International Graduate Students’ Mental Health Diagnoses, Challenges, and Support
A Descriptive Comparison to their Non-International Graduate Student Peers
Keywords:Canada, international students, graduate students, National College Health Assessment, mental health, stress, help-seeking
Although there is a growing body of research that suggests the mental health of graduate students differs from that of their undergraduate counterparts, studies examining international students at the graduate level are scarce. This study therefore compares mental health diagnoses, challenges and stressors experienced, and use of mental health support, of international and non-international students who identified as being graduate/professional students. Data from the 2019 Canadian National College Health Assessment were used to compare the international graduate students (n = 1,876) to their non-international peers (n = 4,809). Significant differences were found on prevalence of conditions, certain specific challenges that are experienced, and help-seeking behaviours. Overall, international and non-international students may experience similar challenges, but international students are less likely to seek support. The findings suggest a need for graduate advisors and student affairs professionals to recognize the unique experiences of international graduate students particularly with their help-seeking behaviours.
Abu, A. (2017). Speaking Your Language—MHIF (Round 2). Retrieved from http://campusmentalhealth.ca/project/speaking-your-language/
American College Health Association. (2013b). American College Health Association-National College Health Assessment II: Reliability and Validity Analyses 2011. Hanover, MD: American College Health Association. Retrieved from https://www.acha.org/documents/NCHA/ACHANCHAII_RELIABILITY_AND_VALIDITY_ANALYSES.pdf
American College Health Association. (2014). American College Health Association-National College Health Assessment II: Graduate & professional students reference group data report Spring 2014. Hanover, MD: Author. Retrieved from https://www.acha.org/documents/ncha/NCHAII%20SPRING%202016%20’s GRADUATE%20PROFESSIONAL%20REFERENCE%20GROUP%20DATA%20REPORT.pdf
American College Health Association. (2019). American College Health Association-National College Health Assessment II: Canadian reference group data report Spring 2019. Hanover, MD: Author. Retrieved from https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_CANADIAN_REFERENCE_GROUP_DATA_REPORT.pdf
Baird, L. (1990). The melancholy of anatomy: The personal and professional development of graduate and professional school students. In J. C. Smart (Ed.)., Higher Education: Handbook of Theory and Research, vol. VI (pp. 361-392). New York: Agathon Press.
Bekkouche, N. S., Schmid, R. F., & Carliner, S. (2022). “Simmering pressure”: How systemic stress impacts graduate student mental health. Performance Improvement Quarterly, 34(4), 547-572. DOI: https://doi.org/10.1002/piq.21365
Barreira, P., Basilico, M., & Bolotnyy, V. (2018). Graduate student mental health: Lessons from American economics departments. Harvard University. Retrieved from https://scholar.harvard.edu/sites/scholar.harvard.edu/files/bolotnyy/files/bbb_mentalhealth_paper.pdf
Briggs, P., & Ammigan, R. (2017). A collaborative programming and outreach model for international student support offices. Journal of International Students, 7(4), 1080-1095. doi:10.5281/zenodo.1035969 DOI: https://doi.org/10.32674/jis.v7i4.193
Bryce Loo. (2016). Career services for international students: Fulfilling high expectations. World Education Services.
Canadian Association for Graduate Studies. (2018). 44th statistical report, 2018. Ottawa, ON: Author. Retrieved from https://cags.ca/wp-content/uploads/2019/04/44th-Statistical-Report-Part-1-2018.pdf
Canadian Bureau for International Education (2020). International students in Canada continue to grow in 2019. CBIE. Retrieved August 19th, 2022, from https://cbie.ca/international-students-in-canada-continue-to-grow-in-2019/
Canadian Bureau for International Education. (2021). The student’s voice: National results of the 2021 CBIE International Student Survey. Retrieved from https://cbie.ca/wp-content/uploads/2022/06/CBIE-2021-International-Student-Survey-National-Report-FINAL.pdf
Clough, B. A., Nazareth, S. M., Jamin, S. M., Day, J. & Casey, L. M. (2019) A comparison of mental health literacy, attitudes, and help-seeking intentions among domestic and international tertiary students, British Journal of Guidance & Counselling, 47(1), 123-135. DOI: https://doi.org/10.1080/03069885.2018.1459473
Eisenberg, D., Hunt, J., & Speer, N. (2013). Mental health in American colleges and universities: variation across student subgroups and across campuses. The Journal of Nervous and Mental Disease, 201(1), 60-67. DOI: https://doi.org/10.1097/NMD.0b013e31827ab077
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Prevalence and correlates of depression, anxiety, and suicidality among university students. American Journal of Orthopsychiatry, 77(4), 534-542. DOI: https://doi.org/10.1037/0002-94188.8.131.524
Erichsen, E. A., & Bolliger, D. U. (2011). Towards understanding international graduate student isolation in traditional and online environments. Educational Technology Research and Development, 59(3), 309-326. DOI: https://doi.org/10.1007/s11423-010-9161-6
Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T., & Vanderford, N. L. (2018). Evidence for a mental health crisis in graduate education. Nature Biotechnology, 36(3), 282. DOI: https://doi.org/10.1038/nbt.4089
Forbes-Mewett, H., & Sawyer, A. M. (2016). International students and mental health. Journal of International Students, 6(3), 661-677. DOI: https://doi.org/10.32674/jis.v6i3.348
Gan, J. & Forbes-Mewett, H. (2018). International students mental health: An Australian case study of Singaporean students’ perceptions, in K. Bista (ed.), Global Perspectives on International Student Experiences in Higher Education: Tensions and Issues, USA: Routledge pp. 228-42. DOI: https://doi.org/10.4324/9781315113456-15
Garcia-Williams, A. G., Moffitt, L., & Kaslow, N. J. (2014). Mental health and suicidal behavior among graduate students. Academic Psychiatry, 38(5), 554-560. DOI: https://doi.org/10.1007/s40596-014-0041-y
Golberstein, E., Eisenberg, D., & Gollust, S. E. (2008). Perceived stigma and mental health care seeking. Psychiatric Services, 59(4), 392-399. DOI: https://doi.org/10.1176/ps.2008.59.4.392
Hamamura, T., & Laird, P. G. (2014). The effect of perfectionism and acculturative stress on levels of depression experienced by East Asian international students. Journal of Multicultural Counseling and Development, 42(4), 205-217. DOI: https://doi.org/10.1002/j.2161-1912.2014.00055.x
Hamamura, T., & Mearns, J. (2019). Depression and somatic symptoms in Japanese and American college students: Negative mood regulation expectancies as a personality correlate. International Journal of Psychology, 54(3), 351-359. DOI: https://doi.org/10.1002/ijop.12467
Hyun, J., Quinn, B., Madon, T., & Lustig, S. (2007). Mental health need, awareness, and use of counseling services among international graduate students. Journal of American College Health, 56, 109-118. https://doi.org/10.3200/JACH.56.2.109-118 DOI: https://doi.org/10.3200/JACH.56.2.109-118
Hyun, J. K., Quinn, B. C., Madon, T., & Lustig, S. (2006). Graduate student mental health: Needs assessment and utilization of counseling services. Journal of College Student Development, 47(3), 247-266. http://doi.org/bh2h7f DOI: https://doi.org/10.1353/csd.2006.0030
Hwang, B., Bennett, R., & Beauchemin, J. (2014). International students’ utilization of counseling services. College Student Journal, 48(3), 347-354.
Jorm, A. F., Korten, A. E., Jacomb, P., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166, 182–186. DOI: https://doi.org/10.5694/j.1326-5377.1997.tb140071.x
Kilinc, A., & Granello, P. F. (2003). Overall life satisfaction and help‐seeking attitudes of Turkish college students in the United States: Implications for college counselors. Journal of College Counseling, 6(1), 56-68. DOI: https://doi.org/10.1002/j.2161-1882.2003.tb00227.x
Koo, K., Kim, Y. W., Lee, J., & Nyunt, G. (2021). “It’s my fault”: Exploring experiences and mental wellness among Korean international graduate students. Journal of International Students, 11(4), 790-811. DOI: https://doi.org/10.32674/jis.v11i4.2801
Lee, E. J., Ditchman, N., Fong, M. W., Piper, L., & Feigon, M. (2014). Mental health service seeking among Korean international students in the United States: A path analysis. Journal of Community Psychology, 42(6), 639-655. DOI: https://doi.org/10.1002/jcop.21643
Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle, L. (2017). Work organization and mental health problems in PhD students. Research Policy, 46(4), 868-879. doi:10.1016/j.respol.2017.02.008 DOI: https://doi.org/10.1016/j.respol.2017.02.008
Lu, S. H., Dear, B. F., Johnston, L., Wootton, B. M., & Titov, N. (2013). An internet survey of emotional health, treatment seeking and barriers to accessing mental health treatment among Chinese-speaking international students in Australia. Counselling Psychology Quarterly, 27(1), 96–108. doi: 10.1080/09515070.2013.824408 DOI: https://doi.org/10.1080/09515070.2013.824408
Misra, R., & Castillo, L. G. (2004). Academic stress among college students: Comparison of American and international students. International Journal of Stress Management, 11(2), 132-148. https://psycnet.apa.org/doi/10.1037/1072-5245.11.2.132 DOI: https://doi.org/10.1037/1072-5245.11.2.132
Mitchell, S. L., Greenwood, A. K., & Guglielmi, M. C. (2007). Utilization of counseling services: Comparing international and US college students. Journal of College Counseling, 10(2), 117-129. DOI: https://doi.org/10.1002/j.2161-1882.2007.tb00012.x
Morris, C. (2021). “Peering through the window looking in”: postgraduate experiences of non-belonging and belonging in relation to mental health and wellbeing. Studies in Graduate and Postdoctoral Education, 12(1). https://doi.org/10.1108/SGPE-07-2020-0055 DOI: https://doi.org/10.1108/SGPE-07-2020-0055
Myers-Walls, J., Frias, L. V., Kwon, K., Ko, M. M., & Lu, T. (2011). Living life in two worlds: Acculturative stress among Asian international graduate student parents and spouses*. Journal of Comparative Family Studies, 42(4), 455-XIV. DOI: https://doi.org/10.3138/jcfs.42.4.455
Nilsson, J. E., Berkel, L. A., Flores, L. Y., & Lucas, M. S. (2004). Utilization rate and presenting concerns of international students at a university counseling center: Implications for outreach programming. Journal of College Student Psychotherapy, 19(2), 49-59. DOI: https://doi.org/10.1300/J035v19n02_05
Ogunsanya, M. E., Bamgbade, B. A., Thach, A. V., Sudhapalli, P., & Rascati, K. L. (2018). Determinants of health-related quality of life in international graduate students. Currents in Pharmacy Teaching and Learning, 10(4), 413-422. DOI: https://doi.org/10.1016/j.cptl.2017.12.005
Oswalt, S. B., & Riddock, C. C. (2007). What to do about being overwhelmed: Graduate students, stress and university services. College Student Affairs Journal, 27(1), 24-44.
Oswalt, S. B., & Wyatt, T. J. (2011). Sexual orientation and differences in mental health, stress, and academic performance in a national sample of US college students. Journal of Homosexuality, 58(9), 1255-1280. DOI: https://doi.org/10.1080/00918369.2011.605738
Posselt, J. (2021). Discrimination, competitiveness, and support in US graduate student mental health. Studies in Graduate and Postdoctoral Education, 12(1). doi: http://dx.doi.org/10.1108/SGPE-07-2020-0042 DOI: https://doi.org/10.1108/SGPE-07-2020-0042
Poyrazli, S., Kavanaugh, P. R., Baker, A., & Al‐Timimi, N. (2004). Social support and demographic correlates of acculturative stress in international students. Journal of College Counseling, 7(1), 73-82. DOI: https://doi.org/10.1002/j.2161-1882.2004.tb00261.x
Poyrazli, S. (2015). Psychological symptoms and concerns experienced by international students: Outreach implications for counseling centers. Journal of International Students, 5(3), 306-312. DOI: https://doi.org/10.32674/jis.v5i3.424
Prieto‐Welch, S. L. (2016). International student mental health. New Directions for Student Services, 2016(156), 53-63. DOI: https://doi.org/10.1002/ss.20191
Quaye, S., & Harper, S. (2015). Student engagement in higher education: Theoretical perspectives and practical approaches for diverse populations (2nd ed.). New York, NY: Routledge.
Rahn, R. N., Pruitt, B., & Goodson, P. (2016). Utilization and limitations of the American college health Association's National College Health Assessment instrument: a systematic review. Journal of American College Health, 64(3), 214-237. DOI: https://doi.org/10.1080/07448481.2015.1117463
Redekopp, D. E., & Huston, M. (2020). Strengthening mental health through effective career development: A practitioner’s guide. CERIC. Retrieved from https://ceric.ca/publications/strengthening-mental-health-through-effective-career-development-a-practitioners-guide/
Reynolds, A. L., & Constantine, M. G. (2007). Cultural adjustment difficulties and career development of international college students. Journal of Career Assessment, 15(3), 338-350. DOI: https://doi.org/10.1177/1069072707301218
Shadowen, N. L., Williamson, A. A., Guerra, N. G., Ammigan, R., & Drexler, M. L. (2019). Prevalence and correlates of depressive symptoms among international students: Implications for university support offices. Journal of International Students, 9(1), 129-149. https://doi.org/10.32674/jis.v9i1.277 DOI: https://doi.org/10.32674/jis.v9i1.277
Shen, Y. J., & Herr, E. L. (2004). Career placement concerns of international graduate students: A qualitative study. Journal of Career Development, 31(1), 15-29. DOI: https://doi.org/10.1023/B:JOCD.0000036703.83885.5d
Statistics Canada. (2020a). Table 37-10-0004-01 Canadian graduate tuition fees by field of study. Retrieved from https://doi.org/10.25318/3710000401-eng
Statistics Canada. (2020b). Table 37-10-0006-01 International graduate tuition fees by field of study. Retrieved from https://doi.org/10.25318/3710000601-eng
Statistics Canada. (2021). Prior to COVID-19, international students accounted for the growth in postsecondary enrolments and graduates. The Daily. Retrieved from https://www150.statcan.gc.ca/n1/en/daily-quotidien/211124/dq211124d-eng.pdf?st=9_T_-oDG
Sverdlik, A., & Hall, N. C. (2020). Not just a phase: Exploring the role of program stage on well-being and motivation in doctoral students. Journal of Adult and Continuing Education, 26(1), 97-124. DOI: https://doi.org/10.1177/1477971419842887
The Canadian Bureau for International Education. (2016). A world of learning: Canada’s performance and potential in international education. Retrieved from http://net.cbie.ca/download/World-of-Learning-2016-EN.pdf
Wyatt, T., & Oswalt, S. B. (2013). Comparing mental health issues among undergraduate and graduate students. American Journal of Health Education, 44(2), 96-107. https://doi.org/10.1080/19325037.2013.764248 DOI: https://doi.org/10.1080/19325037.2013.764248
Yoon, E., & Jepsen, D. A. (2008). Expectations of and attitudes toward counseling: A comparison of Asian international and US graduate students. International Journal for the Advancement of Counselling, 30(2), 116-127. DOI: https://doi.org/10.1007/s10447-008-9050-4
Zhou, Y., Zhang, H., & Stodolska, M. (2018). Acculturative stress and leisure among Chinese international graduate students. Leisure Sciences, 40(6), 557-577. DOI: https://doi.org/10.1080/01490400.2017.1306466
How to Cite
Copyright (c) 2022 Journal of International Students
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
All published articles are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 Unported License.