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Mental health and living abroad: New data reveals the most common pitfalls

Studying or working abroad is a fantastic experience for many, offering new experiences and perspectives. However, it can also provide significant challenges, especially with regards to wellbeing and mental health.

Mental health and living abroad: New data reveals the most common pitfalls
Living in a new country can be exciting but also daunting. Photo: Getty Images

Many people experience significant challenges to their general wellbeing and mental health when moving to – and living in – another country. This can take many forms, such as:

  • Difficulty accessing medication, particularly medication prescribed in the previous country of residence.
  • Not being able to navigate the local health system to book an appointment.
  • Not being able to find the right ingredients for a vegan or vegetarian diet.

In partnership with AXA Global Healthcare, we take a look at some of the major issues facing international professionals, as well as what can be done to look after health and general wellbeing as an expat.

Difficulties faced

Having moved to Berlin from Saudi Arabia to study and work in HR, Hanan Asgar was excited about the opportunities Germany offered. As she says: “I wanted freedom, respect and equality for myself and my generation.”

However, the combination of being completely new in a foreign country, together with an unfortunate incident in her first few days in her new homeland – about which Hanan had no one to speak to – meant that Hanan began to feel isolated and anxious.

She tells us: “My anxiety grew and I actually ended up locking myself in my dorm room and questioning my choice of moving to Germany. But after some reflection, I realised that it was me who was missing out on the lectures I was avoiding. So I took the courage to step out again and face what was to come.”

Living and working abroad, far from home, can present a number of obstacles. Learn more about how AXA provides mental health and wellbeing healthcare as part of its global health plans 

Hanan subsequently underwent treatment for anxiety and depression with a therapist, and has now been living happily in Berlin for the past six years.

Hanan’s experience with initial culture shock and mental health challenges, while living and working abroad, is shared by many expats. A social listening study conducted by AXA* in 2021, across six popular nations or regions for those living abroad, discovered:

  • Anxiety was the most common difficulty faced by expats in France, the Scandinavian countries and the United Kingdom – 24%, 27% and 32% respectively.
  • Depression was the second most commonly experienced challenge.
  • Those in France were most likely to experience anxiety and depression regarding the consequences of Brexit.
  • Other issues that those in France, Scandinavia and the United Kingdom identified as obstacles associated with living abroad, included dealing with chronic illness (such as living with a condition like diabetes), safety concerns (for example, crime) and stress related to the workplace.  

Exercise can help deal with stress. Photo: Getty Images

Strategies that work 

Fortunately, the AXA study also shows that there are a number of strategies that work when dealing with health and general wellbeing issues. Their study found the following:

  • Building strong support networks and healthy relationships with friends and co-workers was seen as important by expats in all countries.
  • Building strong support networks, as well as spending time on entertainment and hobbies, were particularly important to those living in the United Kingdom
  • Exercise – outdoor, or in a gym – was particularly helpful to those in Scandinavia and France, while those in France reported that they had also had specific success with mindfulness practice and good nutrition.
  • The most effective and useful strategy that AXA discovered, however, was proactive and preventative healthcare, such as accessing a GP or qualified psychologist. 

Discover more ways to look after mind and body while living abroad with AXA and their Mind Health Service 

Seeking out the right health professionals for both body and mind can significantly reduce the levels of anxiety and depression experienced by those living abroad. Regular check-ups can prevent conditions becoming chronic, while discussing mental health and wellbeing can substantially reduce the pressure that many feel. Prevention, as the saying goes, is better than cure.

Hanan Asgar moved from Saudia Arabia to Berlin. Photo: Supplied

Ensuring you have the right healthcare

Finding the right health professionals abroad can be difficult due to language differences, cultural attitudes and varying levels of healthcare. As Hanan reports of her own experience: “I sought professional help and it was quite challenging to find a therapist who spoke English. It took months just for an initial appointment. In the meantime, I would go to an emergency psychological help centre or ask a friend to be around. It all worked out in the end, but it did take a mental toll on me”. 

This is why finding a health insurance provider that offers fast and effective links with health professionals is key. When looking for an insurance plan, consider what AXA has to offer, and the Mind Health Service1 they provide for their customers.

Included with all individual and small business coverage plans, the Mind Health Service provides up to six telephone-based sessions for those covered, in addition to their Virtual Doctor Service2. It’s easy and fast to connect to a qualified psychologist who speaks your language, wherever you are in the world, whenever you need it. There is no extra charge for this service for individual, family or SME customers, it has no impact on your excess and outpatient or policy allowances, and can also be used by anybody who is covered by your plan. 

Living abroad is, for many, the experience of a lifetime. The memories and friendships created can endure long after we’ve returned home. That’s why it’s so important to ensure that the care and support is there to ensure you can keep enjoying your new country.

Ensure that your time overseas is happy and healthy.  Access up to six telephone sessions with a qualified psychologist through AXA’s Mind Health Service, available at no extra charge as part of all individual coverage plans

*Social media listening, commissioned by AXA – Global Healthcare, conducted by Listen + Learn from 2018-21, across six regions: Canada, Dubai, France, Hong Kong, Scandinavia and UK

¹The Mind Health Service is provided by Teladoc Health
²The Virtual Doctor Service is provided by Teledoc Health

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.

Member comments

  1. disappointed of the use of the word “expats” that word is just creating a classist differentiation that shouldn’t exist, and using our privilege to create a gap doesn’t help, we all are migrants, that’s it.

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HEALTH INSURANCE

Why getting rescued in the Swiss Alps could cost you thousands

With holidays just around the corner, many mountain enthusiasts will be heading for the Alpine peaks. An important thing to remember is that even in the summer, accidents can happen and mountain rescue in Switzerland can come at a high price.

Why getting rescued in the Swiss Alps could cost you thousands

It is true that statistically most mishaps in the mountains are related to winter sports — skiing, snowboarding and the like.

About 50,000 accidents a year are recorded in the Swiss Alps each winter, “the vast majority of which are linked to skiing and snowboarding, the two disciplines that also generate the highest costs”, according to Swiss National Accident Insurance Fund (SUVA).

While summer mountain activities seem to be less risky, accidents can — and do — happen nevertheless. Again according to SUVA, such popular activities as base jumping, rock climbing, or hiking on unsteady surfaces can result in accidents.

In fact, the mere fact of just hiking can prove dangerous: every year, some people are attacked by cows while strolling in the mountains. One such case involved two hikers who were knocked to the ground by a cow in Nidwalden — an incident which inflicted bruises and shock on the hikers (the cow was fine).

But you don’t have to be an extreme sports enthusiast or approach cattle to sustain injuries in the mountains — just ask David, a UK national living in Vaud.

In July 2021, David rode his mountain bike near Arosa, Graubünden, when he hit a rock and fell into a metre-deep crack, breaking his foot in the process. Passersby called for help.

“A helicopter came and three people got me out of the ditch, stabilised me ,and airlifted me to the nearest hospital”, he said

The final bill just for the rescue amounted to 3,200 francs.

While it may seem like a steep price for a service that “took one hour tops”, this sum is not exorbitant or even unreasonable.

What you should know

Mountain rescues are generally provided by air ambulance services such as Rega, Air Glaciers or Air Zermatt. All three work on a subscription model, meaning people can become donors, which could, in certain cases, lower the cost of a rescue.

As Rega, the largest of the three services, noted on its website, it can, “at its own discretion and within the bounds of its resources, waive or reduce the costs of any emergency services”.

This was not the case for David who had no subscription, but has taken out one since the accident.

READ MORE: Rega: What you need to know about Switzerland’s air rescue service

Mountain biking can sometimes be dangerous. Photo by Tim Foster on Unsplash

The exact cost of the rescue varies according to three criteria, Rega spokesperson Emilie Pralong told Le Temps newspaper in an interview.

These criteria are “the duration of the mission, the transport costs (pilot, paramedic, helicopter), and the services of the emergency doctor”.

At a rate of around 100 francs per minute of flight, the bill can quickly skyrocket but in the easily accessible mountain area (as was the case for David) ranges from 2,500 to 3,500 francs charged to the patient.

Does health insurance bear at least part of these costs?

Unlike its Alpine neighbour Austria, where public health insurance will pay for mountain air rescue only if the patient is in danger of death, things are a bit different in Switzerland, where health insurance is private.

In Switzerland, the mandatory accident insurance paid by the employer covers the cost of rescues, even if you are not physically injured, according to Moneyland.ch consumer website.

On the other hand, for children, pensioners or people without professional activity, “the compulsory health insurance will cover half of rescue costs up to the maximum amount of 5,000 francs per calendar year,” said Pascal Vuistiner, spokesperson for Groupe Mutuel’s Romandie.

There are also additional insurance policies that will cover unpaid costs, including those incurred abroad, especially as the basic Swiss plan only covers rescues in Switzerland.

For instance, many supplemental health plans include some coverage for search and rescue costs, medical transportation, and repatriation.

Coverage for search and rescue operations is typically limited, ranging between 10,000 and 100,000 francs. Many (but not all) Swiss supplemental health insurance offers include unlimited coverage for ambulance transportation and repatriation to Switzerland for medical care.

READ MORE : Should you buy supplemental health insurance in Switzerland?  

Coverage for search and rescue and/or emergency medical transportation is also part of many travel insurances.

However, “with very few exceptions, coverage for search and rescue operations is limited. Maximum benefits can be as low as just 5,000 francs, or as high as 60,000 francs”, according to Moneyland.

In David’s case, most of the costs of his airlift, surgery, hospital stay and post-op physical therapy were covered by the above-mentioned insurance policies. The only thing hurt in the long run is his pride, as this was the only fall the experienced mountain biker has suffered in his life.

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