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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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OPINION & ANALYSIS

OPINION: Anti-abortion activists in Switzerland are just posturing with latest hollow move

As women’s reproductive rights are on the verge of being drastically eroded in the United States, Switzerland is witnessing the launch of two parallel popular initiatives seeking to restrict access to abortion here, writes Clare O'Dea.

OPINION: Anti-abortion activists in Switzerland are just posturing with latest hollow move

This is pure posturing by anti-abortion activists. It is obvious they can’t win the popular vote – the last time there was a vote on abortion in 2014, 80 per cent voted to leave the current regime unchanged – but Swiss campaigners still want to remind the public of their dissent. 

If they hurt women along the way, perhaps that’s acceptable collateral damage for them. Or perhaps that’s the whole point. The initiatives were launched together in December 2021 and the signature gathering deadline is in June 2023.   

All these campaigners achieve by dragging abortion onto the public agenda is piling additional stress and guilt on women who are going through a personal, in some cases heartbreaking, healthcare dilemma. Perhaps the rationale is that this extra pressure would have a deterrent effect. 

Switzerland was one of the first European countries to legislate for abortion in 1937, allowing abortion when the woman’s health was in danger. The cantons were free to decide how strictly to interpret the law and this led to a patchwork of abortion services across the country. 

Women ended up needing to travel inside the country to access abortion right up to 2002 when voters accepted the new abortion law allowing unrestricted access to abortion in the first 12 weeks of pregnancy. The law set conditions for abortions after this point. 

Reader question: Is abortion legal in Switzerland?

The first of the two initiatives is the ‘Save viable babies’ campaign to stop late-term abortions unless the mother’s life is in danger. This would apply to pregnancies from 22 weeks gestation where the foetus could potentially survive outside the womb with medical support. 

The second one is the blandly named ‘Sleep on it’ initiative, seeking to impose a one-day waiting period before allowing women and girls to access abortion treatment. Both sets of signatures are being collected together “for synergy reasons”. 

Three Swiss People’s Party (SVP) parliamentarians are behind the campaigns, including two women, Andrea Geissbühler and Yvette Estermann. They got nowhere in parliament with similar proposals which is why they are taking them to the people. No political party supports either initiative. 

Of the total of some 11,000 pregnancy terminations performed in Switzerland each year, approximately 95 per cent are carried out by the 12th week in accordance with the so-called time-limit regulations. 

Only a very small proportion of all terminations take place at an advanced stage of pregnancy. Some 150 terminations per year are performed after the 17th week of pregnancy. The ‘Save viable babies’ campaign is targeting pregnancies terminated from 22 weeks gestation onwards. There are an estimated 40 such cases per year. 

Just to be clear, the campaign wants the whole country to vote on the fate of 40 women per year going through a terrible personal crisis along with their distressed families. 

OPINION: Switzerland’s denial of voting rights to foreigners motivated by fear

The Swiss National Advisory Commission on Biomedical Ethics published an opinion on the practice of late termination of pregnancy in 2018. Here’s what they had to say about these 40 cases annually. 

“The reasons and circumstances underlying advanced pregnancy termination are many and varied. Almost always, the women concerned find themselves in a situation beyond their control, posing a moral dilemma. The need for a decision, and the consequences thereof, can have a lasting impact on the women and their families. Accordingly, the primary ethical principle is that all options need to be jointly considered, with empathetic and careful support being provided for the people concerned.”

Those options include what is called palliative birth for babies with serious conditions who will die at birth or shortly afterwards. 

Guess what, collecting signatures for 18 months for a popular initiative banning late term abortions is the opposite of empathetic support. It exacerbates the suffering involved. But this is a mindset where nothing is more important than the life of the foetus, least of all the parents’ suffering. 

The number of abortions carried out in advanced pregnancy has remained virtually unchanged over the last ten years. Forty out of 11,000 is not very many, but the fact that these situations arise every year represents a sad fact of life. 

EXPLAINED: What happened after Swiss women got the right to vote in 1971?

Meanwhile the ‘Sleep on it’ initiative seeks to introduce a one-day wait between contacting a doctor and receiving the treatment. In three-quarters of cases this means a prescription for abortion pills. 

The one-day wait seems like a spurious and hollow demand. It is normal to think before you go to the doctor for any procedure. I have no doubt that when a woman asks a doctor for an abortion, she has already thought about it – for days if not weeks. She doesn’t need to go through an extra sleepless night to satisfy anyone.   

We know that the best way to reduce the number of abortions is either to reduce the number of unintended pregnancies – through information and services – or to significantly improve the material situation of women, for example income, housing, safety or job security. These factors already contribute to Switzerland’s low abortion rate

But the anti-abortion activists famously concentrate on the least effective tool – banning abortion or making access difficult. 

As an Irish citizen born in the 1970s, I came of age in a country that enshrined the right to life of the unborn in the constitution in 1983, which is what the ‘Save viable babies’ initiative seeks to do. That constitutional ban took a terrible toll on Irish women and girls for 35 years until it was repealed.  

This constitutional ban affected not only abortion services but maternal care in Ireland, with unnecessary suffering and risks imposed on miscarrying women by doctors afraid of breaking the law, as is now being seen in Poland.  

What we know about Swiss abortion is that it is safe, legal and rare. In an imperfect world, this is as good as it gets, no matter what the purists say.

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