Managing Mental Health Abroad

Acculturation stress emerges from conflicts when individuals must adjust to a new culture of the host society. Some of the significant forms of acculturation stress stem from (1) difficulties assimilating to host country’s norms, (2) language barriers, and (3) perception of your identities in host country.

Another source of stress when traveling abroad is homesickness. Homesickness is defined as a longing for one’s home during a period of absence, often including missing family members, friends, pets, home cooked meals, etc. Even the disruption of daily routines can result in homesickness.

Traveling abroad can amplify pre-existing mental health concerns due to acculturation and homesickness stressors. When adjusting to your new environment, heightened stress is especially common during the first few weeks of travel.

False! Homesickness and acculturation stress can affect even the most experienced travelers on the shortest of trips. Even if you have never dealt with mental health concerns, the unique experience of traveling abroad may trigger its development.

Recognize that there will be stressful moments throughout your experience, such as the effects of time zone changes, homesickness, and new environment adjustments. Culture shock is not a psychological disorder but a developmental phase that is expected when one adjusts in a cross-cultural context.

False! Having a particular mental health diagnosis does not mean that your experiences will be less enjoyable. Still, it does mean that you need to be proactive with travel planning to get the most out of the experience while meeting your mental health needs.

• What do you need to successfully manage your mental health and well-being during your travel experience?
• What are the language or cultural barriers you could encounter?
• Do you need to consult a mental health professional in your host country for continued care or to refill a prescription?
• What types of treatment are available to you in your host country?

(See U-M’s Travel Health Preparation Guide for details.)

If you feel comfortable, consider discussing mental health needs with your Study Abroad Advisor. Your advisor can guide you in identifying country-specific concerns and available support options as you develop an individualized strategy for your mental well-being.

• If you anticipate needing accommodations (e.g testing, classroom, assistive technology, etc.), make an appointment with a counselor from Services for Students with Disabilities (SSD) to learn more about the types of accommodations available and receive documentation of accommodation needs for education abroad experiences.
• While not all accommodations are guaranteed while abroad, SSD–in collaboration with study abroad advisors and host country staff–will work to ensure students can make an informed decision about their experience.
• You should discuss potential accommodations early on in your travel planning process so that there is a higher probability that they can be arranged.

• If you currently see a therapist/psychiatrist regularly, determine if this can continue abroad.
• You should have access to several counseling options (See “Additional Resources” section).

• Explore U-M’s Resilient Travel website to learn how to cope with stressors abroad.
• Consider ways you manage stress at home through activities such as daily journaling, regular exercise, meditation, and maintaining regular sleep routines. Develop a plan for prioritizing your mental well-being.
• Talk to your support system members about mutual expectations for keeping in touch while you are abroad

• If you are comfortable disclosing pre-existing mental health conditions with host country contacts, disclosing diagnoses can help your contacts support you in an emergency or be aware of warning signs.
• Find resources such as emergency hotlines and the nearest medical services in your host destination.

Medications legal in the United States might be illegal abroad. Follow these steps to determine access:

• Check the INCB: International Narcotics Control Board, which provides a list of regulations of controlled substances in different countries.
• Contact the U.S. Consulate/Embassy (or your home country’s consulate) in your host country to see if you are allowed to bring specific medications and through what process.
• Fill out the GeoBlue (BCBS Global) Pre-Departure Questionnaire and request to connect with a clinician who can give specific advice about your health needs.

If a medication is legal but not available in your host country, contact your physician if an extended supply of your medication(s) is possible. If this is not possible or if your medication is illegal, consult with your physician about alternative options. This process will take time so pursue this route sooner rather than later

Accommodations & Healthcare Access | Pre-Departure

• U-M Services for Students with Disabilities (SSD) – helps students with determining accommodation options they need to thrive while abroad.
  • SSD Education Abroad Information
  • Schedule an appointment with SSD
• GeoBlue (BCBS Global) Pre-Departure Program – Understand how your health needs can be met by completing a questionnaire and requesting to speak to a clinician.

Self-Guided Support | Pre-Departure & While Abroad

• Togetherall – virtual platform to anonymously seek well-being support from peers.
• Aiberry: mental wellness screening tool

• Remember some stress is normal – give yourself time to adjust to changes and try to remain positive.
• Don’t isolate yourself. Engage with peers and in activities. Connect with your home support system.
• Follow your routines and therapy, if applicable.

• Identify the effects of acculturation stress, such as changes in your behavior, sleep, or appetite, mood fluctuations, and social isolation.
• Practice grounding techniques or breathing exercises.
• Recall coping strategies. What has helped in the past?
• Focus on a manageable aspect of the problem. What do you want to focus on first? Develop a plan of action.

• If you feel paralyzed by stress, can’t control your emotions, depression interferes with your ability to function, or notice these or similar symptoms in a loved one, it may be time to seek additional support and professional care. (See “Additional Resources” section).

• If you are comfortable disclosing pre-existing mental health conditions with host country contacts, disclosing diagnoses can help your contacts support you in an emergency or be aware of warning signs.
• Find resources such as emergency hotlines and the nearest medical services in your host destination.

Medications legal in the United States might be illegal abroad. Follow these steps to determine access:

• Check the INCB: International Narcotics Control Board, which provides a list of regulations of controlled substances in different countries.
• Contact the U.S. Consulate/Embassy (or your home country’s consulate) in your host country to see if you are allowed to bring specific medications and through what process.
• Fill out the GeoBlue (BCBS Global) Pre-Departure Questionnaire and request to connect with a clinician who can give specific advice about your health needs.

If a medication is legal but not available in your host country, contact your physician if an extended supply of your medication(s) is possible. If this is not possible or if your medication is illegal, consult with your physician about alternative options. This process will take time so pursue this route sooner rather than later

Self-Guided Support | Pre-Departure & While Abroad

• Togetherall – virtual platform to anonymously seek well-being support from peers.
• CAPS Stressbusters App – a free app that helps integrate mental health wellness strategies into your life.
• MiTalk – self-help resources on various mental health topics.

Virtual Counseling Options | While Abroad

• Uwill Teletherapy Services – offers students with access to a therapist of their choice via the mode of their choice – video, phone, chat or messaging. (Six sessions at no cost).
• GeoBlue (BCBS Global) Wellness Assist – a telehealth counseling option to address issues related to managing life changes, harassment, anxiety, depression, academic pressure, stress, and more.

In-Person Counseling Options | While Abroad

• GeoBlue (BCBS Global) Travel Abroad Health Insurance – Schedule an appointment (one-time or reoccurring) with a psychiatrist or therapist in your host destination through the GeoBlue (BCBS Global) App or GeoBlue (BCBS Global) website.

Crisis Services | While Abroad

• Emergency number in your host country
• International suicide hotlines
• CAPS After Hours – when CAPS is closed, offers clinical support by a mental health professional to any U-M student or anyone concerned about a U-M student during a mental health crisis situation.

• Home has changed: Changes that have occurred while abroad may impact your ability to readjust to life. You have adapted to another culture and routine, so adjusting to home life may take time.
• You have changed: Sometimes traveling abroad can profoundly affect your perceptions of the world, yourself, your country, and others. It can be difficult to reconcile your newfound and past beliefs.
• Missing your host country: You may feel like you are back in your host country. You may become upset when others don’t understand your experience.