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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:

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?
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.
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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Explained: How dangerous are French heatwaves?

A recent report highlighted the potential risks to athletes’ health if this summer’s Paris Olympic and Paralympic Games take place during a heatwave. The report, backed by climate scientists and athletes, warned of the potentially fatal risks of high temperatures at this year’s Games.

While most people are unlikely to be trying to break a 100m record during a heatwave – or any other time in fact – high temperatures bring with them serious risks to health.

Mercury rising

Any temperatures in France are getting higher, the country has endured a series of record heatwaves in recent years.

The all-time temperature record for Paris is 42.6C, set during a heatwave in 2019. It’s entirely possible this record won’t last long – 2022 was the hottest year on record in France, with a record 33 days meeting officially defined heatwave conditions: five in June and 14 in both July and August.

Vérargues, in the southern Hérault département, holds the highest recorded temperature in France – 46C set on June 28th, 2019.

The highest national average temperatures in France were recorded later in the year: August 5th, 2003, saw an average national temperature of 29.47C, followed by July 25th, 2019, when the average daily temperature was 29.4C.

And remember – air conditioning is not standard in French homes.

Health risks

There is no question that heatwaves can be fatal – some 400 people died in France in a two-week heatwave in August 2023 when new local temperature records were set around the country, according to public health data.

Over the whole of last summer, some 5,000 excess deaths were recorded between June 1st and September 15th, 2023, of which 1,500 were attributed to the heat.

Over the same period, nearly 20,000 heat-related emergency calls were recorded, according to a report by Santé Publique France published in February this year, and 10,600 additional hospitalisations followed a visit to the emergency department during periods of high temperature.

The risk is highest among the elderly or people with chronic health conditions, but also at risk are outdoor workers and people exercising – including hiking – during the hottest part of the day.

The government issues weather warnings – ranging from yellow (be aware) to red (potential risk to life) during heatwaves and we would strongly advise people to take notice and follow the advice, even if you come from a hot country.

Climate trends

And it seems that the situation is not going to get better soon, even if the response has improved.

“By the end of the century, heatwaves will be more frequent, more intense, and spread over a period from May to October,” warned France’s Haut Conseil pour le climat (High Council for the Climate) in a report in 2021.

Around 80 percent of the French population will experience 16 to 29 abnormally hot days each year over the three decades to come, as climate change takes hold according to a 2022 study by national statistics institute Insee – with Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté and Occitanie the most affected regions.

It estimates that more than 9 million people will have to endure more than 20 extremely hot days each year in the years to come. Nighttime temperatures will also rise, with some areas seeing up to 19 abnormally hot nights each year, compared to seven between 1976 and 2005.

The phenomenon of ‘tropical nights’ – where the temperature does not drop below 23C even at night – is linked to sleepless nights and heat stress, as the body does not get the chance to cool itself.

Meanwhile, Santé Publique France’s figures underline the impact of high temperatures during heatwaves, it said, and confirmed the need for measures throughout the country, and for a reinforced strategy of adaptation to climate change, to reduce the impact of heat on health.

The unusual Pentecôte public holiday in France, when many people work ‘for free’ by donating that day’s salary a government ‘solidarity fund’ for the elderly, was introduced in 2005 following the disastrous 2003 heatwave, when more than 15,000 French people, most of them elderly, died in the sweltering temperatures.

Heat islands

The particular problem with Paris – and other major conurbations – is that it is a noted ‘urban heat island’, where temperatures can be up to 10C warmer than in the surrounding countryside, due to a combination of human activities, concrete surfaces that reflect heat, and heat pollution such as air conditioning units and cars.

The phenomenon also leads to significantly warmer nighttime temperatures, as heat accumulates during the day but cannot escape in the same way it might in a less dense environment – making for sticky nights that make it hard to sleep and increase the effects of heat stress, especially among the elderly or ill.

Emergency plans

One thing that has improved in recent years is how France deals with its heatwaves.

After 2003’s fatal summer, the French government introduced new protocols to protect the public whenever the temperature rises above a certain threshold.

Today, when the temperature soars, the government issues health advice on staying safe, which includes: drinking plenty of water to stay hydrated, staying indoors during the hottest part of the day (afternoon and early evening), keeping in the shade, exercising only during the coolest parts of the day (early morning and late nights) and eating regular meals.

Most cities now have heatwave plans. Parks stay open at night and ‘cool rooms’ open up to give those in at-risk groups a chance to be taken somewhere they can cool down.

Fire risk

Extreme temperatures and long periods without rain also increase the risk of wildfires.

The year 2022 was the worst on record for wildfires in France. In total 72,000 hectares, or an area seven times the size of Paris, burned over the summer.

Overall, 90 percent of fires are caused by humans – either deliberately or accidentally. But while casually throwing away a cigarette is objectively dumb, heatwaves can – and do – increase the risk of fires.

Where weather conditions do have a major effect is in turning what would perhaps have been a containable fire into a wildfire that devours thousands of hectares of ground and prompt evacuations.

High temperatures make it more likely that fires will start, but drought conditions cause these fires to spread – parched vegetation with no moisture catches extremely easily. In the height of summer, large parts of the south of France are particularly at risk of wildfires.

This is far from a new phenomenon. It’s why there has always been a wildfire ‘season’ in the hottest months of the year and why wildfires are much less common – though not unheard of – in winter.

In October 1970, 11 people died in a wildfire near France’s far southeastern border with Italy and in 1985 an inferno in the same area killed five volunteer firefighters.

Deaths are more unusual today, thanks to improved techniques and technology, but the fires themselves are getting more common, bigger and occur over a wider geographical area.

Poor air quality resulting from wildfire smoke can be a serious health risk to those with respiratory conditions.

If you live in an area where wildfires are common, make sure you sign up to the government emergency text alert system so you get the latest advice on whether you need to evacuate. You can also keep track of the risk of wildfire in your area by checking the government’s forest fire map, which is updated daily.

And you have legal obligations, too, relating to keeping your property as clear as possible of fire hazards during key wildfire periods.

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