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 | While You’re Abroad | When You Return | Questions | Useful Links

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 symptoms 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 reasons 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 badly. 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 figure 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:

As part of the on-site orientation, we expect that participants will be given information about locating local contact numbers for agencies and organizations that deal with crisis issues such as assault, rape, suicide, alcohol and drug abuse counseling, depression, etc. On Kalamazoo programs we ask our Resident Directors to include this in the materials students receive at orientation. If participants need help in one of these areas while abroad, we hope he/she will seek it out. In addition, the CIP urges participants to talk with the Resident Director or a staff member at the program. These are highly personal issues and it is difficult to talk to anyone about them. The Kalamazoo Directors have experience in helping students through tough times.

In cases of crisis, the counseling center here at the College is available to the participants via Skype or email. Local contacts are another good option. If a study abroad participant is the victim of an assault and battery, sexual assault or rape, we encourage participants to inform the Resident Director and the local authorities in addition to seeking help and counseling from a crisis center or other professional.

Carry the contact information of your onsite director, CIP staff, K College Counseling Center, and insurance cards with you at all times so that you have access to these numbers.

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 you, 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 on studying abroad, you now have the 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 means the loss of a support network, a routine, and a familiar environment. If you are taking any new medications, it is particularly 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 Skype, phone or email?

The Counseling Center at Kalamazoo College may be available to assist you if you are experiencing a crisis or mental health emergency. However, long-distance contact, via Skype, email or telephone, typically does not provide adequate information for professional evaluation and using these modalities can make providing adequate care quite challenging. 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?

Students are encouraged to be vigilant about their mental and emotional health while abroad. Some study abroad sites have resources available for on-site counseling in English. Students are encouraged to contact CIP staff during the orientation process if they have specific concerns about availability. The Counseling Center at Kalamazoo College may also assist in this process. Resident Directors have information available upon request about local doctors, clinics, and programs available to Kalamazoo students.

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 your insurance company 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.

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 CIP, 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 students participating in study abroad are required to have hospitalization and medical insurance that is valid outside the United States. This covers hospitalization and other related costs in a catastrophic event. Students should contact their insurance provider for details about what is covered outside of the United States. For students who need coverage while on study abroad, there is a plan available through Kalamazoo College. Many doctors and hospitals in the U.S. require only that you present a policy number at the time of service. This is not the case abroad: regardless of what insurance you have, students will be expected to pay all medical bills themselves at the time of service. However, this is generally much less expensive than in the U.S. U.S. insurance companies will not pay directly overseas. Students will have to get itemized statements and present them to the insurance company so that they can be reimbursed for medical expenses. Students should check with their health insurance companies for further information on the type of documentation required.

Kalamazoo College Counseling Center: Services include individual and small group interventions.

HTH Worldwide Health Insurance: HTH has mental health professionals available by phone 24/7, and will also refer students to local mental health professionals.

Prepared by Kenlana Ferguson, Ph.D., LP K College Counseling Center