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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

Reader question: Are there limits on bringing medicines into Italy?

Over-the-counter painkillers can be surprisingly expensive in Italy, and some brands of medicine that visitors use back home aren't available in Italian pharmacies. So what are the rules on bringing medicines in from outside the country?

Reader question: Are there limits on bringing medicines into Italy?

Question: I’m moving to Italy for a few months and planning on bringing some painkillers with me, as I’ve heard they cost a lot more over there. Does Italy have rules on how much I can bring?

Basic pharmaceuticals can cost considerably more in Italy than in countries like the US or the UK.

For example, a box of 20 paracetamol will set you back around five euros on average in Italy, while a pack of 16 pills of the same painkiller in the UK costs 49 pence, or 57 centesimi. In Australia, a box of 20 paracetamol caplets will set you back around $3.49 (€2.30) and in the US there are much bigger savings to be made on larger-size packs, which are not available in Italy.

It’s not just headache pills: cold and flu tablets, lozenges and antihistamines are all often significantly more expensive in Italy than in many other countries.

With these kind of price differences, it’s understandable that visitors would want to save money by bringing their own medication over from abroad.

So what are the rules on bringing pharmaceuticals into Italy – and why are they so pricey in the first place?

Why are pharmaceuticals so expensive in Italy?

In essence, Italy has a powerful pharmacists lobby that raises strong objections at the slightest sign of market liberalisation.

Italy has strict rules in place governing the number of pharmacies that can operate in a given area based on the number of people living there, as well as around transfer of ownership, with many pharmacies simply being passed down to the next generation. While the system may not exactly be a monopoly, in the past it’s certainly seemed not far off one.

The passage of the Bersani law in 2007 relaxed the rules slightly, allowing basic over-the-counter drugs like painkillers to be sold outside of pharmacies for the first time; and a 2012 decree increased the number of drugs that could be sold in those venues without a prescription.

But that doesn’t mean you can just waltz into a supermarket, swipe a couple of packets of ibuprofen off the shelves next to the washing up liquid and the toothpaste and walk out with them for less than the price of a cappuccino, like in the UK.

Parafarmacie or ‘parapharmacies’, drug stores that were introduced in the wake of the Bersani law, are allowed to sell a limited range of over-the-counter drugs along with health and beauty products – but still require a pharmacist to administer the transaction.

Basic pharmaceuticals are often considerably more expensive in Italy than in other countries.

Basic pharmaceuticals are often considerably more expensive in Italy than in other countries. Photo by JACK GUEZ / AFP

The same rule applies in supermarkets, where medicines must have their own dedicated counter that is manned at all times by at least one qualified pharmacist.

This means it’s not unheard of to end up spending 50 centesimi per pill for a basic headache drug like paracetamol, and sometimes even more. According to a 2016 survey, buying drugs at the supermarket as opposed to other venues offered savings of around 10 percent – not exactly life-changing.

READ ALSO: How to get a coronavirus test in Italy

The rules on bringing medicines into Italy from abroad

For controlled substances – that includes drugs like Adderall and Valium, which are considered narcotics in the EU – Italy’s rules are fairly strict.

You’ll need a prescription along with an official certificate stating the country and place of issue, the issuing authority, the prescribing physician and patient, and the dosage.

With these types of drugs, you’re also only allowed a 30 day supply – so if you’re in the country for longer than this, you’ll want to bring extra prescriptions from your doctor that will allow you to top up your medication in Italy for the length of your stay.

As for over-the-counter pharmaceuticals and non-narcotic prescription medicines, Italy doesn’t appear to have any clear published rules on importation for personal use. 

READ ALSO: Italy’s transport mask rule extended to September as Covid rate rises

Other EU countries such as Sweden and Finland allow travellers coming from outside the Schengen area to bring a three-month supply of these kind of pharmaceuticals, so it’s safe to assume that similar limits will apply in Italy.

The Local has sought confirmation from the Italian authorities as to the legal limit of over-the-counter medication that can be brought over from abroad.

If you do find yourself needing to buy basic painkillers and other drugs at an Italian pharmacy or parafarmacia, remember to ask for the generico (generic) version. 

You’ll usually be automatically handed a branded version as it increases the pharmacy’s mark up, so asking for the generic version could save you a good few euros.

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