Every student responds differently, but it's not unusual that they may suffer from low mood, anxious or fearful thoughts, tiredness, insomnia, loss of self-confidence, and loneliness. Many carry a weight of expectation from families with pressure to achieve. This is particularly true where families have made significant financial investment to support the student's studies. They may have additional difficulties where there is a crisis back home and where the distance and cost of travel mean that it is not easy to return.
When things get challenging, it's not always easy for them to access support. Mental health, support services, and therapies are viewed very differently in different cultures. In many countries there is still substantial stigma and shame attached to mental ill health. Just the practical understanding of how to access care in the NHS can be a barrier for students getting the care they need.
Work previously undertaken at the University of Nottingham into the experience of Chinese and Malaysian students indicates that there are a complex range of factors that can impact international students' health and wellbeing. Each year at Nottingham over 27% of our population are international students so it's crucial that we understand how to best support their needs. In addition, the number of international students presenting at our specialist services is increasing year on year. For example, in our Mental Health Advisory Service we have increased from 119 international students in 2015–16 to 185 in 2017–18. And this upward trend shows no sign of abating.
Universities are now prioritising mental health, adopting whole university approaches, based on Universities UK's Stepchange framework to improve outcomes. There is of course no 'one-size-fits-all' solution: different student populations and different types of institution require different interventions. The mental health needs of international students differ in significant ways from those of home students, and must be addressed differently by universities and healthcare providers. However, few currently provide targeted mental health support for these students. This is not to say that there aren't examples of good practice within the sector. Providing explanatory documentation about the NHS and how health services in the UK work is a positive health promotions intervention. Peer-led programmes like the Global Buddies scheme that University of Nottingham Students' Union runs deliver culturally appropriate and sensitive support. External providers offering bilingual services and technological delivery are providing new approaches to addressing issues.
But for all of the good work within the sector, there is no store of best practice or specific guidance for colleagues. That's why we have recently submitted a business case to the Office for Students' Achieving a step change in mental health outcomes competition call that is focused on creating a toolkit for the higher education sector as a whole. Working with colleagues from SOAS, University of Leeds, Student Minds, and CampusLife, our intention is to provide resources and examples of best practice that will allow institutions to co-create local responses to the needs of their international students. Through effective engagement and coproduction we believe that we can all establish more culturally competent services.
At a time when Brexit and the Augar review make for an uncertain future, one thing that we can be certain of is that so long as Universities look to recruit international students, there will be a need for services and initiatives that are tailored to meet their needs.
Andy will be speaking on supporting international students' mental health at Universities UK International's flagship annual conference – the International Higher Education Forum – on March 27th at Imperial College London. He will share the stage with Professor Kathryn Mitchell, Vice Chancellor, University of Derby; Yinbo Yu, International Students' Officer, NUS; and chair Debbie McVitty - Wonkhe's Editor. www.universitiesuk.ac.uk/ihef
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