Rising student mental health problems need urgent action

Prompted by rising reports of student distress and suicide, universities are becoming increasingly responsive to the mental health and well-being needs of their students.

But the impact of the COVID-19 pandemic on the day-to-day experiences of international students calls for immediate, whole-of-university action that is proactive, visible and accessible.

Most international students transition into university at a time of life when they are also transitioning to adulthood, a period associated with greater than average levels of anxiety and mood disorders. To be successful, they must manage disparate academic, social and cultural expectations and integrate into unfamiliar communities, while assuming financial independence and personal responsibility.

The COVID-19 pandemic presents a plethora of additional challenges to international students that exacerbate their vulnerability to mental health issues and simultaneously isolate them from potentially vital support mechanisms.

COVID-19 and international student vulnerability

COVID-19 is having a major influence on international students’ financial security. The scarcity of casual work has left many unable to meet accommodation and day-to-day living costs.

The ramifications of financial insecurity on international student mental health can be profound. In this environment, the cost of repeating units of study intensifies the pressure to achieve a pass mark and heightens despair when students fail.

Financial desperation and a poor knowledge of relevant regulations leave international students prone to exploitation by unscrupulous employers and landlords. Most concerningly, financial stress is directly associated with international student suicide.

The fate of loved ones at home is a further, ongoing source of stress. At the time of writing, the almost exponential rise in COVID-19 cases and associated deaths in India are a source of distress among the second largest international student group of many OECD countries.

Meanwhile, Chinese students, the most populous international student group in the United Kingdom, United States and Australia, face increased incidences of racism and hostility in the latter two countries as their host nations’ leaders place blame for the pandemic on China’s shoulders.

This year, higher education’s almost wholesale move to online learning has obscured university support services from the view of newly commencing students and stifled their capacity to make meaningful support networks. Urgent proactive action is required to alleviate the effect of these cumulative influences on international students’ mental health and well-being.

Engagement with wider community

The mandatory move to online learning that has occurred in many universities is particularly disappointing for international students who are highly motivated by the prospect of face-to-face interaction with their tutors and domestic student peers.

Perhaps more importantly, online learning limits the opportunities for new students to engage academically, acculturate within the university environment and develop social networks. Innovative pedagogical approaches can go some way to mitigate this.

Online synchronous virtual classrooms, for example, offer a way for students to participate in group work with peers and access real-time tutor interactions and academic guidance. Virtual chat rooms can be left open for students outside teaching time, to encourage social interaction between classes.

Student support services are well placed to offer advice on local community services such as finance options, transport and housing and can play an important role in reducing instances of international student exploitation.

Signposting activities to local cultural and religious community groups can introduce these students to safety nets outside the university. The cancellation of orientation or ‘freshers’ week activities, or their replacement with a virtual experience, calls for innovative approaches to support the ongoing visibility and accessibility of these services.

Facilitating help-seeking

Although more prone to mental health problems, young adults are less likely to seek mental health support than younger and older age groups. For some international students, the stigma and shame associated with mental health further reduces the likelihood of help-seeking behaviour.

For Indian students, for instance, reactions of fear, judgement and ostracism towards people with mental health issues, common in their home country, may influence help-seeking behaviour.

Proactive efforts to normalise psychological well-being discussions in the classroom can reduce feelings of shame and enhance mental health literacy, thus helping students ‘find the words’ to express their distress and seek appropriate and timely help.

Allocating non-teaching time within online classes, where students can share their daily experiences, allows them to express concerns and elicit peer support. It also alerts tutors to students who may require individual follow-up.

Responding to students in difficulty or despair

Many students experiencing distress see their tutors as a preferred first contact. Tutors must therefore remain visible and responsive to student need through regular online engagement between scheduled classes.

Although it is unrealistic to expect all university staff to have expert mental health skills, it is vital that they are aware of the issues facing international students, can provide a culturally safe environment where students feel able to disclose, and understand their role as a conduit to appropriate support services.

In addition, the facilitation of help-seeking behaviour must be complemented by the responsiveness and quality of available support services. University mental health staff require an understanding of the different cultural influences on their students’ mental health, including stigma, shame and power relationships. Ideally, the cultural diversity of university counsellors will reflect those of their students.

As the COVID-19 pandemic continues its global surge and resurgence, higher education must step up to meet its duty of care to its increasingly vulnerable international student population.

Dr Lesley Andrew is postgraduate courses coordinator for public health at the School of Medical and Health Sciences, Edith Cowan University, Australia.