In the UK alone, the number of students disclosing a mental illness upon arrival at university has risen almost fivefold in the past decade, and the number of students dropping out due to mental health problems has more than trebled.
“There is often a fear that if they reach out for support they’ll be seen as weak or it might go on their academic record”
Academic and financial pressures, coupled with challenges around living independently for the first time, can make transitioning to post-secondary education a stressful time.
Nevertheless, these stressors can be far greater for international students who, in addition to language barriers, may also be facing disrupted support networks, greater financial strain and, in some cases, the stigma around mental health.
Human resources services and technology company Morneau Shepell has been working with academic institutions across the US and Canada for the past three years to help meet the needs of international students.
Through its International Student Support Program, students can instantly be connected with counsellors who speak their language. The service is available in Chinese, Arabic, English, French, Spanish and Korean, and can be accessed 24/7 over the phone or through the program’s app.
“Research has shown that international students are less likely to reach out for support and that there is a significantly higher stigma around mental health issues,” explains Matthew McEvoy, senior director of the ISSP at Morneau Sheppell, which won The PIEoneer Award for Student Support in 2017.
“There is often a fear that if they reach out for support they’ll be seen as weak or it might go on their academic record. When they do reach out, [international students] are often significantly more distressed than a typical domestic student.”
“Help them feel that they’re connected with the broader university and people care about them. That’s really important”
Robust referral systems
Responding to the needs of international students is, as with domestic students, reliant on having strong referral systems in place. Although many universities offer mental health support and activities to bolster wellbeing, ensuring that students actually use those services is another matter entirely.
The ISSP is one of the mechanisms that colleges in North America have been using to ensure that international students don’t slip through the net.
More than 70 campuses currently offer the program to international students, staff and, in some instances, their immediate families. It is also available to domestic students taking part in a year or semester abroad.
“Although many colleges have resources available for mental health support on campus, they’re often strapped and don’t necessarily have the cultural or the language know-how,” McEvoy explains.
International student support programs are utilized by as many as 70 N.American HEIs to spot issues as they develop. Photo: Pexels
“The ISSP is able to integrate with the work that they are doing and augment it by providing instant access 24/7 in the relevant culture and language. Matching that, for most institutions, is simply impossible from a resources perspective.”
Campus and faculty staff are also vital in ensuring students get the right help at the right time and training them to recognise the signs of mental health problems is crucial.
As part of the ISSP, staff are trained to recognise the typical signs of distress in international students, as these can often look quite different from those manifested by the average domestic student.
Another training program that has become increasingly popular in universities in the UK, US and Australia is Mental Health First Aid. MHFA helps staff to identify the risk factors and warning signs for mental health, establish strategies to support someone in distress and, if necessary, refer them to more specialised services on or off campus.
The training also differentiates to a certain extent between international and domestic students.
Nataly Bovopoulos, CEO of Mental Health First Aid Australia, which owns the MHFA program, explains: “International students face a number of additional challenges like language difficulties, lower levels of social support, culture shock, adapting to a different physical climate, higher mismatched expectations of study, higher psychological stress, and fewer personal resources.
“Our training provides case studies that include international students and we also include a video where a staff member from a university talks about these additional challenges faced by international students.”
“We counsel students on looking after themselves”
When considering the referral systems for international students, it is also important to factor in any intermediary organisations.
One of the most popular work abroad schemes for UK students, for instance, is the British Council’s Language Assistants Program. Although the responsibility for the student’s wellbeing ultimately lies with the host university or institution, the BC acknowledges that it could look at incorporating mental health into the program’s pre-departure briefings.
“We counsel students on looking after themselves,” says Simon Graham, who manages the program.
“This includes forming supportive social networks and friendship groups, developing coping mechanisms and encouraging students to communicate with their mentor teachers.
“However, we do not talk specifically about mental health at the present time. This is an area we could look at.”
Peer support and a sense of belonging
Students are key components in universities’ referral systems, and peer support schemes are increasingly important.
In the UK, a number of students’ unions have been rolling out Look After Your Mate training in collaboration with the UK’s student mental health charity, Student Minds. Similarly, ‘buddy programs’ designed to support international students have long been popular in institutions including the University of Birmingham, UK; University of Minnesota, US and McGill University, Canada.
Peer support is also a valued strategy in universities with high percentages of international students. For example, the Central European University in Hungary, a graduate level university where around 77% of the student body is international, will soon be rolling out its first peer support program.
Medical students at Monash University, having completed the 13 hour Mental Health First Aid for Medical Students course. Photo: MU
The dean of students at the CEU, Chrys Margaritidis, says: “in many cases, students will be hesitant and won’t come to me or their department head if they need support.
“They need something that’s informal and approaching us can often feel like a big step. This isn’t therapy or psychological counselling, but really a first step in helping students to come forward.”
Of course, peer support does more than connect the dots between international students and university services — it helps to create a welcoming, enabling environment in which students, both international and domestic, feel that they are valued and supported.
Jordi Austin, student support services director at the University of Sydney and immediate past president of the Australian and New Zealand Student Services Association affirms: “We know that in the lead into exams especially, a lot of people are feeling isolated and lonely.
“If we ever notice that a student is withdrawn, someone in our team will connect with them”
“So, how do we get them to come out and join in stress-buster activities? Help them feel that they’re still connected with the broader university and people care about them. That’s really important.”
At American University Sharjah, UAE, 83% of students are classed as international. The institution strives to create a sense of community that, ultimately, allows students to reach out for support as and when they need it.
“We always have a core group of five to ten peer advisors who participate in orientation and typically become quite friendly with our study abroad students,” explains Dr Linda Angell, director of international exchange programs at AUS.
“We also have many outings and activities throughout the semester and if we ever notice any reason for concern — for example, that a student is withdrawn — someone in our team will connect with them.”
Both students’ unions and accommodation services can also help in delivering wellbeing initiatives targeted at the student community more broadly. For instance, the Residence Life team at the University of Edinburgh runs a number of wellbeing activities for all students, including its popular ‘Paws Against Stress’ initiative.
Willamette University, Oregon offers a pet respite initiatives to students. Photo: Frank Miller
Inspired by a growing trend, the department’s Residence Life team brings dogs into students’ accommodation during exam periods to offer respite from academic pressure.
In the US, Michaela Kleinert, an associate professor at Willamette University in Salem, OR, explains how she came to start the “Dog Days” student initiative at her own dog-friendly campus.
“Over lunch, I was typically walking [my own dog] across campus, and it was just striking how many students would ask if they could pet him because they missed their own dogs, they missed their family, they had a bad day, they were anxious about an upcoming test,” she says.
“So, I started Dog Days in the fall of 2014 to ease some of the anxiety during finals week.”
There is still a long way to go, but as the collective understanding and expertise of universities around student mental health and wellbeing continue to develop, so too will their ability to address the needs of international students.
While these differ from the needs of domestic students, the components in addressing them ultimately remain the same: enabling environments, strong services and robust referral systems.
- This is an abridged version of an article that originally appeared in The PIE Review, our quarterly print publication.