Are mental health patients fit for long-distance patient transportation?

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Traveling internationally can be exhilarating, but it can also be stressful, and stressors impact people differently. They may intensify mental health problems in passengers with pre-existing or latent psychiatric disorders or make unusual behaviours and abrupt mood swings become apparent for the first time. Indeed, exposing travellers to an unfamiliar environment, such as airports or airplanes, can trigger anxiety, depression, and other abnormal behaviours such as drug and alcohol abuse, suicidal thoughts, and violence. Simply put, it exacerbates symptoms in passengers with mental problems, making them a danger to themselves and others.

The key points to remember about mental health patients long-distance transport:

• Most mental health patients can fly without issue.
• Patients afflicted with acute psychosis or schizophrenia or in the late stages of dementia or Alzheimer's disease should not fly commercially without professional assistance.
• This assistance can be sought through our medical escort service. However, a private air ambulance is recommended for more serious cases.

Is flying safe for mental health patients?

Most passengers with mental problems can fly without issue, however a psychiatric evaluation (fitness to fly) may be required in some situations.

The key consideration when flying with a psychiatric disorder is the same as it is in other medical conditions - will the flight environment aggravate the passenger’s mental health, or will his condition interfere with the safe flight?

According to the World Health Organization (WHO), mental illness is one of the three major health issues arising mid-flight, the other two being physical injury and cardiac events. However, thanks to modern management of psychiatric conditions, flying commercially and without medical help should not be an issue for the vast majority of mental health patients. On the other hand, it is vital that their condition is stable, and that any medication is taken on time.

However, for the purpose of this article, let us concentrate on passengers whose mental illness causes them to be disruptive, disorganised, aggressive, or unpredictable. The reasoning is straightforward: flying is not recommended in these circumstances. And it appears that the longer the distance travelled, the bigger the risk.

Conditions when flying commercially is not an option

Flying commercially is not an option if you have:

• have severe psychosis;
• have schizophrenia;
• are in the late stages of dementia;
• suffer from Alzheimer's disease.

Fears of strangers or crowds, fear of tight places, or fear of flying can all be triggered by travel. Travel-related psychotic decompensation can affect people with no prior psychiatric history and intensify symptoms in people who already have mental health issues. The chance of having a psychotic reaction while travelling rises with age, cognitive impairment, and the side effects of travel-related medicines. Dehydration, motion sickness, forced immobility, and general physical discomfort are all especially destabilising and may play a role in the onset of psychological disorders. Flying can also signify being cut off from a significant other, as well as one's familiar environment. Trying to fit into a new environment can cause acculturative stress, which can increase symptoms of emotional distress, particularly in individuals with long-term mental diseases like psychosis.

Circadian rhythms are disrupted by changes in ambient light, desynchronization of mealtimes and medication routines, and, especially, sleep deprivation or jet lags. When all of these factors come together, they can be destabilising for anyone, but especially for people with schizophrenia, who may be genetically predisposed to circadian rhythm disruptions. This, in turn, can easily lead to uncertainty, befuddlement, and even full-fledged delusion. Also, there are special risks for patients with schizophrenia, particularly if their purpose for travel is dubious, for example in response to hallucinatory directives.

Let us not forget about the elderly who suffer from dementia or Alzheimer's disease. Even if they are thriving in their current setting and daily routine, this does not guarantee that a trip will be trouble-free. When they are out of their comfort zone, they may have more angry outbursts, anxiousness, or wandering episodes. And when that familiarity is shaken by travel, all bets are off.

Flying commercially with a mental health patient-Management strategies

What should you do if a mentally ill patient expresses a desire to travel? Unless they are severely psychotic and potentially dangerous to themselves or others, they cannot be prohibited from travelling. Care must be taken, though, to avoid serious consequences.

Pre-Travel

• Ensure that your journeys (and any resulting delays) are well-planned.
• Many airlines provide anxiety-relieving courses if flying anxiety is a major source of worry for you.
• Learn about the culture and language of your destination country.
• Learn about medical facilities there, including how and where to get mental health care.
• Make certain that your medical/travel insurance includes mental health coverage.

Medication

• Make sure you have enough of your usual medication to last the entire trip.
• Medications should be easily accessible (in hand luggage), stored in their original containers, and clearly labelled.
• A copy of your prescription (with medicines and dosages) should be carried in the event that medication is lost or stolen.
• Make an appointment with your treating psychiatrist before you go, and ask for a letter in the appropriate language explaining your diagnosis and medications in case you need medical services while abroad.

While in Transit

• Changes in time zones and jet lag can affect your mental health.
• While travelling, make sure you take your medications at the recommended times.
• Drink a lot of water and eat regularly. Avoid drugs and alcohol.

During the trip

• Maintain as much of a regular routine as possible when on vacation. This provides you more control over your environment and makes it easier to remember to take your prescribed prescriptions on time.
• Never stop taking your medication, even if your mental health seems to have improved.
• Maintain enough rest, water, and calorie intake, particularly if a busy schedule is expected.
• Pre-arrange phone calls or video chats with close friends and family, especially if you are travelling alone.
• Do not delay seeking advice if you fear your mental health is deteriorating.

Medical Repatriation UK’s medical escort service-for optimum safety

A person who is suffering from severe mental illness should never travel alone. There are far too many choices to be made, complicated instructions to follow, and strangers to meet. They are unlikely to arrive at their destination safely. Even patients with well-managed psychotic illnesses may need an escort to ensure regular medication is taken and to provide assistance in the case of a problem.

Medical Repatriation UK can provide a medical escort service as an alternative to our private air ambulance service when your loved one is suffering from a mental illness but plans to fly anyhow. This service is intended for (mental health) patients who are stable and can sit up during take-off and landing on domestic and international commercial airline flights.

Our medical flight escorts will travel with the patient in regular passenger seats on commercial airline flights. They are aeromedically qualified and will monitor the patient throughout the trip, whether it is a short domestic flight or a long international flight. They are qualified healthcare professionals certified to not only support and monitor our mental health patients, but also reduce the anxiety and stress that flying brings.

When necessary, we provide basic medical equipment such as pulse oximeters, and monitoring devices. Besides, having multiple air medical escort flights on commercial carriers has helped us develop a close relationship with different airline companies, which makes airline ticketing, ground support coordination in and out of the plane and at all stops easier, as well as clearance with airlines and airport authorities.

To continue, compared to a dedicated air ambulance, our medical escort service is more cost-saving. This service, however, provides a lower degree of medical treatment for the patient and will only be considered in non-serious situations. The aid and medical care supplied will be limited and mainly for the patient's comfort. As a result, this service is not meant for people who are severely psychotic.

Our air ambulance: your tailor-made solution

Medical transportation may be required for patients with behavioural or mental health difficulties for a variety of reasons. The most usual scenario is providing safe long-distance transportation for patients who need to be transferred from one health facility to another for rehabilitation, specialised treatment, or long-term care. At Medical Repatriation UK, we collaborate with case managers and healthcare providers to ensure that these types of missions run smoothly.

Traveling by private air ambulance is a prudent decision and, in many circumstances, the only way to ensure the safety and medical well-being of mental health patients. When a patient is transferred by our air ambulance, they are transported quickly, have constant access to medical care, and are kept in a safe and regulated environment.

Treating a mental health patient during transport

On a medical air transfer by plane or helicopter, caring for mental health patients necessitates specialised expertise and training. We start by educating our staff, understanding that each patient with a mental or behavioural illness is unique and deserves a tailored treatment strategy. These patients are cared for with dignity and without prejudice by our team of highly qualified medical specialists. They show respect and concern for each patient while treating and transporting them, and provide moral support, such as calming discussions, to help them achieve peace of mind. We also address more serious medical treatment considerations when carrying patients with various behavioural health problems. Our medical team is ready to transport individuals who need to take medications on a regular basis.

Do you have any additional questions?

Please go to our FAQ, if you are interested in learning more about what we have to offer.

Contact us right away for medical repatriation!

Please contact our 24-hour service at any time if you require additional information or a free non-binding quote. Our friendly and knowledgeable staff can be reached at:

• Telephone: +44 (0) 20 3608 0483
• Email: info@medical-repatriation.uk
• Our contact form