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Student mental health is an enduring issue on college campuses: one that has grown more acute as institutions see more and increasingly serious conditions among students. In particular, international students struggle with mental wellness and face barriers in accessing resources. Given there are over one million international students enrolled in U.S. colleges and universities, in what ways can higher education leaders support international studentsโ mental health on campus?
International Student Enrollment Statistics
The total number of international students enrolled in U.S. colleges and universities in 2019 was 1,095,299, making up 5.5% of the total student body, including:
Top U.S. schools hosting international students:
Top states hosting international students:
[More about immigrants in the U.S. from the PEW Research Center.]
Health and well-being of international college and university students
Unfortunately, international students have many stressors. Of course, exams, homework, internships, work-study jobs, social life, family issues, and finances are always part of the college student experience. But international students add adjusting to a new academic environment, culture shock during the first year of college, language barriers, prejudice, and living far from the support of family and friends. Itโs no wonder that living and studying abroad is taxing on international studentsโ mental health.
Additionally, international students often feel pressure to succeed academically based on their cultural background and their familiesโ financial sacrifices to allow them to study abroad. For instance, Asian American communities, like Chinese students studying in America, are burdened with the โmodel minorityโ stereotype โ an assumption that depicts international students as uniformly well-adjusted, attaining more socioeconomic success than other minority groups, and excelling academically, particularly in math. However, both Asian American students and Chinese students studying in America are highly diverse across subgroups in rates of socioeconomic, physical health, and mental health challenges.
Compounding all these issues, international students are less likely than domestic students to address mental health problems or even be aware of the availability of services. The American College Health Association found that only 12% of students who reported suffering from significant anxiety or depression went to counseling. And a study published in the Journal of American College Health found that while international graduate students were as likely as domestic graduate students to report stressors affecting their well-being or academic performance, they were less likely than their American peers to be aware of available counseling services or demonstrate help-seeking behavior โ 61% of international students versus 79% of domestic students.
[Read more about the health and well-being of Asian Americans from TimelyCare.]
Discover how telehealth supports the well-being of international students
Why are minorities less likely to get treatment?
There are several common reasons why international students are less likely than domestic students to seek mental health support, including:
Stigma of mental illness
Students from certain cultures are not familiar with talking about their feelings, let alone sharing them with strangers. They often worry their parents and families may not approve of them reaching out for help. Others are reluctant to admit that theyโre experiencing difficulties, perceiving it as a failure.
Resource awareness
The broad array of support services offered by counseling centers on university campuses in America typically donโt exist in other countries. So, many international students donโt think to seek out these services on campus.
Fear of public agencies
Stress associated with the fear of deportation has been shown to have harmful effects on an individualโs long-term physical and mental health. Children are especially vulnerable to this type of trauma, instilling a fear of deportation early on to significantly impact the uptake of mental health services.
Lack of health insurance
Studies show immigrants have lower rates of health insurance, use less health care, and receive a lower quality of care than U.S.-born populations.
These factors all contribute to the reasons international students are less likely than domestic students to seek mental health treatment.
[More about immigration, health care, and health from the Robert Wood Johnson Foundation.]
How COVID-19 compounded stress for international students
According to the Institute of International Education, nine out of 10 international students who enrolled when COVID-19 began remained in the U.S. While international students stayed for a variety of reasons, the same is true for all of them โ theyโve had to deal with the unprecedented challenges brought on by the pandemic.
Of the 5.3 million international students across the globe, nearly 44% are studying at the five largest coronavirus host countries โ U.S., Britain, Australia, Germany, and France. All of these countries are under significant stress from COVID-19 and, according to the World Health Organization, four of them are severely affected. Even under regular circumstances, international students are more prone to mental health issues, struggling with the local medical system, and less motivated to seek mental health services than their domestic peers. COVID-19 put them into a more isolated position abroad with less access to public resources for mental health support due to monetary, informational, language, or cultural barriers.
As a minority on campus, international students have needs often neglected by their colleges. For instance, some campuses closed without considering that many international students didnโt have a home in America outside their campuses, nor could they return home due to closed borders, reduced international flights, and potential exposure to COVID-19 during travel.
For those who stay in their host countries, they have unmet psychological needs having been physically away from their significant others in their home country and lacking social support in the local community, not to mention the psychosocial problems associated with societyโs responses to COVID-19. Furthermore, a surge of discrimination has been rising toward international students, especially those of Asian origins. Perceived as threats, they are more likely to be scapegoated for spreading the virus or be attacked for acting differently towards COVID-19 due to cultural differences.
What can higher education do to help international students?
1. Provide financial support to those students excluded from federal aid
Providing assistance shouldnโt be expensive. For example, since some dorms are operational and open anyway, international students stuck in off-campus housing can be offered low-cost dorm housing at subsidized rates through the summer.
2. Create or expand networks of social support
In addition to offering free housing, meals, and health care for international students, colleges can also provide free remote mental health access, as well as link students with local hosts or peer mentors. International students are fearful given the pandemic and political uncertainty. Counseling support, support groups, and other such programs can make a big difference.
3. Establish processes to make one-on-one student advising
Expand visa status-related advising for international students, so they can make informed decisions. U.S. laws determining F-1 (student) and H-1 (work) visas are changing rapidly, as the federal administration considers new regulations. Expert advising is needed to dispel panic and confusion among students.
4. Create new internships and grant opportunities
Most international students who returned to their home countries when campuses shut down lost their summer internships, which hurt them financially as well as professionally. Faculty and staff can mitigate the damage and retain students by advocating for their international students and actively work with career development professionals and other campus administrators to gain access and opportunities for them.
5. Educators should be generous in assigning grades and flexible with deadlines
Professors can support their international students by reaching out and asking them how theyโre doing. Some of those students may be so lost and inexperienced that they may not know how to apply for financial aid or that they can reach out to their embassies for support. Also, by providing international students with flexibility with deadlines and generosity in assigning grades, professors can reduce some of the stressors facing these students.
6. Provide telehealth services
Students consistently describe a high level of satisfaction with telehealth services, including automated messaging platforms and self-directed therapy platforms. And, telehealth services allow international students to avoid the stigma of seeking mental health treatment. This is an obstacle particularly for minority students, who are less likely than White students to utilize mental health services despite experiencing similar or elevated rates of markers of mental illness such as suicidality, suicide attempt, or self-harm.
[More mental health tips for international students from U.S. News]
Focused on improving the health, wellness, and cultural adjustment of international students, TimelyCare offers colleges and universities virtual mental health resources and services centered around telehealth. TimelyCareโs total health and well-being solution is an extension of your current, on-campus health services and student support to improve the mental and physical health of your students. With 24/7/365 access to providers in all 50 states, TimelyCare helps you meet the needs of international students and your student body at large.
To explore how TimelyCare can provide telehealth programs that deliver quality care to your students while helping them manage stress, contact TimelyCare.
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