Over the years, the United States has attracted thousands of international students originating from different countries and cultures. The country is generally perceived as a source of advanced technology, an economic giant, and a world leader in intellectual knowledge. According to Williams, Case, and Roberts (2018), the international students’ population accounts for approximately 5.5% of all students enrolled in institutions of higher learning in the U.S. International student is a term used to describe a group of heterogeneous students from diverse backgrounds. As the number of these students continues to increase in U.S. campuses, institutions of higher learning are faced with the challenge of providing services that meet the various needs of this diverse population. Mental health concerns are one of the key issues that have drawn the attention of psychologists, counselors, and educators. Often, international students experience cases of depression, anxiety, and stress as they struggle to cope with the new environment and different cultures.
While institutions continue to make efforts to deal with the problem of mental health amongst students, international students are less likely to make use of counseling services as compared to their domestic colleagues. In light of these facts, this paper critically evaluates the problem of mental health issues in a U.S. institution of higher learning, New York University (NYU), with the aim of providing improvement recommendations to the school’s senior management. The theoretical framework surrounding the issue is explained from the perspective of two major theories; person-centered theory and cognitive behavioral therapy (Kronholz, 2014). International students face unique difficulties when compared to their domestic counterparts. For instance, this population suffers from culture shock, home-sickness, language-related problems, and isolation. Additionally, international students encounter difficulties related to financial stress, dietary restrictions, discrimination and lack of support from American peers, and cultural misunderstandings (Han et al., 2013). Due to language barriers, international students also face challenges of integrating with other students, making it very hard to share their problems with colleagues and counselors.
Acculturation levels have also been found to significantly affect psychological adjustment among international students. Specifically, low acculturation has been associated with negative psychological symptoms such as suicide and depression (Kronholz, 2014; Bertram et al., 2014). Students respond to these challenges in an array of ways. For instance, some international students may manifest their distress physically through insomnia, stomach problems, and headaches. On the other hand, some may develop panic and eating disorders, and anxiousness. Transiting from one academic system to the other can turn unexpectedly confusing leading to isolation, overwork, and anxiety (Erichsen & Bolliger, 2011). Students who suffer from anxiety or depression experience diverse effects on their social and academic lives and are more likely to achieve low grades or even drop out of school. Addressing the issue is, therefore, a matter of urgency as it has a direct impact on students’ performance and health (Glass & Westmont, 2014). Consequently, there is a growing need to implement campus-wide strategies geared towards improving student mental health, especially among the international student population.
Research Synthesis and Context Analysis
The role of international advisors on mental health is a significant contributor to the positive well-being of international students. Students who report having a good and functional relationship with their advisors are less likely to suffer from serious stress or emotion-related problems. The fact that international students are reluctant to discuss such issues with staff for the fear of appearing weak presents a unique form of challenge to managers of institutions of higher learning presents a serious set of challenges (Birnbaum et al., 2012). While not trained as professional counselors themselves, faculty members in institutions of higher learning such as New York University usually appear on the front lines when addressing international students’ mental healthcare needs. Typically, academic staff interacts with students regularly hence they are in a position to guide them through the stressful ordeal of adjusting to the new environments and academic tasks. As a result of such interactions, faculty members can serve as good university members to watch out for any distressful signs among these students.
The New York University stands as one of the most respected and prominent research universities in the world. The institution is a leader in global education featuring top-ranked academic programs. According to international student enrollment statistics by EducationData (2020), the NYU topped U.S. institutions of higher learning hosting international students in 2019. Further, the university draws its students from early every state and has an international student population originating from over 133 countries. Similarly, NYU prides on the diverse background of its faculty and staff ensuring that its students benefit from a wide range of perspectives. Despite the advantages that emanate from such a large diversity, the problem of mental health is a serious challenge to the university. According to NYU, 55% of its students reported that mental and emotional problems had negatively affected their academic performance (NYU, 2020). Similarly, 59% of the students at the university that demonstrated symptoms of mental health reported that problems emanating from such complications had made it very difficult to take care of things at home, get along with other people, and do their schoolwork. Considering the large number of international students in NYU, the failure to intervene and provide the necessary assistance to this student population has the potential of creating far-reaching implications.
International students turn to different stakeholders that are struggling to deal with the problem of mental health amongst students of higher learning. Some of these stakeholders are within the organization while others are external. An important stakeholder in managing the health of students in institutions of higher learning in the university health Centre (UHC). Being an important organization within the institution of learning, UHCs provide crucial services including wellness exams, referral to local physicians, psychological treatments, and medications (Carmack, Bedi, & Heiss, 2016). The purpose of UHCs is to assist students to deal with both mental and psychical consequences of otherwise stressful university life. At the New York University, the NYC Student Health Centre (SHC) acts as a service Centre and campus resource for matriculated students at the institution (NYU, 2020). The facility offers hassle-free appointments, universal, and walk-in medical as well as counseling services at low costs or subsidized prices to all campus students. Key services offered at NYC’s SHC include counseling and wellness services (CWS), pharmacy, global health services, and healthy living. For students experiencing problems related to mental health, the CWS acts as the best point of reference. The facility helps students with any mental health concerns they might experience during their stay at the university, including stress, depression, suicidal thoughts, anxiety, and family issues.
According to Yoo and De Choudhury (2019), mental illness rarely occur as a solitary experience, but rather a culmination of social as well as ecological underpinnings. As a result, there is a need to involve multiple stakeholders to help with the problem. These may include peers and friends, student’s family members, on-campus clinicians, administrators, and instructors. The need for multiple perspectives when dealing with the problem of mental health amongst international students in institutions of higher learning emanates from the fact that many of these students do not always feel free to seek out conventional services such as the ones offered in UHCs (Carmack et al., 2016). Despite acknowledging this need, however, the lack of actionable and timely information hinders the efficacy and appropriateness of the actions of many of these stakeholders (Yoo & De Choudhury, 2019). For instance, campus administrators such as officers in charge of student affairs assist students to achieve their professional and educational goals. However, since mental issues largely affect student performance, such administrators may tend to employ campus-wide strategies to target only vulnerable students. However, the officers may lack timely and actionable data about students that can adequately support evidence-based programs and adjustment policies to help many students suffering from mental illnesses. As a result, involving a wide range of stakeholders ensures that efforts and expertise are synced hence achieving better results.
On-campus clinicians act as important campus stakeholders that can assist international students to cope with stressful university life. These clinicians include counselors, psychiatrists, therapists, dietitians, and case managers. Typically, these care providers are usually affiliated with the university’s student health services and their main purpose is to administer treatment and counseling (Wu, Garza, & Guzman, 2015). Counseling sessions can be undertaken through different platforms such as clinical questionnaires and face-to-face interviews. Assessment can be done during the initial stages such as during admission. Afterward, symptoms of mental health illness are tracked for interventions. However, the approach suffers from serious setbacks. Or instance, counseling sessions only capture student’s status at a specific time during the interviews. Consequently, the information may change significantly hence providing misleading interventions. The need to employ the services of other stakeholders such as technology experts is, therefore, an important aspect in helping institutions of higher learning such as NYU in helping international students deal with stressors. For instance, information technology companies can help the organization develop self-tracking technologies for medical health.
According to Kronholz (2014), different theoretical guidelines can be utilized when working with international students. Key among these theories is the person-centered theory that considers a humanistic approach by dealing with ways in which people perceive themselves consciously as opposed to how a counselor can interpret their ideas and unconscious thoughts. The theory places a lot of emphasis on the importance of empathy as well as the ability to relate to others in an accepting manner. In order for multicultural counseling to work perfectly, the therapist should fully receive the client. Similarly, the client must feel received and understand by the therapist in return. Once the counselor becomes fully aware of the influence of culture and self, it becomes possible for the therapist to subscribe to the notion of being receptive towards the counseling process for the international students. Person-centered therapy also supports the idea of culture-free models (Kronholz, 2014). The culture-free model serves as a central component to counseling international students. The theory describes a model that attempts to develop counseling measures that are free from cultural bias and not dependent on any particular cultural context. Another theory that may be efficacious when dealing with international students is cognitive-behavioral therapy. Due to the difficulty in obtaining data on the international student population, it is pretty challenging to reach a consensus regarding a specific empirical intervention to be used among international students across all institutions of higher learning.
Implications and Recommendations
Addressing the problem of mental health care among international students in U.S. institutions of higher learning requires multi-perspective approaches. While universities such as NYU have implemented some strategies geared towards helping students deal with mental illnesses, there is still a lot that needs to be done. Typically, the most conventional measures adopted by many institutions of higher learning tend to favor domestic students only, while leaving out a large junk of international students (Mesidor & Sly, 2016). For instance, the fact that international students do not always feel free to report symptoms of mental illnesses to conventional campus counselors due to challenges such as fear of discrimination, financial pressures, and language barriers is a serious setback. In the light of the existing gaps, the following recommendations are proposed;
Widening information access relating to mental health. While universities offer extensive orientation as well as pre-arrival information to international students seeking to join U.S. institutions, such orientation programs tend to last up to one week. Many students indicate that these events and programs are very useful in helping them cope with the new experiences and environment. However, the preparatory strategies tend to focus more on practical experiences such as study skills, financial management, and immigration processes. As such, the programs are less likely to focus on emotional or psychological processes, perhaps as a way of avoiding sounding negative or causing alarm among international students (Auerbach et al., 2018). The implication is that students may be left unprepared for other aspects of change hence affecting their sleep pattern, moods, and social confidence. To address the issue, institutions of higher learning should give consideration to ongoing programs that support students’ mental health (Lértora, Sullivan, & Croffie, 2017). Similarly, it may be worthwhile to devote more time to orientation programs, this time focusing more on mental health challenges that the international students are likely to encounter during their stay at the university. The university can use senior international students who have navigated campus successfully.
Collaborating with academic and student affairs departments. Offering programs at different locations such as the international students’ office, halls of residence, and academic departments can play an important role in helping international students cope with the new challenging environment. Such programs should aim at connecting international students to colleagues coming from similar cultures (Sullivan & Kashubeck-West, 2015). At the same time, international students are able to connect to domestic students hence helping the students build social support, develop stronger language skills, enhance their confidence and skills of navigating in a new, unfamiliar environment.
Developing contingency plans for mental health issues. Acknowledging that mental health is a pertinent issue among international students is the first step towards coming up with the right strategies for addressing the problem. Institutions of higher learning should develop policies and contingency plans that are geared towards addressing the challenges of mental health among students. For instance, campuses can develop policies and processes surrounding family contacts such as factors that would require the institution to reach out to family members, and arrangements for translation services in case of language barriers (Birnbaum et al., 2012). Additionally, considering the inclusion of provisions in student insurance policies that cover different aspects that address international students’ needs such as costs of sending them home, cost of staff travels when required to accompany the students’ home among other emergencies (Ozturgut, 2013). Such contingencies ensure that students are covered from earlier stages thus avoiding situations where mental health issues escalate and remain unattended, leading to severe implications such as dropping out of school or suicide.
International advisors on mental health issues. Advisors play a crucial role in the life of international students. Typically, students rely on advisors to facilitate professional development, funding for research, and facilitate advancement throughout the program. Students with functioning relationships with their international advisors are placed in a better position to seek counseling services. While most institutions of higher learning have UHCs that seek to address the mental health needs of their students, most international students are reluctant to seek help from these facilities. As a result, these students may be left to struggle with serious health issues that have serious implications on student life. However, having international advisors who focus on mental health issues can open a window for students to share their concerns. Students may feel more comfortable discussing their problems with international advisors as opposed to domestic ones. Consequently, this will improve early reporting and detection of mental illnesses thus allowing the university fraternity to intervene before harm is done.
Training faculty members on special mental health issues. All faculty members, especially those in the role of advisors should be educated and trained on specific mental healthcare issues surrounding international students. Similarly, they should be trained on how to improve their interaction and relationship with the international students (Han et al., 2013). Faculty members spend significant time with students during classes and as a result, they can be better placed to spot red flags pertaining to the deteriorating mental health of their students. However, without the necessary training, the staff cannot be able to effectively play this role. Faculty members also need to educate faculty members on how to encourage their students, especially international students on how to pursue healthy lifestyles such as moderating time spent on the internet, regular exercise, diets, and other recreational activities. Just referring the students to mental health professionals on campuses cannot be an adequate intervention mechanism (Prieto‐Welchm, 2016). Therefore, academic staff can be equipped with basic training on how to handle cases of mental health amongst their students as they act as the first line of defense to international students who may not feel comfortable visiting counseling services offered at campuses.
Developing mental health outreach programs targeted to specific student groups. Students coming from different backgrounds usually experience greater levels of stigma towards underlying mental health issues. For instance, Asian international students tend to experience greater comfort with counseling, less openness and prefer a flexible counseling format. Further, young adults who perceive public stigma surrounding mental illness may be reluctant to seek mental health (Leong, 2015). To address the issue, there is an urgent need to develop a mental outreach program that targets specific international student groups that are at high risk of developing mental health issues. Similarly, new models that advocate for culturally sensitive care continuity with tailored mental outreach are a necessity.
Mental health is one of the leading concerns surrounding international students studying in the United States. International students suffer from culture shock, home-sickness, language-related problems, and isolation. This group of students also encounters difficulties related to financial stress, dietary restrictions, discrimination and lack of support from American peers, and cultural misunderstandings. Since mental illness rarely occurs as a solitary experience, but rather a culmination of social as well as ecological underpinnings, there is a need to involve multiple stakeholders to help with the problem. In light of the literature considerations and existing gaps in institutions of higher learning, the following recommendations are made in an effort to improve the mental health of international students on the campus such as NYU; widening information access, collaborating with academic and student affairs departments, developing mental health contingency plans, utilization of international advisors, and developing mental health outreach programs.
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