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Mental Health Abroad

Whether you are currently being treated for mental health concerns or if you see them as something in your past, you should know that preparing for and participating in this new experience can bring about a return or increase in symptoms.

Since it is always easier to prevent or respond to difficulties if they have been anticipated ahead of time, use this guide to prepare for mental health considerations and services abroad.

Before You Go

Although the state of one’s mental health is a personal matter and responsibility, we urge you to be open with your study abroad adviser about your pertinent health history, including mental health, and areas of potential vulnerability. Disclosing mental health information helps you plan with others so that the necessary support will be in place when you go abroad.

Determine if study abroad is a good fit.
If you are currently involved with mental health services, 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.

Bring prescription medications abroad.
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.
  • 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. Consult with your physician about any necessary adjustments to your dosage due to significant changes in time zones.

Research mental health services in your host country
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, do some research before you go. Determine if, what, and where those services are available in your host country.

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. 

Typical reactions to culture shock include feeling:

  • Helpless
  • Out of control
  • Vulnerable
  • Fearful
  • Anxious
  • Confused
  • Sad

Keep in mind that any high stress situation can cause unusually strong emotional reactions and can interfere with effective functioning. Culture shock can also exacerbate previous symptom or stir up deeper emotional issues. It is extremely important that you share your reactions with others and seek support immediately.

Establish 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.

Tips for adjusting to a new culture

  • Take care of yourself physically, 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. It will take time to figuring out how your new life experiences fit into your previous culture and life experience.

Determining if you need professional support
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

Remember, you know yourself best and should seek out assistance when needed.

Dealing with a crisis situation
Anytime you are in a crisis situation abroad, or feel your health and/or safety is at risk:

  • 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 can also contact Northwestern for any emergency.

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

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. Read more about reverse culture shock and re-entry strategies.

Frequently Asked QuestionS

1. 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, 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. rather 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.

2. 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. Find a mental health professional in your host country, rather than relying on service providers in the U.S.

3. Will I have access to a local mental health professional while I'm abroad?
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.

4. 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 Mobility International’s medications tipsheet

5. 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. Watch this video for more information about prescription medication abroad.

6. 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.

7. 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.

Useful Links