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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Urgent care: How to access non-emergency medical care in France

Whether you're a resident, tourist or second-home owner, here's what to do if you need non-emergency medical care while you are in France.

Urgent care: How to access non-emergency medical care in France

You might be curious what to do in France if you’ve ever suffered from a stomach virus that hangs around a little too long, wondered if you’ve came down with a case of strep throat, or worried about a minor allergic reaction.

Obviously if you have a major medical event you should either visit a hospital urgences (Emergency Room) or call an ambulance (more on how to do that below) – but if your problem is not quite an emergency but still something that you need help with, there are several options.

Here are the services available and how they can be accessed by French residents, tourists and second-home owners.

SOS Médecins

This is the ’emergency doctor’ service and will connect you with a general practitioner, available 24/7. You can use it if you’re a visitor to France, you’re on holiday in a different part of France, you’re not yet registered with a doctor or simply if your own doctor is not available (either because it’s out of normal hours or your doctor is on holiday).

SOS Médecins is most known for their house-calls, as they will come directly to your home to give you a consultation. However you can also visit their local office or request a téléconsultation (online appointment). In either case, the person you see is a doctor and they will be able to diagnose you and prescribe medication, as needed. 

The SOS Médecins website gives three options: make an appointment by calling (the number is 3624), make an appointment online, or walk-in for a consultation (hours will vary for this depending on the location).

When making your appointment, you can request an English speaking doctor, but it is not guaranteed you will get one. 

When calling to make the appointment, you will need to know your département number, your phone number, the patient’s first and last name, the exact address (including the building code, floor, and any other relevant apartment-specific information), the reason for the call, and the age of the patient.

Cost – SOS Médecins varies in price depending on the time of day and location (whether the consultation is at the centre or at your home). For a house-call on holidays, weekends, and nights you can expect the fee to range between €50 to 80, which may be in part reimbursable by Assurance Maladie if you are registered in the French medical system.

Maisons Médicales de Gardes

These are community health centres that are intended to stay open after working hours and on the weekends. They are intended to ease the burden on emergency room by offering a place for people with non-life threatening emergencies to go outside of normal operating hours.

You can look online to see the closest Maison Médicale to you, or you can call your regular doctor and listen to their voice machine – usually they will list your after-hours options. For more information, you can visit this website.

Before walking up to the centre, you can call to allow the operator to assess your situation and give you a recommendation regarding whether you need emergency treatment or whether you can be treated at the Maison Médicale.

Cost – you can expect to pay between €40 to €60.


Pharmacists in France are highly qualified (it takes between five and seven years to complete the training) and by law all pharmacies must have at least one qualified pharmacist on the premises.

Although they cannot prescribe medication, you can go to a pharmacy with a minor medical problem, to ask advice or for treatment for less serious injuries, or to get over-the-counter medication such as cough syrup or painkillers. You can visit on a walk-in basis and there is no need for an appointment.

If the pharmacist cannot treat you, they will tell you whether you need further assistance from a doctor or whether your medical issue is urgent enough to warrant an ambulance or trip to the hospital.

If you suspect you have Covid-19, you can get a test at a pharmacy. For strep throat or tonsilitis (une angine), you can ask for a rapid test (TROD or Test Rapide d’Orientation Diagnostique) at any pharmacy. If it is a positive result for bacterial strep, then you’ll be referred back to a primary care doctor in order to get a prescription for antibiotics. This test is covered by Assurance Maladie if you are registered in the French system.

READ MORE: How to get the flu vaccine in France

You can find a ‘pharmacie de gard‘ (a 24-hour pharmacy) by also going on the SOS Médecins website and using their locator tool.

Cost – Seeking the assistance of a pharmacist is free, but if they recommend medication or treatment, you will likely have to pay, although some treatment types are reimbursed if you are registered in the French health system. 

Make a doctor appointment

Oftentimes, foreigners or tourists do not think they can make an appointment with a general practitioner in France if they do not have a carte vitale or are not registered in the French healthcare system.

In fact, anyone can make an appointment to see a French doctor, there is no need to be registered with them. One of the easiest ways to do this is by going to the website Doctolib and signing up for an appointment.

On Doctolib, you can see the medical professional’s qualifications and languages spoken, so you can filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

On the Doctolib website, you can set a preference for Aujourd’hui (today) or Dans les prochains trois jours (In the next three days), and you can also set your motif de consultation (type of consultation) to an online appointment, if you are not looking to make the trip to the doctor’s office (not all doctors offer these).

Cost – Everyone who visits a doctor in France is expected to pay, the standard rate is €25. If you are registered in the French medical system part of the cost will be reimbursed through your carte vitale.

If you are a tourist or second-home owner you may be able to claim the cost back on your health or travel insurance, depending on the policy.

If you are still in the process of registering for your carte vitale be sure to ask for a feuille de soins – this is basically a receipt, and when you get the card you can claim back medical costs incurred while you waited using the feuille de soins.

When booking the appointment, check to see whether the physician is ‘Secteur 1’ or ‘Secteur 2’ – this will determine if they are allowed to charge additional fees. A sectuer 1 doctor must apply the basic rate set out by the medication convention. For a GP, the fixed price is €25.

For an emergency 

If your situation is a life-threatening emergency, you should seek immediate assistance.

READ MORE: Emergency in France: Who to call and what to say

Call 15: You will be put in contact SAMU who provides ambulances and emergency medical care. 

Call 18: You will be put in contact with the fire department (les pompiers) who are trained to provide emergency medical assistance.

Call 112 (or 114 for people with hearing and speaking difficulties): This is the EU-wide emergency phone number. You might be more likely to reach someone who speaks fluent English on this line. 

Cost – emergency medical treatment is open to everyone including visitors. If you go to the hospital and receive treatment without being admitted, you will be charged a one-off fee of €18.

If you are admitted to hospital you may have to pay, depending on the treatment you receive and the nature of the problem – more details here.

Although hospitals will ask for your carte vitale as standard, you can still receive treatment if you don’t have the card.