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Mental health: what are the warning signs international residents should look out for?

Even today, mental health issues are too often subject to stigma and taboos. If you’re living or working abroad, you can face huge challenges and not know where to turn for help or support.

Mental health: what are the warning signs international residents should look out for?
Photo: Getty Images

The Covid-19 pandemic has shone a light on some issues of stress, loneliness and depression. But it should not need a global crisis to increase awareness of and create more open discussion about such a serious issue.

The Local has partnered with AXA – Global Healthcare to examine how and why people living international lives should pay special attention to their mental health.

Moving abroad to work? Find out more about AXA – Global Healthcare’s international health insurance options

Trouble adjusting? You’re not alone

Following a career overseas as an international worker can be exciting and challenging in equal measure. Multinational workforces are now the norm in most global major cities and businesses increasingly view diversity as one of their biggest strengths.

Yet many people struggle to adapt as they face up to dealing with culture shock, new ways of working, a different language, and being distant from friends and family. If this sounds familiar, you’re far from alone.

One in five employees surveyed in AXA’s 2020 World of Work research¹ experienced mind health difficulties while working away from home. Half said that the biggest impact on their mental health came at the start of their time in a new location.

Mental health challenges faced when working away from home can have a number of consequences, such as work performance issues, increased risk of illness and organizational difficulties. In some cases, this can lead to assignments ending early and missed experiences. 

Working away from home always comes with its own series of challenges, without mental health difficulties compounding the situation. This is why it’s so important not only to monitor how you’re doing, but also be able to have meaningful conversations with your manager if you’re struggling.

This is not always possible. Around two thirds (64 percent) of employees surveyed agreed that their employer could do more to support their mental health and 50 percent said that their employer only offers support in response to a crisis¹. In taking a new position overseas, it’s worthwhile asking what support a potential employer can offer you.

With AXA’s Mind Health service, you can speak to a psychologist from wherever you are in the world².

Know the warning signs

While everybody responds to stress and difficulties differently, there are common signs that you may be struggling. If you experience a number of the following over the space of a few weeks, it’s worth contacting a health professional to talk.

Reflect, reevaluate, recharge

It could be worth monitoring your mood and observing whether there is a discernible dip, or an increase in negative feelings.

There are a number of free apps and online tools, including AXA’s Low Mood and Anxiety Quizzes, that can allow you to track your daily mood over the space of weeks or months. They can also allow you to identify triggers for sudden dips in mood, or anxiety.

If the results of your mood tracking raises concerns about your mental health, your insurer will often have support services to help you rest, recharge and heal. 

AXA, a global leader in health insurance, has multiple levels of cover to suit you at different stages of your life, giving you access to local healthcare professionals and facilities. If you struggle with the local language, and/or prefer to speak to a doctor from where you are, their Virtual Doctor service can do everything from consultations, to prescriptions and referrals to specialists if you need further treatment³. 

Mental health is as important as our physical health, and it deserves the same attention. If you’re in an environment that may lead to increased stress and mental health challenges, it’s worth considering how you can take the best care of yourself and make the most of your opportunities abroad.

Understand the range of insurance options that can help you take care of your health with AXA

1. Research conducted in April 2020 by Savanta. A total of 543 HR decision makers (108 in North America, 105 in the UK, 51 in France, 54 in Germany, 111 in China, 55 in Hong Kong and 59 in Singapore) and 568 non-native assignees (107 in North America, 113 in the UK, 57 in France, 57 in Germany, 116 in China, 60 in Hong Kong and 65 in Singapore) were surveyed.

2. The service provides you with up to 6 sessions with a psychologist, per mind health concern, per policy year.

3.  Appointments are subject to availability. You do not need to pay or claim for a consultation but you will be charged for the cost of the initial phone call when using the call back service. Telephone appointments are available 24/7/365 and call-backs are typically within 24 hours. Video appointments are available between 08.00 and 00.00 UK time, Monday to Friday. Video appointments in German are available between 08:00-20:00 CET, Monday to Friday. Prescriptions are available if medically necessary and are subject to your location.

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

Reader question: How can foreign doctors practise medicine in Austria?

If you are a doctor moving to Austria, there are a few legal requirements you need to follow before starting your medical practice. Here is what you should know.

Reader question: How can foreign doctors practise medicine in Austria?

Medical doctors are in high demand all over the world, especially as the coronavirus pandemic showed us how much we are short-staffed in the health sector.

In Austria, it’s no different, and the federal government has already announced several measures to attract people to its health sector in the future.

READ ALSO: More pay and longer holidays: How Austria hopes to attract 75,000 new nurses

Among the measures are changes to its Red-White-Red residence permits, those that, for example, allow workers, including in shortage occupations, to immigrate to Austria on a work visa.

Things will get easier for many IT employees, engineers, and tourist sector workers, but in some sectors, including the health one, there are a few more hurdles before starting working.

READ ALSO: How Austria is making it easier for non-EU workers to get residence permits

When it comes to medical activities, even European citizens who already have a right to live and work in Austria might need to go through a process to get their education certified and valid to start a medical practice in the country.

The process will depend primarily on where your training has taken place and what type of medical activity you intend on doing. All details can be found on the Austrian Medical Association (Österreische Ärztekammer).

General requirements for medical practice

In order to take up a medical practice in Austria, every physician (doctor, specialist, or general practitioner) needs to register with the Ärztekammer and meet the general legal requirements.

These include having full legal capacity concerning professional practice, good character and reputation required for fulfilling professional duties, fitness to practice needed for completing professional responsibilities, sufficient knowledge of the German language and legal residence giving access to the labour market.

READ ALSO: Everything foreigners need to know about the Austrian healthcare system

There are also specific requirements that need to be met depending on where your training took place.

Training took place within the EEA or in Switzerland

In this case, the process tends to be a bit easier, and you need to provide evidence of your basic medical training and any specific or specialist training you might have. For that, a diploma for medical study issued by an EEA member state of Switzerland will work.

You can check whether your documents are eligible for automatic recognition in Austria by emailing the Austrian Medical Association at [email protected].

Medical training outside the EEA (but recognised)

If you have had medical training outside of the EEA or Switzerland, but your training has been recognised by one of these states, the rules are also a bit different. You must show evidence of the medical activity and proof of its recognition.

Additionally, you must be authorised to independent medical practice in the country that recognised your education and has at least three years of actual and lawful professional experience in that country to have your training recognised through a non-automatic recognition of third country diplomas process.

You need to contact the International Affairs Team of the Austrian Medical Association ([email protected]) to get more information.

Medical training done in a third country

If you have completed your medical training in a third country and do not fulfil the requirements for a non-automatic recognition (above), you must first have your university degree recognised as equivalent by an Austrian university.

This process is known as Nostrifizierung.

In Austria, the Nostrifizierung procedure is done by the medical universities (Vienna, Graz or Innsbruck) with similar processes. In Vienna, you need to submit an application form, an education history for the comparison between the Curriculum taken and the one offered in Austria, and a possible “random test”.

Among the documents to be submitted in the application process is proof that you have a B2 level of German, a document from the Ärztekammer that you are required to go through the Nostrifizierung process and a confirmation that you paid the €150 fee. You can find a list of all documents you’ll need to submit here.

READ ALSO: Six things to know about visiting a doctor in Austria

The universities will then “investigate” if your education is equivalent to the one offered in Austria. The first step is a curriculum comparison (checking for both content and hours of classes), but they may also carry out a “random test” in some cases.

The test will be in German, but the participants selected will be allowed to use a language dictionary – the test results are only a part of the nostrification process and help the universities assess if the candidate’s training is equivalent to an Austrian one.

After you go through the recognition processes (Nostrifizierung), you can register with the Austrian Medical Chamber.

Registration with the Austrian Medical Association

Before starting medical practice in Austria, every person needs to register with the Austrian Medical Chamber. For this, they will need to send documents including proof of nationality, proof of lawful residence, a certificate of good standing from countries where they have practised medicine for more than six months within the last five years, a criminal record certificate, medical certificate (confirming physical and mental fitness to practice the medical profession) and more.

READ ALSO: EXPLAINED: How the Austrian healthcare system works

The application for registration has to be filed with the Austrian Medical Chamber.

The Medical Chamber of the respective province where you plan to exercise the medical profession is available to further assist with this. You can arrange a meeting with them to clarify general questions about the process.

Here you can find more information.

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