Understandings of mental health, disclosure and help-seeking among international students studying in Scotland

Background: International students not only contribute a significant proportion of the income of UK Higher Education (HE) institutions, but also enrich the diversity of the HE student population and strengthen the workforce. Many studies have documented the various psychosocial, academic, and financial challenges in the HE environment. Research has yet to specifically explore the understandings and experiences of mental health, disclosure and help-seeking drawing upon international students' perspectives.

Aims: To explore the distinct concerns international students experience in terms of their mental health, issues in disclosing mental health problems and in seeking help for mental health within HE institutions in Scotland.

Method: Two studies were carried out: (1) The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with international students studying in Scotland. Data were audio-recorded, transcribed and analysed using thematic approach. (2) The second study was a cross-sectional online survey comparing domestic (n = 547) and international students (n = 213) in terms of mental health literacy, disclosure and help seeking behaviour. Descriptive and inferential statistical analysis was conducted for the quantitative data.

Findings: The four main themes identified for study 1 included: (1) Adaptation and acculturation difficulties, (2) Negative beliefs, stigma and fear of judgment, (3) Barriers in communication, and (4) Integration and acceptance. For study 2, international students reported lower levels of mental health literacy and higher levels of help seeking intentions compared to domestic students. For international students, mental health literacy was positively associated with psychological adaptation, and lower stigma was positively associated with help seeking intention.

Conclusions: Supporting international students in HE institutions involves addressing the challenges and barriers in overcoming adaptation and acculturation difficulties that may inhibit disclosure and help seeking for mental health problems. Mental health practitioners and policy makers should be aware of the need for supporting international students and enhancing mental health professionals’ cultural competencies.