NAFSA Region V Conference 2015

Improving Mental Health Awareness Among International Students

Presenters

Jennifer Frankel

Justin Osadjan

Colleen Seaton

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 challenged- cultural differencesFinancesNeed to reformulate identity & personalityChallenge to skills & abilitiesMay have studied abroad to avoid problems at homeLanguage barriersUnfamiliarity with US systemsPhysical differences that set them apart (hijab)Political systems can make them feel implicated

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

Working With International Students

Take an active role in understandingApproaching an unfamiliar situation

Describe- stick to the facts

Analyze- possible explanations

Evaluation- personal feelings (awareness)

Working With International Students, Cont.

Intercultural AwarenessDirect/Indirect

Formal/Informal

Collectivism/Individualism

High context/Low context

Equality/Hierarchy

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

An Advisor’s Role“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...”

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

Second-Level Support:Mental Illness

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

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

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.”

Warning Signs Hopelessness/ Feeling TrappedLack of PurposeChange in AppearanceAcademic ProblemsProblems with Sleep/AppetiteSocial Isolation/ Withdrawal from OthersLack of Concern about Personal WelfareIncreased Drug/Alcohol Abuse, or RelapseThreat of Harm to Themselves or Others

Helping Students Seek CareOn-campus assistance:

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

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

Know the warning signsAskPersuade – active listening + support + non-judgemental = receptiveRefer – connect students to resourcesFollow-up with the student

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

Programming: NU International Office

Orientation

Understanding health insurance in the US

Culture Shock

Workshops

Winter is coming back!

Culture Shock! – Halloween

Community Programs

Thanksgiving

Peer Mentors

Programming: Counselling & Psychological Services

Programming: Counselling & Psychological Services

Stress Management Clinic

Meditation Groups

Relaxation and Biofeedback

Sleep for Health & Performance

Happiness 101

Programming: Roosevelt University

Orientation

Introduction to staff of Counseling Center

Cultural Adjustment

Counselling Center Liaison

A designed counsellor is assigned to international office staff

Counseling Center Wellness Programs

Relationship-building with Students

Programming: Staff TrainingSuicide Prevention Training- QPR

Although suicide is one of the most preventable forms of death, it is the second leading cause of death among college students.

Question, Persuade and Refer

http://www.qprinstitute.com/

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