Compounding Stress: The Pandemic’s Effects on Mental Health
Unsurprisingly, the past year has taken a tremendous toll on the mental health of students everywhere. A survey of more than 16,800 students in 21 countries conducted for Chegg, an education technology company, found that more than half of undergraduates said their mental health had suffered as a result of the COVID-19 pandemic.
For international students, however, the toll has been even greater. The pandemic exacerbated existing issues, created new ones, and required more attention and care for students’ mental health than ever before. The changes that institutions undertook to address student needs will have an impact long after the pandemic is over.
Pandemic Pressures on Students’ Mental Health
“International students across the globe have been hit particularly hard by the pandemic due to additional sources of uncertainty,” says Cory Owen, EdD, associate dean of students at Yale-NUS College and the author of Advising International Students with Disabilities. “For many international students, they needed to make difficult decisions on whether to stay in the country of their studies or go back home, and regardless of their choice, there were severe repercussions to their mental health.”
Under the best of circumstances, international students must make more adjustments than their domestic peers do when studying at a U.S. institution.
“It’s hard to live in a country where you don’t know the rules and where you’re operating in a language that is not your native tongue,” says Emma Swift, EdM, associate director of the Office of International Education at the University of Vermont and the author of U.S. Classroom Culture, a NAFSA student guide.
The emotional pressures on international students came from multiple directions, says Ling Jin, MA, student development coordinator at Duke University’s International House. Some of the pressure came from the adjustment to remote learning. But there were others, she says, including uncertain job prospects postgraduation and personal safety and xenophobia in the United States.
“You have the response of any young person living through the pandemic—and doing it in another country far away from their support networks.” —Emma Swift
For international students who had just arrived on campus, the problem was even worse. Jin notes the issue of “isolation, especially for first-year graduate and professional students living off campus, who are far away from families and yet to form their own community locally.”
Two March 2021 surveys from LewerMark Student Insurance found that more than three-fourths of the company’s clients, and over half of nonclient educators, said they noticed a significant or slightly higher increase in mental health issues among their international student populations during the pandemic.
On top of pandemic-related stress, U.S. policy last summer added yet another layer of uncertainty as the Trump administration proposed forcing international students taking online courses to leave the country.
“You have the response of any young person living through the pandemic—and doing it in another country far away from their support networks,” says Swift. “Then you have this immigration rule that can make what you think you’re doing in the fall no longer possible. That’s a lot for anyone to handle.”
While the proposed rule never took effect, it did underscore the uncertainty many students felt about their future as the election neared.
Addressing Barriers to Seeking Help
Over the past year, most institutions built on existing resources or developed a range of mental health services available to students dealing with unprecedented levels of stress. But cultural issues can create barriers for international students who need care.
“The fear and shame surrounding mental health issues is still a different factor for students from abroad,” says Patricia Burak, PhD, a faculty member in the College of Arts and Sciences at Syracuse University and the editor of Addressing Mental Health Issues Affecting International Students. “In the United States, students are more quick to admit to having mental health problems.”
“Nobody has been living their best life during the pandemic,” says Swift, and unfortunately, some of the usual resources that students turn to have been compromised or unavailable.
“The fear and shame surrounding mental health issues is still a different factor for students from abroad. In the United States, students are more quick to admit to having mental health problems.” —Patricia Burak
“College is such a time of transition and change that many of the typical stressors that we see have been exacerbated by the pandemic,” says Owen. “For students starting a new program this fall, many of the typical support structures created through traditional orientation programs had to be shifted and may not have created the same level of support as we would usually see.”
Natalie Cruz, MEd, a doctoral student at Old Dominion University, is part of a team of researchers who surveyed undergraduate and graduate international students to determine the effect of the pandemic on their mental health. Cruz and her colleagues, Jason Lynch, PhD, of Appalachian State University, and Peggy Gesing, PhD, of Eastern Virginia Medical School, asked 173 students about their experiences and how well their institutions were supporting them.
Cruz said that the survey found “students were scoring in the range of what could be a trauma response—fear and anger, hopelessness, and overall thinking that their mental health had been negatively impacted.”
How Institutions Are Responding to Increased Need
To address these feelings, institutions have been working diligently to offer help. “At Syracuse and across many campuses, the counseling centers have been ramped up,” says Burak. The resources are not strictly counseling services; Burak notes that Syracuse offers students everything from yoga to pet therapy to reduce their stress levels.
Duke’s International House offers a range of wellness activities, including mindfulness classes. Both Duke and Syracuse are also training faculty and staff to recognize the mental health needs of international students.
At Yale-NUS College, a student organization called P.S. We Care provides one-on-one confidential peer counseling on campus 6 days a week from 9:00 p.m. until midnight. The students receive training from the institution's counseling center on best practices and how to know when to refer a student to a professional counselor.
“By having this additional layer of support, our students have another avenue to explore options, be heard, and learn more about resources,” says Owen.
Peer-to-peer support has also proven beneficial to international students at Embry-Riddle Aeronautical University. Anastasia Fynn, MBA, director of international student and scholar services, solicited international student input through a survey and found that 75 percent of the students said they would turn to their friends first if they were having mental health problems.
“In the past, everyone just assumed all students needed the same resources to be successful, so the offerings were more generalized. Now they are more intentional.” —Anastasia Fynn
Embry-Riddle subsequently started promoting resources via social media, recognizing that students would amplify the message to their peers. Fynn says that as a result of the survey, the school is now tailoring help to address the specific needs of international students.
“In the past, everyone just assumed all students needed the same resources to be successful, so the offerings were more generalized,” she notes. “Now they are more intentional.”
One challenge for international students who do seek help remains language. “They may feel most comfortable expressing themselves in their native languages rather than English,” says Fynn. “They may not know how to say how they feel in English, but they may be able to describe it in their own language.”
To address that issue, Embry-Riddle partnered with a third-party contractor to deliver counseling services in other languages. “If I’m [a student] from Saudi Arabia and I want counseling in Arabic, I can get that,” Fynn says. “It helps a lot.”
Making Pandemic-Initiated Changes Permanent
The increased attention to international students’ mental health needs seems to be paying off. Cruz says her survey found a majority of students felt their institutions were supporting them. There was a correlation between feeling supported and better mental health. Moreover, students showed they were willing to seek help when they need it.
“While telehealth has been incredibly helpful during the pandemic, most students still indicate that they prefer in-person sessions. Nevertheless, knowing that we can easily shift to virtual sessions will allow us more flexibility in responding to emerging student needs.” —Cory Owen
“You read in the literature that because of cultural issues, international students don’t feel as comfortable seeking out mental health resources, but we find that students were pretty comfortable doing so,” Cruz says. “They said they were more comfortable than doing so in their own countries.”
One tool that is very likely to remain in widespread use is virtual counseling. “Zoom has made many of our services and programs more accessible to students, so in the long term, we plan to continuously incorporate virtual elements in our services and programming,” says Jin.
Owen agrees, noting that virtual sessions can ease students’ fears of being seen entering a counseling center. However, she says that most students would rather sit down in person with a counselor.
“While telehealth has been incredibly helpful during the pandemic, most students still indicate that they prefer in-person sessions,” she says. “Nevertheless, knowing that we can easily shift to virtual sessions will allow us more flexibility in responding to emerging student needs.”
Swift expects that the emotional effects of the pandemic will linger. “People will have this feeling that I’m behind and that I didn’t get the full experience I wanted,” she notes. “What are all the things people have lost? Maybe you come back to the United States, but things are still really bad back in your home country. We may go back to normal, but people are going to come back with a different lens on the world.” •
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