Mental health and study abroad

My daughter will be a junior next year and is in the process of submitting her application to study for a year in France through a program offered by her college. This has always been in her plans and we have given our blessing (as well as our money!) to this endeavor.

My only concern is that she is being treated for anxiety and depression, both of which are under control with medication and therapy. We all feel that this needs to continue through her year abroad. She is stable now, but doesn’t want to take chances. We’re not worried about the medication bit, as she can bring enough to carry her through until winter vacation, and we can either bring more to her if we visit, or she can refill her prescription if she comes home for Christmas. My real concern is the therapy.

Has anyone here had experience with finding a therapist overseas for their child? D’s French is excellent, but generally, people want therapy in their own language. How did this go for your child?

I should add that she is very good with new situations and new people, is drawn to international students, and has traveled abroad with us or student groups many times. Homesickness isn’t an issue. Her anxiety comes from being a gifted, hard-driving perfectionist and she is slowly learning to let go of that.

Is she doing her study abroad through a school that specializes in study abroad? The reason I ask is that schools like this have offices that will assist you with this sort of question. My D did her study abroad through Butler, and their staff was amazing. Coincidentally, my D studied European health care systems while she studied abroad, and she says the French health care system is one of the best in the world. Hopefully, your D will be in good hands while on her adventure.

I’d start by talking to her current therapist. Is there a way she can arrange to stay with him/her and talk through Skype or something? It may be less disruptive.

^^^I was thinking the same thing. Skyping with the current therapist would be a great solution.

I didn’t even think of that, but some of our grad students do that. Great idea! The only issue would be if there are meds involved - in that case, she would still have to have a doctor in France.

DS uses skype to keep appts with his therapist when he is at school in another state. That has worked out great, as he didn’t have to start over with a new person, and he has a lot of confidence in this therapist.

The therapist is not who writes the prescription. That’s done by a different dr. Maybe the program could discuss what would happen overseas if prescriptions should need tweaking (as sometimes happens).

My daughter’s therapist will do phone appointments but they are not covered by insurance. That is OK with me, but might be an obstacle for other families, depending on finances.

Therapists are usually licensed to provide services only within the country, I highly doubt hers will agree to provide skype consults while your D is overseas. However, as you said, France’s health care system is great, you can get started early by doing a google search according to your criteria and reaching out to them. After your D signs a consent to release information , her therapist and doctor can share their notes and medical history, which will provide the drs in France a good starting point to treat her. I understand your concerns though and wish her the best of luck!

Thanks for the ideas. I hadn’t even thought of Skype, so that may be a solution. She has a therapist, who provides the talk therapy on a weekly basis, and a psychiatrist, whom she meets with monthly to regulate her medication. The MD says he can work it out with her insurer to provide a few months worth of medication for her to take with her (apparently, he does this for several of his patients who study or live abroad) and then she can refill them when she comes back for a visit here. My main concern is that she continue the talk therapy because that is working so well. I will encourage her to try to connect with a therapist in France before she goes over there.

Getting meds during holiday break works, after the fall, but then Jan. through May or so is a much longer stretch. Can she get 6 months at a time?

What is the insurance situation? Many plans for international study won’t cover preexisting conditions and some won’ t take anyone with a preexisting condition at all. Many also limit “neurological” or psychological issues. Try calling Square Mouth (find it online) for help with at least finding travel insurance that covers unexpected events.

Or is the school offering a plan?

Do you have funds for private therapy? Students have free access to uni medical services, it can be hit and miss there though (like anywhere). It can take months to secure a spot in private therapy, you could start calling them (google) or ask your current therapist to call around and try find the best fit re personality and availability. You’ll have more say in “who and how and how often” this way.

I suggest discussing this with current therapist. Have your daughter sign a release so that the therapist can talk to you frankly about her situation.

My close friend just had to go overseas and fetch her daughter who just lost it during study abroad. She was doing very well with meds and really little therapy these last few years, but the new situation spun her out of control. Fortunately, no permanent harm appears to be done, but they lost a lot of money, were scared, had to take the time to go get her, and she has lost this year schooling wise. My friend, and most everyone felt she would be fine as she was familiar with the country, and had been going away to college cross country for a couple of years with very little trouble. But things came up, and it was an issue. That it was overseas, added to the time lag and expense to get to her.

Travel insurance is not costly and pays for you to fly over and bring her back if the situation qualifies.

Do meds help enough that she could go without the therapy for that period of time?

Thanks again for your replies and insight. I will definitely be discussing this with her psychiatrist. She has signed the waiver. I don’t know what the school insurance plan is yet, as she has just turned in her application. Approval seems likely, but @compmom’s comments make me wonder if the school could use her mental health history as a reason to deny her. (They did require her to get approval from her therapist, so maybe that will be sufficient to fill their mental health requirements.) I will also look into the Square Mouth insurance.

Her meds are now generic, so if insurance won’t pay for a six month supply, we can cover that. Her psych doesn’t think there will be a problem in any case, as he has worked with study abroad kids before.

I do hope this plan works for her, but not at the cost of the progress she has made.

Another thing (that you probably know or would be told): when traveling out of the country and bringing medication(s), especially “brain” drugs, it’s a good idea to carry a letter from the prescribing physician verifying that the medication(s) were prescribed by that physician. My daughter didn’t need to use the letter but we felt better knowing she had it, in case she was questioned about her meds.

I would cation against a French speaking therapist or one with limited English. Unless your daughter is a native speaker, there will be an adjustment period to speaking only French everyday. If your daughter can not completely articulate her feelings or if a therapist can’t understand her completely, sessions have the potential to be more frustrating than helpful.

I would look for a native English speaking therapist who works with the expat community. If she is going through an American program or university, contact the program staff for recommendations. They almost certainly have had past students in this situation. For the medication, if she brings a prescription from her MD to a French doctor, they will likely be able to write her one she can fill in France. All common antidepressants/benzos are available and inexpensive.

A quick google search turned up this

^^Thank you. She is not going to be in Paris, so will be less likely to find an English-speaking therapist. That’s why the Skype idea sounds so good if she and her therapist and psychiatrist decide that she should continue talk therapy.

That is reassuring to know about the medication!

By “school insurance plan” are you referring to the home US school or the school abroad? If the US school, you should be fine.

To me it seems like perhaps too much risk. How does your D feel about it?

She has already decided this is something she wants to do. It is her decision. I’m just gathering info that will help her make the plan she needs to thrive. I never in a million years thought I’d have to think about something like this, but it is our reality now. People with MI can and do lead productive lives with the proper support, and that’s what we’re trying to give her. Sometimes that support means letting a kid take risks that you don’t feel comfortable with!