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Living abroad: how can you assess your mental health?

Mental health has been in the global spotlight in 2021, from attempts to understand the wider impact of the pandemic to sporting superstars withdrawing from prestigious competitions. 

Published: 15 December 2021 13:17 CET
Updated: 4 September 2023 15:17 CEST
Living abroad: how can you assess your mental health?
A woman feeling under stress at work. Photo: Getty Images

Competing as an elite athlete may seem far removed from your everyday working life. But the increasing willingness of many athletes, celebrities, and even royalty to talk openly about their personal mental health challenges has wider societal implications. 

After moving abroad, it can be difficult to deal simultaneously with an unfamiliar culture, different ways of doing things at work, and a new language. If you moved shortly before or even during the pandemic, things may have been even more challenging for you; you may have been working mainly from home with few chances to meet colleagues, and feeling the distance to family in your home country more than ever.

If you feel concerned about your mental health while living abroad or during an overseas assignment, what should you do? The Local has partnered with AXA – Global Healthcare to offer some guidance for individuals and examine why employers have a crucial role to play.

Working abroad? With AXA’s global health plans, you can speak to a psychologist from wherever you are in the world1

Making mental health a bigger priority

Depression affects more than 300 million people globally, with more than 260 million living with anxiety disorders2, according to the World Health Organization (WHO). The cost to the global economy is around US$1 trillion each year. Furthermore, WHO says that mental health problems can “seriously exacerbate” physical illness. Despite the scale of the problem, countries spend less than two percent of their national health budgets on mental health on average, says WHO.

But are attitudes changing and will mental health eventually be given equal billing with physical health? The reasons for companies to make the mental health of their employees a top priority keep growing. 

Steps to take if you’re feeling low

Opening up about your mental health can be uncomfortable. If you’re feeling low, you may feel you just need to somehow carry on regardless. But it’s important to know that early intervention has proven more effective than trying to continue as feelings of stress or anxiety build up.

So, what should you do if you want to get a realistic assessment of your mental wellbeing? Rather than waiting for a crisis, you can turn to online tools, such as AXA’s LowMoodQuiz and AnxietyQuiz, to honestly assess your state of mind. Such tools are intended to help you as you deal with everyday stresses and strains, not only when a major event occurs.

A young man crying in his workplace. Photo: Getty Images

What if you know you’re struggling and feel the time has come to seek help? Here are three different ways you could start a meaningful conversation with your manager, according to AXA – Global Healthcare:

  1. Be proactive – look for opportunities to regularly check-in with your manager, whether through digital communications or telephone. Could you set aside 30 minutes at the start and end of each week to reflect on your achievements together and discuss any challenges? 
  2. Use a mood scale – actively and regularly reflecting on your mood can help you recognise and flag times when you might need support from your manager. Making use of online tools like the quizzes above could help you.
  3. Ask questions – encourage your manager to share details about the support available to help you maintain good mental health. Fearful of asking for help? You shouldn’t be. Do you have the option, for example, to speak confidentially to a trained professional, whether face-to-face or by phone or video chat?

Your employer’s role

AXA suggests managers can look out for signs that an employee could be struggling with their mental health. If you have a benefits package, your employer or manager could also share details of the support available through that, such as confidential ‘virtual therapy’ by phone or video call. As a global leader in health insurance, AXA has multiple levels of health cover to fit your needs, giving you access to local healthcare professionals and facilities.

If you’re a member with a global healthcare plan, you can use AXA’s Virtual Doctor service³ to confidentially discuss anything you like. If it’s mental health support you need, they’ll refer you to the Mind Health service, to speak to a fully qualified psychologist.

Find out more about how AXA – Global Healthcare can support you

1. The service provides you with up to 6 sessions with a psychologist, per mind health concern, per policy year. Available with a healthcare plan from AXA – Global Healthcare.

2. Research commissioned by AXA found that anxiety and depression were among the top health and wellbeing concerns for expats.

3. The Virtual Doctor and Mind Health services are provided by Advance Medical (a Teladoc Health company).

This article was produced by The Local Creative Studio and presented by AXA.

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.

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

Published: 23 April 2024 12:55 CEST
How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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