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Patients with mental problems - the most defenseless travellers.
J Travel Med. 2017 Sep 01; 24(5)JT

Abstract

Background

Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers.

Methods

Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless.

Conclusions

Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists.

Authors+Show Affiliations

SOS Hungary Medical Service, Debreceni Egyetem Orvos- es Egeszsegtudomanyi Centrum.Department of Psychiatry, St. Janos Hospital, Budapest, Hungary.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28931125

Citation

Felkai, Peter, and Tamas Kurimay. "Patients With Mental Problems - the Most Defenseless Travellers." Journal of Travel Medicine, vol. 24, no. 5, 2017.
Felkai P, Kurimay T. Patients with mental problems - the most defenseless travellers. J Travel Med. 2017;24(5).
Felkai, P., & Kurimay, T. (2017). Patients with mental problems - the most defenseless travellers. Journal of Travel Medicine, 24(5). https://doi.org/10.1093/jtm/tax005
Felkai P, Kurimay T. Patients With Mental Problems - the Most Defenseless Travellers. J Travel Med. 2017 Sep 1;24(5) PubMed PMID: 28931125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients with mental problems - the most defenseless travellers. AU - Felkai,Peter, AU - Kurimay,Tamas, PY - 2017/01/19/accepted PY - 2017/9/21/entrez PY - 2017/9/21/pubmed PY - 2018/5/16/medline KW - Travel psychosis KW - aeromedical evacuation KW - airport security KW - pretravel advice KW - repatriation KW - travel insurance JF - Journal of travel medicine JO - J Travel Med VL - 24 IS - 5 N2 - Background: Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers. Methods: Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless. Conclusions: Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/28931125/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/tax005 DB - PRIME DP - Unbound Medicine ER -