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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

What are Spain’s abortion laws for foreign residents and visitors?

With news that millions of women across the United States could soon lose their right to an abortion, we look at what the abortion laws are in Spain and find out if women overseas can fly to Spain to have the procedure.

What are Spain's abortion laws for foreign residents and visitors?

What happens if you find yourself in a difficult situation and need to terminate your pregnancy because of health or psychological reasons or even personal circumstances? Is it possible to get an abortion in Spain?

Abortion has been legal in Spain since 1985.

The initial version of Organic Law 9/1985 law allowed abortion in three cases: in criminology or rape cases within the first 12 weeks, if the pregnancy posed a threat to the physical or mental wellbeing of the pregnant woman (without a limit) or if the fetus could be born with serious physical or psychological defects within the first 22 weeks of gestation.

Then in 2010, the Law on Sexual and Reproductive Health and the Voluntary Interruption of Pregnancy was approved, allowing any woman over the age of 18 to terminate a pregnancy of her own free will during the first 14 weeks of pregnancy.

Foreign visitors

Spanish abortion law also allows foreigners to travel to Spain and have the procedure done here. Of course, foreign patients must also abide by the law set out above – ie. voluntary abortions are not possible after 14 weeks of gestation, but they can take place up until 22 weeks if there is a serious risk to the health of the pregnant woman or if the fetus has serious abnormalities or an incurable disease.  

Be aware, however, that if you are under the age of 18, you will need your parents’ consent if you wish to terminate a pregnancy.

Foreigners who do not reside in Spain cannot get abortions through the Spanish public health system and will have to pay for it privately instead. This is because they are not registered with the health system and do not pay social security to be able to access it.

Abortion clinic

Is it possible for foreigners to get an abortion in Spain? The short answer is yes. Photo: Scott Olson/Getty Images/AFP

This means that you will have to go to a private clinic or hospital instead. 

There are many private abortion clinics across Spain that are willing to treat foreign visitors, particularly in the country’s big cities, where you’ll be able to find a doctor who can speak to you in English or maybe even your own native language.

According to the latest stats from the Spanish government, there are a total of 207 authorised private abortion clinics in Spain. 

It’s unlikely that your health insurance from your home country will cover for procedures abroad, but it’s best to check with them first. 

If not, you’ll have to pay yourself. Prices for an abortion at a private clinic in Spain start at €300. 

Foreign residents

If you’re a foreign resident in Spain who is legally registered as living here and paying into the social security system, then technically you will be able to receive an abortion for free through the national health service.

However, in reality, this is not always possible as many doctors across Spain refuse to perform abortions, calling themselves “conscientious objectors”.

FOCUS: How women in Spain face barriers despite abortion being legal

So many doctors deny the procedure across the country, that there are 11 provinces in Spain, where no public hospitals have carried out voluntary abortions since the law allowed it in 2010, according to data from the Health Ministry

Furthermore, eight of these provinces have not reported abortions in the past 30 years. 

This means that if you live in Huesca and Teruel in Aragón; Ávila, Palencia, Segovia, Soria or Zamora in Castilla y León; Cuenca, Guadalajara and Toledo in Castilla-La Mancha); and Cáceres in Extremadura, it could be almost impossible for you to get a termination through the public health system.

Across Spain as a whole only 6.20 percent of all abortions, according to the most recent data from the Ministry of Health, were performed in public hospitals. Another 8.12 percent were performed in specialised centres of the public network, while a huge majority (almost 86 percent) were performed in outpatient centres of private clinics.

If you go straight to a private clinic, it’s unlikely that your social security will cover the procedure, however if you go to your public health doctor or gynaecologist first, they may be able to refer you to a private clinic, meaning that social security may be able to cover it. Be aware though, the waiting times will be a lot longer if you do it the second way. 

READ ALSO: Where in Spain is primary healthcare most overburdened?

Last month, Spain announced that it had criminalised the harassment or intimidation of women going for an abortion under new legislation approved by the Senate.

This means anti-abortion activists who try and convince women not to terminate their pregnancies could face up to a year behind bars.

According to the latest Spanish government data, the number of voluntary abortions decreased in 2020 by 10.97 percent compared to the previous year, registering a total of 88,269. 

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