Maintaining good mental health can be challenging, especially in a foreign country. Before you decide on your next destination, it is important to figure out how you’ll be able to prioritise your mental health, as well as the type of care you’ll be eligible to receive as an expat. Sadly, Turkey doesn’t have many resources for mental healthcare, but it is beginning to develop more. Though Turkey’s provision is behind that of other nations, the country is slowly making strides to make mental health care more ubiquitous.As an expat in Turkey, you will be required to have health insurance in order to receive a work permit or residence. The levels of coverage will vary depending on the category you fall into, as well as whether you are paying for private or public insurance. If your home country’s government health care plan is compatible with Turkish legal requirements, you may be able to resume these plans during your stay in Turkey.
Countries covered under this bilateral contract include: Albania, Germany, Austria, Holland, Azerbaijan, Belgium, Bosnia-Herzegovina, Luxembourg, Libya, Norway, the Czech Republic, Romania, Denmark, Sweden, Turkish Republic of Cyprus, France, Quebec, Macedonia, Switzerland and Georgia. If you are not from one of these countries, you will either be registered through your (Turkish) company, or you will have to pay a monthly premium of around TL200 to TL300 (approximately US$30 to US$45) to the Social Security Institution, in order to have access to healthcare.
Turkey’s general health insurance even covers those who can’t afford to make premium payments, by extending free-of-charge healthcare. You have the option to register through either a private or public insurance company, though most expats choose a private one, as they tend to have more English-speaking doctors. Private health insurance, while more easily accessible for expats, has far less coverage for mental health care. If you choose private insurance, you will need a passport, proof of residency in Turkey, and family names to use as references. While access to basic health care is abundant for those in Turkey, mental health care facilities, doctors, and resources are harder to allocate.
Fortunately, mental health care is becoming more and more easily accessible in Turkey. The process has been slow-going, beginning with the implementation of the Republic of Turkey National Mental Health Policy (NMHP) in 2006. Before this, patients in psychiatric hospitals were treated poorly and did not have access to adequate care. It is important to note that this policy is not law, but rather a plan to begin new programmes and offer opportunities for people to take care of their mental health. The policy includes information on organisation of services, treatment and rehabilitation services, child and adolescent mental health, financing, quality improvement, legislation, advocacy training and research, and human resources.
According to the International Journal of Mental Health, as of 2007, there were only 1,300 psychiatrists for a population of 70 million; this averages out to only 14.3 psychiatric beds per 100,000 people. Because of this, the psychiatric community and the Ministry of Health began to prioritise mental health care in Turkey.
The national mental health policy (NMHP) was most recently updated in 2011, and it has since included timelines for the implementation of the mental health plan, a shift of services and resources from mental hospitals to community mental health facilities, and the integration of mental health services into primary care. This means that primary healthcare doctors can prescribe psychiatric medicine, but primary healthcare nurses still cannot. Doctors still have some restrictions on what they can prescribe, because the majority of them hadn’t received official in-service training on mental health in the last five years (when this policy was last updated).
Keep in mind that psychiatrists work mainly in large cities and in the western parts of Turkey. According to the Psychiatric Association of Turkey, 760 psychiatrists out of 1149 are located in Istanbul, Ankara and Izmir. You’ll find that this trend extends to psychologists as well, with 149 of the 266 psychologists working within the Ministry of Health at general hospitals, compared to 34 working in specialist psychiatric hospitals. Private healthcare plans usually provide more benefits, like higher grade hospitals with better facilities, more specialised staff, and private rooms.
Private hospitals can be found in major cities in Turkey, such as Istanbul, Izmir, Kusadasi, Bodrum, Marmaris and Alanya. As an expat, you will have access to both general and private hospitals, but the cost may vary depending on your particular insurance coverage.
According to the World Health Organisation (WHO), in Turkey, neuropsychiatric disorders are estimated to make up about 17% of the total amount of disease. The most common psychiatric disorders in Turkey are: pain disorder, major depression specific phobias, panic disorder, obsessive–compulsive disorder and somatization disorder. Conversion disorder and dissociative disorders are also commonly found. Most people will be prescribed medication from a general practitioner, instead of a psychiatric doctor, as they are less common.
The most important thing to do is to choose an insurance plan that will best suit you and your needs. You will have access to healthcare regardless, but there are often large disparities between hospitals and other resources in Turkey. So, you will have to research different premiums and decide whether public or private healthcare/insurance is right for you.
There are three different types of hospitals in Turkey: state-funded hospitals, university hospitals, and private hospitals. University hospitals offer the highest standards of care and medical professionals, whereas state hospitals typically serve the middle to lower classes and are much more likely to suffer from over-capacity or limited funding. Private hospitals offer healthcare that is similar, both in cost and in quality, to Western healthcare, although a limited percentage of Turkish citizens can afford to use them.