NAFSA Region II Conference 2015

Improving Mental Health Awareness Among International Students

Presenters

Jennifer Frankel

Linda Melville

Chalimar Swain

Agenda

Achieving Mental Health: Creating AwarenessSecond-level Support: Mental IllnessHelping Students Seek Care/BarriersResources/Best PracticesCase Studies and Discussion

Achieving Mental Health:Creating Awareness

What is Mental Health?

Mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

- Centers for Disease Control and Prevention

Challenges for International Students

Far from family and friendsValues are being challengedNeed to reformulate identity & personality Challenge to skills & abilitiesMay have studied abroad to avoid problems at home

How Can We Assist?Make them aware of the challengesHelp them to create a support systemInform them about campus and community resourcesOffer workshops to help cope with common stressors

(culture shock, academics, etc.)Educate campus staff

Types of Programs that HelpBuddy/Peer mentor programsCulture shock workshopsUniversity 101-type coursesSocial organizations/student clubsHoliday programsFriendship family programsStaff training

Train Advising and Office StaffDiscuss common issuesTeach active listeningEncourage empathyCreate a plan of actionRemind staff to be courteous and friendlyCreate a welcoming environment

Second-Level Support:Mental Illness

Series105

101520253035404550

Experienced Emotional/Stress Related ProblemsConsidered Seeking CareActually Sought Care

44%

33%

17%

(Source: Hyun, Quinn, Madon, & Lusting, 2010)

Domestic Students:

56%

Domestic Students:

36%

International Students Are Not Seeking Care

Commonalities with US Students

90% of students who seek counselling improve within 6 monthsIssues are similar, most common include:

Anxiety related to performanceFear of failureFinances

Source: Data from UNM Counseling Center

Unfamiliarity with US systemsPhysical differences that set them apart (hijab)Political systems can make them feel implicated

Differences from US Students

What is Mental Illness?

Mental illness is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.”

- Centers for Disease Control and Prevention

Mental Illness – Birds Eye View

Source: National Institutes of Health, 2013 Source: World Health Organization, 2002

450 million people affected

Almost 50% affected

Helping Students Seek Care:

Eliminating Barriers

“Adequate orientation and administrative support for international students are key factors in successful transitions.”

(Source: Hyun, Quinn, Madon, & Lusting, 2010)

Domestic

Students: 79%

Yes No

39%

61%

Knowledge of Campus Counseling Services

Worldwide StigmaMental illness often goes undiagnosed and untreated among international students due to the negative connotations associated with the subject around the world.

Common Myths

“Counseling is for crazy people.”

“Everyone will know I saw the counselor.”

“I can handle my own health problems. If not, it means I’m weak.”

An Advisor’s Role and Boundaries

“International students who reported a more functional relationship with their advisors were

less likely to report having an emotional or stress-related problem in the past year and [to

report] using counseling services...”

Warning SignsChange in AppearanceAcademic ProblemsSocial IsolationNoticeable Changes in MoodUnusual or Odd BehaviorsDrug/Alcohol AbuseThreat of Harm to Themselves or Others

Helping Students Seek CareOn-campus assistance:

Mental Health StaffHoursAverage CostNo counseling center?Relationships with other providersSuggestions from other departmentsHelplines

Insurance and Mental HealthWhat is Legally Required?

Nothing!

Mental health insurance coverage is not required by

the government for international students.

Questions to Consider:

1. Do the students’ insurance plans cover mental health?

2. Does the insurance company offer language support?

3. Do students realize that claims are confidential?

Best Practices & Resources

Best Practices: Awareness & Action

1. Train advisors to spot red flags• Numerous/repeated failed courses

• Difficulty sleeping/sleeping too much

• Isolation

• Requesting a medical RCL/LOA

2. Understand the “international” component • Cultural coping strategies/ perceptions of resources

• Additional stressors or factors impacting primary issue

Best Practices: Awareness & Action

3. Indentify resources & protocols• CARE Team

• Counseling Resources

• Other Resources

4. “High Touch” assistance and follow through • Refer to another person, not another office

• Demystify processes (i.e., counseling center intake)

• Follow-up to see how things are going

Best Practices: Awareness & Action

5. Set boundaries• Refer as appropriate

• Understand your capabilities and triggers

• Be clear about your role

6. Interdepartmental outreach • Help others understand international students’

unique needs

Best Practices: CARE TeamCentralized team: indentifies and provides support for escalated

issues

1. Centralized response/tracking for situations of concern; including referrals to/coordination with specific resources needed

2. Coordination of support and response; ensure multiple perspectives:

• Multicultural sensitivity

• Social and emotional wellbeing

• Academic outcomes

3. Training opportunities for ISSS staff: holistic response to advising

Best Practices: CARE Team, con’t.

Meets weekly, discusses current student situations, formulates action plans and assigns follow-up

Care Team does NOT:

1. Provide mental health treatment or assessment

2. Adjudicate conduct issues

Structure

3 permanent members (Director, Associate Directors)

2 rotating members (advisors, GA’s)

Resources and AwarenessMental Health Awareness Video Resource:

www.internationalstudentinsurance.com/explained/mental-health-video.php

NAFSA provides the following publications:

Health and Wellness for International Students

Best Practices in Addressing Mental Health Issues Affecting Education Abroad Participants

www.nafsa.org/Find_Resources/

Resources - National Hotlines National Suicide Prevention

1-800-273-TALK

www.suicidepreventionlifeline.org

Substance Abuse and Mental Health Services Administration (SAMHSA)

1-800-SAMHSA-7 or 1-877-726-4727

www.samhsa.gov

It Gets Better Project (LGBTQ)

1-866-4-U-TREVOR (866-488-7386) or 1-888-843-4564

www.itgetsbetter.org/pages/get-help also includes state specific resources

https://www.nami.org/Find-Support/LGBTQ

The National Domestic Violence Hotline

1-800-799-SAFE

http://www.thehotline.org/

Case Studies & Discussion

Case Study #1During an appointment with a student to discuss her request for a reduced course load (RCL), the student tells you that she needs to drop at least one, and maybe more courses. When you ask her why, she is vague, stating that she is having trouble with the topics. You notice that last semester, she had failing grades in 3 out of 4 courses. You mention this, and ask her if anything specific is causing her difficulty. She says she’s having trouble sleeping at night and is very tired each day and can’t go to class.

What follow up questions could you ask?

What resources could you offer?

What possible mental health issues might you be aware of?

Case Study #2Julio, an exchange student from Spain, seems to be constantly in the office. Several times, he has spent up to two hours speaking with an advisor. He also attends all of your workshops and social events. He appears to be very extroverted and nice, if perhaps a little needy. About two months after the start of the semester, you notice that Julio is in the office every day, often meeting with one particular advisor or sometimes just “hanging out”. Soon after, the advisor comes to you and expresses concern about the things Julio is telling her. He seems to be having major issues with his family at home, and is very lonely and isolated. Lately she’s also noticed that Julio looks disheveled and unkempt. The advisor doesn’t really feel comfortable with the amount of time he’s spending with her, but she’s hesitant to bring anyone else in because “Julio trusts me”. What are the issues? What actions should you take?

Thank you!

Q&A