Mental Health Abroad
Frequently Asked Questions
I’m currently working with a counselor. What should I consider when discussing study abroad and my mental health needs?
It is extremely important to discuss your plans to go abroad with your treatment professional. Traveling abroad presents unique challenges that can heighten current symptoms. While it’s very exciting to think about studying abroad, keep in mind that moving to a different country for an academic term means the loss of a support network, a routine, and a familiar environment. Particularly if you are taking any new medications, it is important that you reach a stable condition for a period of time before leaving to go abroad.
While it may be disappointing or difficult to make changes to your previously laid out plans, it is much easier to make changes to your study abroad plans while you are still in the U.S. than waiting until you are abroad. Postponing or adapting your study abroad plans may be what you need to do to best take care of yourself. All of these things are important to consider and discuss with a mental health professional when considering study abroad.
Can I work with a mental health professional in the U.S. while I’m abroad, either via phone or email?
Long-distance contact, via e-mail or telephone, typically does not provide adequate information for professional evaluation. In addition, licensing laws and liability insurance in the U.S. may not cover psychotherapy practiced across international lines. We strongly encourage you to find a mental health professional in your host country, rather than relying on service providers in the U.S.
Will I have access to a local mental health professional while I'm abroad?
Finding resources and establishing your support system is an important thing to do before you go. All Northwestern study abroad students are required to purchase HTH Worldwide health insurance, as well as register with International SOS, a safety and security company. Both HTH and International SOS have mental health professionals available by phone 24/7, and will also refer students to local mental health professionals. If you are hoping to continue counseling sessions while abroad it is highly recommended that you work with HTH and/or your family's insurance company, your study abroad program and Northwestern to confirm an arrangement ahead of time. For more information about HTH Worldwide and International SOS, see Useful Links.
I’m currently taking medication prescribed by a psychiatrist; can I keep taking this while I’m abroad? How do I get a refill?
If you are taking a prescription medication, talk with your prescribing physician well in advance about getting the supply you need for going abroad. You can also contact HTH Worldwide insurance to find out if your medication is available abroad. You will want to bring an adequate supply in the original container, and a prescription with your physician's explanation of the condition and the generic and brand names of the medication and dosage information. Check with the embassies of the countries you expect to visit to make sure your medications are not illegal there. For more information visit http://www.miusa.org/ncde/tipsheets/medications/.
Can I have my parents send me refills of my medication?
Do not plan on sending medications abroad since it will require customs paperwork and may be delayed in delivery. For more information about prescription medication abroad, watch this video:
If I disclose my mental health history to my study abroad adviser, program director or other administrator, will this jeopardize my ability to participate in a study abroad program?
Students with pre-existing mental health conditions will not be discriminated against in the application or approval process. Any information shared with the Study Abroad Office, other university personnel or program staff will be used to assist you in making the best decision about your study abroad plans. We strongly encourage you to disclose your mental health history if you plan to study abroad, as this will only help to ensure that you have a safe and successful experience.
Will my health insurance cover mental health treatment while I am abroad?
All study abroad students purchase HTH Worldwide insurance before going abroad, which does cover some mental health treatment abroad. It is important to contact them ahead of time to confirm that your treatment needs will be covered. You should also check with your regular policy to see if it provides the coverage you need for medical services abroad, and whether your plan pays providers directly, or requires you to pay and seek reimbursement. Pay close attention to benefits relating to pre-existing conditions, prescription drugs in more than a 30-day supply, and mental health coverage for seeing psychologists or counselors.
Before You Go
Although the state of one’s mental health is essentially a personal matter and a personal responsibility, we urge you to be open with study abroad personnel about your pertinent health history, including mental health, and areas of potential vulnerability. Disclosing mental health information helps you plan with others so that you can be assured the necessary support will be in place when you go abroad.If you are currently involved with mental health services, you should discuss the advisability of participating in a study abroad program, and issues related to cultural adjustment, with your mental health practitioner. You may determine that based on your current symptoms, postponing or making adjustments to your plans is necessary in order to best take care of yourself.
If you are taking a prescription medication, bring an adequate supply in the original container, and a prescription with your physician's explanation of the condition, as well as the generic and brand names of the medication and dosage information. Check with the embassies of the countries you expect to visit to make sure your medications are not illegal there.
Be sure to review potential side effects of your medications with your provider, as your body may react differently because of adjustment to new sleep habits, time zones, activities, and diet.
Do not plan on sending medications abroad since it will require customs paperwork and may be delayed in delivery. Maintain your usual dosage and pattern of taking your medication while you're abroad. Be sure to consult with your physician prior to making any changes to your dosages. Consult with your physician about any necessary adjustments to your dosage due to significant changes in time zones.
Remember that while you may see your mental health concerns as something “in your past”, preparing for and actually participating in this new experience may bring about a return of symptoms or increased depression and anxiety. Since it is always easier to prevent or respond to difficulties if they have been anticipated ahead of time, speaking with a medical or mental health professional before you leave will allow you to prepare coping strategies and appropriate treatment options. Contact your current providers or Counseling and Psychological Services (CAPS) for support prior to your departure and/or to discuss your readiness to study abroad.
Mental health support services vary worldwide and you may not have access to mental health services in some countries. If you anticipate needing support services while abroad, it is essential that you do some research before you go in order to know if, what, and where those services are available in your host country. For more information about mental health abroad, watch this video:
While You’re Abroad
Culture Shock
Culture shock is a normal developmental phase of adjustment to a new cultural environment. Culture shock occurs when one’s values and typical ways of viewing the world clash with the values and viewpoints of the new culture.
- Helpless
- Out of control
- Vulnerable
- Fearful
- Anxious
- Confused
- Sad
Keep in mind that any situation entailing a high level of stress can cause unusually strong emotional reactions and can interfere with effective functioning. Often times culture shock can exacerbate previous symptoms. There are occasions when the experience of culture shock can stir up deeper emotional issues. It is extremely important that you share your reactions with others and seek support immediately.
While it may be tempting to find other U.S. students who share your frustrations about your host culture, it is important to find a balance between gaining support from other U.S. students and establishing new friendships with host country residents who can help explain the reason behind some of the customs/behaviors you might find troubling. This will help you make healthy adjustments abroad. Working through culture shock can be a valuable growth experience – one that strengthens identity and intercultural competence.
Other important things to consider during this time of adjustment:
- Be sure to physically take care of yourself, including getting regular and sufficient amounts of sleep and food, even if it is difficult re-establishing a consistent schedule because of jetlag.
- Give yourself permission to feel bad. Negative feelings are normal, and you should process these emotions, rather than just pushing them away and failing to address the issue.
- Don’t make any big life changes while abroad. Just make observations while you’re still figuring out how your new life experiences fit into the culture and life experience you were familiar with before studying abroad. It will likely take more than a month before you’ve settled in well enough to determine whether lasting priorities may have shifted because of your study abroad experience.
How do I know if I need to see a mental health professional while I’m abroad?
If you are currently working with a therapist/psychiatrist, discuss this before you go. Some signs to look for that may indicate the need for professional support include, but are not limited to:
- Heavy alcohol or drug use
- Not getting out of bed
- Staying in a room alone
- Changes in eating habits such as eating excessively or very little
- Avoiding friends
- Not attending classes or marked decrease in academic performance.
What should I do if I am in crisis?
Anytime you are in a crisis situation abroad, or feel your health and/or safety is at risk, you should first contact your study abroad program director and/or the local emergency services. If they are unavailable, HTH Worldwide health insurance and International SOS both have mental health professionals available to you 24/7. You should carry the contact information of your onsite director and ID cards for HTH and International SOS with you at all times so that you have access to these numbers. ID cards are given to all study abroad students prior to departure.
When You Return
While many are aware that there will be adjustments when first arriving in a new culture, sometimes people overlook the fact that similar adjustments are necessary when returning home. New ideas, friendships, and experiences gained overseas will change, and you will return home with a variety of new perspectives. While you have probably made some progress in integrating these changes into your life while studying abroad, you now have a new task of determining how to integrate these changes into your life at home.Just as with the process of leaving home, returning home can create a stressful or novel situation that increases the chances of exacerbating past mental health symptoms or triggering new physical, cognitive, social, or emotional reactions. It is normal to have reactions when determining how your new perspective and new experiences fit into your life at home.
You may experience any of the following:
- Fatigue
- Sleeplessness
- Crying
- Bad dreams
- Difficulty concentrating or making decisions
- Sadness
- Guilt
- Anger
- Loneliness
It is important to know that these reactions are normal, but could lead to isolation if you do not make the effort to re-connect in your home country or are not proactive in seeking out support. Talking through your reactions with a CAPS counselor or other mental health professional may be a good way to ensure that you have a safe place to process your reactions and check in about your mental well being.
Useful Links
Northwestern Counseling and Psychological Services (CAPS): The services that CAPS offers are designed to assist students, mainly through individual and small group interventions, in overcoming obstacles and in achieving their academic and other personal developmental goals. The staff also emphasize with students the importance of taking time to take care of their emotional and psychological health and to find balance in their lives.
HTH Worldwide: The safety and well being of University employees and students who travel outside the United States for University-related activities is of paramount importance. To best meet the medical needs of those who travel abroad, Northwestern University requires all study abroad students to obtain health insurance from HTH Worldwide. HTH has mental health professionals available by phone 24/7, and will also refer students to local mental health professionals.
International SOS: This free service provides students with access to an array of health, safety, and other travel information as well as the ability to sign up for email alerts. Information entered into your Personal Travel Locator will be available to International SOS and Northwestern on-call staff should you need to be located in a crisis or emergency. International SOS has mental health professionals available by phone 24/7, and will also refer students to local mental health professionals.
