Who do you turn to if you have a mental health crisis abroad?

Backpacking; an incredible experience travelling the world and meeting new people, or an emotional rollercoaster that can be isolating and scary? In my experience, it's both.

When I wanted to travel the world back in 2014, there seemed to be an absence of information in hostels and amongst the backpacking community regarding mental health. It wasn’t as talked about then as it is now. However, that wasn’t to say that people didn’t experience difficulties; whether they were emotional, financial, relational or existential; a study into expatriates’ health discussed how travellers experienced higher levels of anxiety, depression and excessive alcohol consumption in comparison to others (Pierre et al, 2013). So what then, is available to backpackers? And what do we do about this?

In London, there is a Facebook group called, ‘London Lonely Girls Group’ for girls looking to find connection and community within London, with, at last count 61,000 members. Speaking to some women from a local West London tennis group organised from there, Carolyn, (25) who came over for a job opportunity from New York, said that the most stressful aspect of moving abroad was, ‘…when the initial excitement of living in a new country wore off and it hit me that this was now my life; I realised had to navigate all of the different aspects of that.’

Another girl, Bijal, (28) explained that she felt the pressure to, ‘…be always having fun, you know? It was difficult to explain to people back home that I actually wasn’t having the time of my life all the time - and they didn’t want to hear.’ Aswini (29), from Singapore, explained how she forced herself to go out often when she first arrived in London because she needed to find friends, which took a considerable amount of energy and time.

Moving abroad, backpacking or constantly travelling for work can put a strain on one’s mental health. There are posts every day on social media from backpackers experiencing difficulties like relationship breakups, requests for emergency accommodation, stories of couchsurfing hosts making unwanted sexual advances; transportation disasters and financial worries.

Barnaby, (32), from London, told me about when he travelled southeast Asia a few years ago, and the isolation he occasionally felt when travelling; ‘you sometimes feel stranded and alone, even when you’re surrounded by people.’ He went on to explain how, even though overall he found travelling to be good for the soul, gratifying and humbling, it can take a toll on the ‘emotionally unprepared - emotions run high and people are constantly arriving and leaving in potentially high-stress situations.’

Indeed, when I went backpacking I experienced constant highs and lows; I saw people in moped accidents, relationship break-ups and having had fights with friends and family while travelling - people often need to offload or talk it through to process what had happened, and without accessible therapy or one’s close friends nearby this can be challenging.

It was due to a chaotic living situation when abroad that led me to my first-ever therapy session, which was a huge eye-opening experience and which helped me enormously. Unfortunately, working in a bar at the time with an irregular shift pattern and low on money, my therapist could offer neither flexibility nor a discounted rate, and I believe that experience has shaped the kind of therapist I want to be now. I also experienced firsthand just how much change could occur from just one session, igniting my interest in single-session and short-term therapy.

When your social support system is back home, and friendships abroad can be transient and surface level, where are backpackers, expats and travellers meant to turn to? It can be useful to have a therapist back home, and people you can call, but maybe there should be better mental health resources set up for backpackers here in the UK; drop-in centres such as new companies like self-space, and therapists who specialise in low-cost, no commitment therapy for those who are struggling and need short-term interventions for that extra support.

This is why I also believe as therapists it would be beneficial for our clients to offer more flexibility, or less than the standard minimum of 6 sessions, and be open to offering single-session therapy. We also need to remind ourselves that not everyone has a fixed shift pattern, or works 9-5. I hope that in the future this changes, and that I will continue to offer this flexibility to my own clients, having been an expat, backpacker, and shift worker myself for many years.