Mental health: what are the warning signs international residents should look out for?

Even today, mental health issues are too often subject to stigma and taboos. If you’re living or working abroad, you can face huge challenges and not know where to turn for help or support.

Mental health: what are the warning signs international residents should look out for?
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The Covid-19 pandemic has shone a light on some issues of stress, loneliness and depression. But it should not need a global crisis to increase awareness of and create more open discussion about such a serious issue.

The Local has partnered with AXA – Global Healthcare to examine how and why people living international lives should pay special attention to their mental health.

Moving abroad to work? Find out more about AXA – Global Healthcare’s international health insurance options

Trouble adjusting? You’re not alone

Following a career overseas as an international worker can be exciting and challenging in equal measure. Multinational workforces are now the norm in most global major cities and businesses increasingly view diversity as one of their biggest strengths.

Yet many people struggle to adapt as they face up to dealing with culture shock, new ways of working, a different language, and being distant from friends and family. If this sounds familiar, you’re far from alone.

One in five employees surveyed in AXA’s 2020 World of Work research¹ experienced mind health difficulties while working away from home. Half said that the biggest impact on their mental health came at the start of their time in a new location.

Mental health challenges faced when working away from home can have a number of consequences, such as work performance issues, increased risk of illness and organizational difficulties. In some cases, this can lead to assignments ending early and missed experiences. 

Working away from home always comes with its own series of challenges, without mental health difficulties compounding the situation. This is why it’s so important not only to monitor how you’re doing, but also be able to have meaningful conversations with your manager if you’re struggling.

This is not always possible. Around two thirds (64 percent) of employees surveyed agreed that their employer could do more to support their mental health and 50 percent said that their employer only offers support in response to a crisis¹. In taking a new position overseas, it’s worthwhile asking what support a potential employer can offer you.

With AXA’s Mind Health service, you can speak to a psychologist from wherever you are in the world².

Know the warning signs

While everybody responds to stress and difficulties differently, there are common signs that you may be struggling. If you experience a number of the following over the space of a few weeks, it’s worth contacting a health professional to talk.

Reflect, reevaluate, recharge

It could be worth monitoring your mood and observing whether there is a discernible dip, or an increase in negative feelings.

There are a number of free apps and online tools, including AXA’s Low Mood and Anxiety Quizzes, that can allow you to track your daily mood over the space of weeks or months. They can also allow you to identify triggers for sudden dips in mood, or anxiety.

If the results of your mood tracking raises concerns about your mental health, your insurer will often have support services to help you rest, recharge and heal. 

AXA, a global leader in health insurance, has multiple levels of cover to suit you at different stages of your life, giving you access to local healthcare professionals and facilities. If you struggle with the local language, and/or prefer to speak to a doctor from where you are, their Virtual Doctor service can do everything from consultations, to prescriptions and referrals to specialists if you need further treatment³. 

Mental health is as important as our physical health, and it deserves the same attention. If you’re in an environment that may lead to increased stress and mental health challenges, it’s worth considering how you can take the best care of yourself and make the most of your opportunities abroad.

Understand the range of insurance options that can help you take care of your health with AXA

1. Research conducted in April 2020 by Savanta. A total of 543 HR decision makers (108 in North America, 105 in the UK, 51 in France, 54 in Germany, 111 in China, 55 in Hong Kong and 59 in Singapore) and 568 non-native assignees (107 in North America, 113 in the UK, 57 in France, 57 in Germany, 116 in China, 60 in Hong Kong and 65 in Singapore) were surveyed.

2. The service provides you with up to 6 sessions with a psychologist, per mind health concern, per policy year.

3.  Appointments are subject to availability. You do not need to pay or claim for a consultation but you will be charged for the cost of the initial phone call when using the call back service. Telephone appointments are available 24/7/365 and call-backs are typically within 24 hours. Video appointments are available between 08.00 and 00.00 UK time, Monday to Friday. Video appointments in German are available between 08:00-20:00 CET, Monday to Friday. Prescriptions are available if medically necessary and are subject to your location.

This article was produced by The Local Creative Studio and presented by AXA.

AXA Global Healthcare (EU) Limited. Registered in Ireland number 630468. Registered Office: Wolfe Tone House, Wolfe Tone Street, Dublin 1. AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland.

AXA Global Healthcare (UK) Limited. Registered in England (No. 03039521). Registered Office: 20 Gracechurch Street, London, EC3V 0BG, United Kingdom. AXA Global Healthcare (UK) Limited is authorised and regulated in the UK by the Financial Conduct Authority.

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Reader question: Can doctors charge a cancellation fee in Austria?

Austrians value punctuality and, naturally, showing up for commitments. If you miss a doctor's appointment, you might be charged a fee. Here's what you need to know.

Reader question: Can doctors charge a cancellation fee in Austria?

Moving to a new country comes with many responsibilities, including learning about specific customs and rules that might not have been common in your country of origin. In Austria, people famously value punctuality and, of course, showing up for your commitments. 

When it comes to doctors’ appointments, you could have to pay a high fee if you fail to show up. So, here’s what you need to know.

Can doctors charge a cancellation fee?

Yes, they are legally allowed to charge a cancellation fee if you don’t show up to your appointment or cancel last minute. The actual cost varies but can’t be higher than €200. 

Each doctor will have a different policy, and not all of them charge a cancellation fee, so check how far in advance you can cancel an appointment without having to pay the fee. Some doctors will also give exceptions, especially if they know the patient is usually punctual and had an unexpected event that prevented them from coming to the scheduled Termin.

READ ALSO: Six things to know about visiting a doctor in Austria

“We understand that something comes up. But then you also have to cancel the appointment. Especially because there is a lot to do at the moment, we have encouraged our colleagues to charge a compensation fee for these last-minute cancelled appointments,” said Christoph Fürthauer, spokesman for physicians in private practice in Salzburg.

Anyone who fails to keep a doctor’s appointment without cancelling in advance is harming not only the doctor but also other patients, Fürthauer added. More often, “repeat offenders” are asked to pay. “For minor things or patients you’ve known for a long time, you’ll be more accommodating. But it’s really up to the individual doctor how they handle it,” he said.

Keep a written confirmation of the appointment

Doctors and doctors’ offices are not infallible, however – neither are the patients. So if you don’t attend an appointment due to a misunderstanding over the date or time of the scheduled meeting, you might have to pay for the fee regardless of whether or not the mistake was yours.

This is almost what happened to Joana, a Brazilian living in Vienna. She said that two days before her first visit to a doctor in the Austrian capital, she got an angry call from the doctor’s office claiming she had missed the appointment and would have to pay a €90 fee.

“It was scary. I barely spoke German and suddenly had this very angry man shouting at me on the phone. I had to hang up because he was being completely unreasonable and wouldn’t lower his voice,” she told The Local.

READ ALSO: Reader question: How to get a flu vaccination in Austria?

“Luckily, I was very insecure about my German and thought scheduling the appointment via email would be best. I went back to check and he had the wrong date; my Termin wasn’t for a couple of days. I replied on the same thread confirming the date again and saying it was very rude to call me like that – but got no apologies, of course.”

This case points out the importance of having a written confirmation of your appointment. Even if many doctors already have online booking offers, many still only reply to phone calls and will only schedule appointments on the telephone. 

If that is the case, send a follow-up email confirming the date and time just to be sure.