Prevalence of common mental concerns and service utilization among international students studying in the U.S. 

ABSTRACT

An estimated one million international students are enrolled in U.S. universities. However, little was known about the landscape of their mental health and help-seeking behaviors. Drawing from a large national university student sample (N = 228,421, 8.49% non-U.S. citizen) from the Healthy Minds Study, data indicated the rates of major depressive disorder, generalized anxiety disorder, eating disorder, non-suicidal self-injury, and suicidal ideation were 27.4%, 20.0%, 26.4%, 17.2%, and 8.8% respectively among international students, with high inter-country variabilities. Contrary to our expectations, there is no strong and consistent evidence suggesting international students were at higher risk for common mental health concerns compared to domestic students. However, among students who were screened positive for these mental health disorders (n = 96,567), there was a significant difference between service utilization rates for international students and domestic students (32.0% vs. 49.8%), even after controlling for gender, age, socioeconomic status, perceived need for help, mental health stigma, and using informal support. Our results highlight the urgency for addressing mental health concerns and equitable mental health care among international students.

KEYWORDS:

• International students
• mood disorders
• suicidality
• eating disorders
• mental health disparity
• mental health utilization

Disclosure statement

No potential conflict of interest was reported by the authors.

Practical implication

Roughly half of the international students from 233 U.S. universities were screened positive for major depressive disorder, generalized anxiety disorder, eating disorder, non-suicidal self-injury, or suicidal ideation. Prevalence rates for these common mental health concerns were lower (except for a higher prevalence of eating disorders) among international students compared to domestic students, although the effect sizes of these differences were small. However, international students significantly underutilize mental health therapy and psychotropic medication services compared to domestic students.

Additional information

Notes on contributors

Xiang Zhou

Dr. Xiang Zhou, is an Assistant Professor of Counseling Psychology at Purdue University and a Licensed Psychologist in Indiana. His research interests include mental health disparity, family processes, and culturally adapted interventions.

Anne Q. Zhou

Dr. Anne Q. Zhou, is an Assistant Professor in the Counseling Psychology program at the University of Florida. Her program of research focuses on mental health treatment seeking behaviors and the barriers to seeking treatment.

Xiaoning Sun

Dr. Xiaoning Sun, is a postdoctoral research fellow at the Shanghai Children's Medical Center affiliated to Shanghai Jiao Tong University School of Medicine. She received her doctorate in clinical psychology from the University of Oregon. Her scholarly interests include the risk and protective factors of children's self-regulation, developmental psychopathology, and cross-cultural psychology.