It is estimated that one in four young people experience some form of severe psychological distress – most commonly depression, anxiety and/or stress. Going to university occurs at a time of immense change and personal development, and studies have found that levels of mental distress are higher for university students compared to the general population. The situation may be even worse for international students and students participating on an overseas program, who are outside of their comfort zones and away from familiar support networks.
With increased awareness and the prevalence of mental health conditions growing amongst students, including a heightened frequency of mental health cases of students who identify as LGBTQIA+, we at CISaustralia recognise that this is a matter to be taken seriously. Australian universities are also taking mental health on as a university-wide responsibility and increasing proactive action and support, rather than reactively responding to a serious incident.
A growing focus on student mental health is important to break the stigma and silence around these topics. Yet, while there is an increase in reporting and documented cases, not all those who experience psychological distress have access to quality care. Travellers especially are often unable to access adequate emergency psychiatric care when away from their own physician and support system, and the availability of culturally compatible mental health services varies widely from country to country.
Below are some steps and tips to keep in mind as you consider an overseas program and prepare for going abroad with a mental health condition. At any time, the team at CISaustralia (both on-site and in the Gold Coast Head Office) are here to answer your questions and provide support – 24/7. Please Contact Us if you’d like to start a conversation.
- Know yourself. Every traveller is unique. What affects you may not affect others in the same way, so it’s important to think ahead of time about the factors that could affect your health while travelling. Doing some research prior to travel and thinking about your triggers may help ease and minimise risk levels when abroad. Some factors to consider and discuss with your physician include sleep levels, diet, in-country support, life events occurring at the same time, work and academic situation, financial events, reason for travel, type and length of travel, travel destination and environment, culture shock and medications, plus if any new medications are required for the destination country such as anti-malarial drugs, which may have psychiatric effects.
- Ensure you’re fit for travel. Talk with your family GP or mental health care provider about your travel plans and any concerns you may have. It’s important to get a good assessment of your suitability to travel, especially following any changes in medication, a recent illness, hospitalisation or major life events.
- Be prepared. Start packing early. Make sure you pack all your prescriptions, have enough dosages and keep emergency contact details easily accessible. Make a checklist ahead of time and cross items off as they are packed. Keep anything you need during your flight(s) in your carry-on bag and think about coping strategies you may want to use while travelling in advance: breathing techniques, meditation, journaling, regular contact with loved ones… you know what tools help you best. We recommend you bring something comforting that reminds you of home or that you associate with happiness in case you encounter times when you just need something familiar to help you cope.
- Check the country’s embassy (or with a physician who specialises in travel medicine). Determine ahead of time whether you can travel with your exact medication to your destination and what documentation you’ll need for customs. Some medications may not be allowed in another country; you may need to get an equivalent medication that is accepted if this is the case.
- Bring documentation for customs. Carry your medication in their original containers and be sure to pack enough to last your entire trip plus a few days in case your plans change or there are travel delays. Refills may not be available if you run out. Have a letter from your doctor clearly stating any pre-existing medical conditions and what medication you are prescribed and authorised to travel with. Valid medical evidence is also good to have on hand in case you need to go to a health professional while travelling.
- Maintain a routine. Travelling can disrupt your regular routine, but it’s important to monitor your medication intake and ensure you take your regular doses at the correct times and frequency. Try to eat and drink healthy, get good sleep and exercise. You may also find it comforting for your inner peace to continue following your regular prayer routine or religious or spiritual practices. It may not always be possible to follow exactly the same prayer routine, e.g. visiting a church or your preferred place of worship; however, local CISaustralia staff can assist and will be well informed about local institutions and places to meditate, practice yoga or just a quiet place to contemplate. Keeping the mind and body well balanced while overseas can be challenging, but the more you stick to a healthy routine, the more your mind will thank you in the long run.
- Find a trusted person. It’s okay to share your condition with someone you trust. Confiding in a friend or trusted person (such as the program’s CISaustralia Site Director) about the basics of your mental health status and what to do in an emergency situation can be a smart thing to do. You don’t have to tell everyone if you are not comfortable, but having a trusted person that will help look out for you may give you peace of mind. And don’t forget to trust and believe in yourself too!
- Take care after your return home. Notice any changes that may have occurred in your health post-travel. Reverse culture shock after returning home can sometimes be harder to adjust to than the initial shock of being in a new culture. Take note of higher-than-normal levels of stress or other mental symptoms and talk to your doctor.
Mental Health Resources
See the Australian Government’s Smartraveller website for more information for Australian travellers with mental health conditions.
You can also find useful resources with the International Association for Medical Assistance to Travellers (IAMAT), including topics related to Travel and Mental Health.
The following websites and service providers offer support, information and resources for a variety of mental health conditions:
- beyondblue: Information and support to help everyone in Australia achieve their best possible mental health, whatever their age and wherever they live
- Black Dog Institute: Online self-help tools and apps that can be accessed from anywhere via desktop, mobile or tablet 24 hours a day
- Butterfly Foundation: Support for eating disorders and negative body image
- Head to Health (Australian Government): Find the right Australian digital mental health resources
- Headspace: National youth mental health foundation dedicated to improving the wellbeing of young Australians
- Lifeline: 24/7 crisis support and suicide prevention services
- MensLine Australia: National telephone and online support, information and referral service for men
- Mental Health Online: Internet-based treatment clinic for people with mental health conditions
- MindSpot: Online assessment and treatment for anxiety and depression
- On the Line: Professional social health business that provides 24/7 telephone, web chat and video counselling support, anywhere and anytime
- QLife: Australia’s first nationally-oriented counselling and referral service for people who are LGBTQIA+; provides nation-wide, early intervention, peer supported telephone and web-based services
- ReachOut: Practical support, tools and tips to help young people get through anything from everyday issues to tough times
- SANE Australia: Mental health awareness, online peer support and information, stigma reduction, specialist helpline support, research and advocacy
- Suicide Call Back Service: 24 hour, nationwide service that provides free telephone, video and online counselling
- THIS WAY UP: Online courses clinically proven to help take control of your wellbeing; free and anonymous ‘Take a Test Tool’
- Batyr@Uni: Structured peer-to-peer programs, student leadership training, staff training and on-campus events to increase awareness to mental health resources
Depression
While everyone feels sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time and sometimes without any apparent reason. Depression is more than just a low mood – it’s a serious extended condition that affects one’s physical and mental health.
Signs and Symptoms
You may be depressed if, for more than two weeks, you feel sad, down or miserable most of the time, or have lost interest or pleasure in usual activities. You may have also experienced several of the following signs and symptoms across at least three of the following categories:
- Behavioural – not going out anymore, not getting things done at work/school, withdrawing from close family and friends, relying on alcohol and sedatives, not doing usual enjoyable activities, unable to concentrate
- Physical – tired all the time, sick and run down, headaches and muscle pains, churning gut, sleep problems, loss or change of appetite, significant weight loss or gain
- Feelings – overwhelmed, guilty, irritable, frustrated, lacking in confidence, unhappy, indecisive, disappointed, miserable, sad
- Thoughts – I’m a failure, It’s my fault, Nothing good ever happens to me, I’m worthless, Life’s not worth living, People would be better off without me
It’s important to remember that we all experience some of these symptoms from time to time, and it may not necessarily mean you’re depressed. Equally, not everyone who is experiencing depression will have all of these symptoms.
Anxiety
Anxiety is more than just feeling stressed or worried. While stress and anxious feelings are a common response to a situation where we feel under pressure, they usually dissipate once the stressful situation has passed, or ‘stressor’ is removed.
Anxiety is when these anxious feelings don’t go away and aren’t easily controlled – when they are ongoing and happen without any particular reason or cause. It’s a serious condition that makes it hard to cope with daily life.
Signs and Symptoms
Symptoms of anxiety are sometimes not obvious as they often develop slowly over time and, given we all experience some anxiety at various points in our lives, it can be hard to know how much is too much. Normal anxiety tends to be limited in time and connected with some stressful situation or event, such as a job interview.
The type of anxiety experienced by people with an anxiety condition is more frequent or persistent, not always connected to an obvious challenge and impacts on their quality of life and day-to-day functioning. While each anxiety condition has its own unique features, there are some common symptoms including:
- Behavioural – avoidance of situations that make you feel anxious which can impact on study, work or social life
- Physical – panic attacks, hot and cold flashes, racing heart, tightening of the chest, quick breathing, restlessness, feeling tense, wound up, edgy
- Psychological – excessive fear, worry, catastrophising, obsessive thinking
These are just some of a number of symptoms that someone with anxiety might experience.
Sources of Support
If left untreated, depression and anxiety can go on for months or even years. The good news is there are a range of treatments available, as well as things people can do on their own to recover and stay well.
Different treatments work for different people. If you are seeking treatment, it is best to speak to your physician or a mental health professional about your options and preferences. You can also try a few of the following ideas for lifestyle changes and social support. Most people find that a combination of tactics work best.
It’s important to remember that recovery can take time. Just as no two people are the same, neither are their recoveries. Be patient and go easy on yourself.
Maintaining a Healthy Lifestyle
Staying well is about finding a balance that works for you, but there are some general principles that most people find useful.
- Maintaining a healthy lifestyle – Eat a healthy, balanced diet, do some form of regular physical activity and get a good night’s sleep. It can also be useful to cut back on alcohol and drugs. It may help to have a friend or family member keep you accountable to help you stay active.
- Reducing and managing your stress levels – Make time to do something relaxing, satisfying or enjoyable each day, even if you initially feel you can’t be bothered. It’s also important to deal with any setbacks and keep trying.
Learning About your Condition
As with any health condition, the more you learn and know, the better able you will be to work out what is right for you. It’s important to learn the facts using reliable sources of information such as the beyondblue website, pamphlets and booklets. A number of other organisations provide useful information. It may be worth talking to your doctor or mental health professional about what you have read to make sure it is accurate and reliable.
Support Groups and Online Forum
Support groups for people with depression and anxiety can provide an opportunity to connect with others, share experiences and find new ways to deal with challenges from others who may have had similar experiences as you. Contact your local community health centre or the mental health association/foundation in your state or territory to find your nearest group, or try searching online.
Some people prefer to seek and offer support or share their stories via online forums. You can visit the Australian Government’s Head to Health website to find trusted communities.
Relaxation Training
Relaxation training calms your body and mind, which in turn helps to reduce anxious thoughts and behaviour. It may also help you feel more in control of your mind and body.
There are several different types of relaxation training, such as breathing exercises that teach you how to slow down and regulate your breathing, or progressive muscle relaxation which teaches you how to tense and then relax specific groups of muscles. Another type of relaxation training involves thinking of relaxing scenes or places. Relaxation training can be learned from a professional or done by yourself.
Free recorded instructions are available online. There are also a number of apps that focus on relaxation and mindfulness – search the Apple Store or Google Play and see what works for you.
Family and Friends
The people close to you can play an important role in your recovery by providing support, understanding and help, or just being there to listen. It can be hard to socialise if you are experiencing anxiety or depression, and many people tend to withdraw or avoid social contact. But spending time alone can make you feel lonelier and cut off from the world, which in turn makes it harder to recover.
It is important to try to get out and spend time with your family and friends. Keep saying ‘yes’ to social invitations – even if it’s the last thing you feel like doing. If you don’t feel like talking and interacting, try an activity where you don’t have to make conversation, like watching a movie or playing a sport.
It can help to talk about how you are feeling with someone who is caring and supportive. Even if you are not looking for support, it can still be helpful to let family and friends know what you are going through, so they are aware. This can help them to better support you.
Staying connected improves your wellbeing and confidence, and doing some physical activity has the added bonus of helping you keep fit and tackle stress.
Recovery and Staying Well
Recovery is a unique and individual process that everyone goes through differently. However, there are some common emotions, or stages of recovery, that many people may experience:
- Shock at having to deal with something difficult and scary that you have no prior experience of
- Denial or difficulty in accepting having a mental health condition, particularly one that many people find hard to understand
- Despair and anger at having to deal with the condition and its related difficulties
- Acceptance of having a condition and the changes it brings, and accepting how others see you and how you see yourself
- Coping by finding new ways to live with and tackle these changes and challenges
Recovery goes beyond focusing on managing distressing symptoms; it is also about having choices and being able to create a meaningful and contributing life. Remember to focus on what you want and why you want it, don’t be afraid to work for it while giving yourself room for setbacks, and seeking help when it’s needed.
Training and Professional Development
CISaustralia is committed to ongoing professional development in the area of mental health. Between December 2016 and January 2017, all CISaustralia staff attended a training package on ‘Mental Health First Aid’ provided by Patricia Contente – Licensed Social Worker and Certified Trainer for Mental Health First Aid. The three sessions formed part of an extended training package to provide staff with a greater insight into mental health challenges and how to best approach and assist our students.
Additional References
- IvyPanda: Study Abroad Stress: The Complete Guide for International Students
- Student Travel and Study Abroad: Mental Health Issues and Awareness – U.S. perspective by Prof. Robert L. Quigley, MD, D.Phil., International SOS, and Dean Hoski, Assistant Vice President, Accident & Health Division, Chubb North America
- NAFSA: Addressing Mental Health Issues Affecting Education Abroad Participants edited by Barbara Lindeman
- IEAA: Mental Health and International Students: Issues, Challenges and Effective Practice by Dr Helen Forbes-Mewett
- English Australia: Guide to Best Practice in International Student Mental Health
- Universities UK: Going international and supporting mental health needs
- University of South Florida Counseling Center: Mental Health Wellness Abroad
- The PIE News: Mental health concerns for 35% int’l students
- The PIE Blog: International students & the power of imagery to address mental health
- The PIE Blog: A slice of happiness: making international students feel at home
- ABC News: Mental health concerns increasingly common among young Australians
- Mission Australia and the Black Dog Institute (PDF Download): Can we talk? Seven year youth mental health report – 2012-2018
