many ways for Chinese to say 'no' even including 'yes,'" Zhang said. "We think totally differently."

Israel-Rosen said the CTI would expand the workshop to a week-long boot camp offered in a number of Chinese cities as well as abroad sometime early next year.

"There is nothing fancy about what we are talking about," Israel-Rosen said. ""We are talking about basic survival."