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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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COVID-19 VACCINES

Italy’s constitutional court upholds Covid vaccine mandate as fines kick in

Judges on Thursday dismissed legal challenges to Italy's vaccine mandate as "inadmissible” and “unfounded”, as 1.9 million people face fines for refusing the jab.

Italy's constitutional court upholds Covid vaccine mandate as fines kick in

Judges were asked this week to determine whether or not vaccine mandates introduced by the previous government during the pandemic – which applied to healthcare and school staff as well as over-50s – breached the fundamental rights set out by Italy’s constitution.

Italy became the first country in Europe to make it obligatory for healthcare workers to be vaccinated, ruling in 2021 that they must have the jab or be transferred to other roles or suspended without pay.

The Constitutional Court upheld the law in a ruling published on Thursday, saying it considered the government’s requirement for healthcare personnel to be vaccinated during the pandemic period neither unreasonable nor disproportionate.

Judges ruled other questions around the issue as inadmissible “for procedural reasons”, according to a court statement published on Thursday.

This was the first time the Italian Constitutional Court had ruled on the issue, after several regional courts previously dismissed challenges to the vaccine obligation on constitutional grounds.

A patient being administered a Covid jab.

Photo by Pascal GUYOT / AFP

One Lazio regional administrative court ruled in March 2022 that the question of constitutional compatibility was “manifestly unfounded”.

Such appeals usually centre on the question of whether the vaccine requirement can be justified in order to protect the ‘right to health’ as enshrined in the Italian Constitution.

READ ALSO: Italy allows suspended anti-vax doctors to return to work

Meanwhile, fines kicked in from Thursday, December 1st, for almost two million people in Italy who were required to get vaccinated under the mandate but refused.

This includes teachers, law enforcement and healthcare workers, and the over 50s, who face fines of 100 euros each under rules introduced in 2021.

Thursday was the deadline to justify non-compliance with the vaccination mandate due to health reasons, such as having contracted Covid during that period.

Italy’s health minister on Friday however appeared to suggest that the new government may choose not to enforce the fines.

“It could cost more for the state to collect the fines” than the resulting income, Health Minister Orazio Schillaci told Radio Rai 1.

He went on to say that it was a matter for the Economy and Finance Ministry, but suggested that the government was drawing up an amendment to the existing law.

READ ALSO: Covid vaccines halved Italy’s death toll, study finds

The League, one of the parties which comprises the new hard-right government, is pushing for fines for over-50s to be postponed until June 30th 2023.

Prime Minister Giorgia Meloni had promised a clear break with her predecessor’s health policies, after her Brothers of Italy party railed against the way Mario Draghi’s government handled the pandemic in 2021 when it was in opposition.

At the end of October, shortly after taking office, the new government allowed doctors, nurses and other healthcare professionals to return to work earlier than planned after being suspended for refusing the Covid vaccine.

There has been uncertainty about the new government’s stance after the deputy health minister in November cast doubt on the efficacy of Covid-19 vaccines, saying he was “not for or against” vaccination.

Italy’s health ministry continues to advise people in at-risk groups to get a booster jab this winter, and this week stressed in social media posts that vaccination against Covid-19 and seasonal flu remained “the most effective way to protect ourselves and our loved ones, especially the elderly and frail”.

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