Patients with mental problems - the most defenseless travellers

Abstract

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.

To travel is to live: embracing the emerging field of travel psychiatry

“…4 Misuse of alcohol and/or psychoactive substances among international travellers may be associated with an exacerbation of existing mental illness and could precipitate an acute psychotic episode. 1,5 Physicians should consequently be mindful about their patients travelling abroad for the purpose of seeking therapeutic or recreational drugs. Drug tourism, whereby tourists cross international borders for the purpose of obtaining or using psychoactive substances, is associated with significant adverse health effects, including drug-induced psychosis, unintentional physical injury, risky sexual behaviour and criminal acts.…”

“…Felkai & Kurimay reported that 11.3% of travellers experience some symptoms of mental illness during travel, with 0.3% of travellers experiencing an acute psychotic episode. 1 Indeed, incidence data reveal that acute psychotic episodes account for one-fifth of travel-related mental illnesses. Travellers who are deemed medically fit to travel and who have no history of mental disorder may develop acute de novo psychosis during their trip.…”

“…The cumulative effects of travel-induced stress, culture shock, inappropriate alcohol intake and/or recreational substance use, circadian rhythm disruption, underlying brain pathology and physical illness have been implicated as contributing factors in the development of first-time psychosis during travel. [1][2][3] Another subgroup of travel-related psychosis occurs during travel to destinations with high religious, cultural and aesthetic value, so-called high-valence venues. 3 However, many of these episodes occur against a background of a pre-existing psychotic illness.…”

“Air rage”: A systematic review of research on disruptive airline passenger behaviour 1985-2020

“…These stressors in combination with individual factors (e.g. anxiety, intoxication and mental illness) can lead to disruptive behaviour and jeopardise safety-a phenomenon known as Disruptive Airline Passenger Behaviour (DAPB), unruly Passenger Behaviour (UPB) or more generally (and especially if aggression is involved) as "air-rage" or "cabin-rage" (Felkai & Kurimay, 2017;Gordon, Kingham & Goodwin, 2004;International Air Transport Association, 2019;Rhoden, Ralston & Ineson, 2008;Vivian, 2000). DAPB includes: refusing to comply with safety instructions, verbal/physical/sexual abuse directed towards cabin crew and other passengers, assault, damage to the aircraft, and damage to employee property (Barron, 2002).…”

Autism Spectrum Disorder and International Travel

“…People living with mental illness are among the most vulnerable groups of international travellers. 1,2 The literature on international travellers with psychiatric disorders is limited. 3 Autism spectrum disorders (ASDs) comprise a group of neurodevelopmental disorders.…”