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FAIE 2019 - Mental Health Session
This document provides information and guidance for training international students on emotional wellness and mental health awareness. It discusses the challenges international students face related to mental health, such as culture shock, homesickness, and stigma. It then offers suggestions for programming and resources to help international students, including check-ins, orientation activities, social support systems, and marketing mental health services indirectly. The document emphasizes building trust and connections as important for supporting student wellness.
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FAIE 2019 - Mental Health Session
- 1. Training Your InternationalStudents Emotional Wellness and Mental Health Awareness
- 2. Presenters Betania Torres Director ofInternational Student Services & Enrollment Southeastern University [email protected] Jennifer Frankel International Director International Student Insurance [email protected]
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- 4. ● What’s GoingOn With Our Students ● Understanding the Challenges ● Overcoming the Challenges ● Programming That Works ● Resources ● Discussion & Questions Agenda
- 5. What’s Going On? 1in 5 children, ages 13-18 will have a serious mental illness 40% of students so depressed they found it difficult to function 61% of students felt ”overwhelming anxiety” 13.9% of entering freshman anticipate a “very good chance” of seeking counselling 38.5% felt things were hopeless Source: nami.org National Alliance on Mental Illness Source: acha-ncha.org American College Health Association
- 6. Mental Health Need,Awareness, and Use of Counseling Services Among International Graduate Students, Journal of American College Health Source: Hyun, Quinn, Madon, & Lusting, 2010 Mental Health Care – Underutilized
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- 8. Culture Impacts AllAspects of Illness • Expression of symptoms outwardly and inwardly • Coping • Where to seek care • Management of symptoms • How they seek help
- 9. Identity Acculturation Social class Race Discrimination Political Oppression Communicationstyles Verbal v. non-verbal High-context vs. low-context Academic Formal vs. informal classroom Presentation styles Outcome vs. process oriented Interpersonal Boundaries Cultural differences in relationships Peer pressure Parental expectations Career Planning Finances Area of study Planning Second language anxiety Daily routine Communicating with professors and classmates Coordinating a living situation Asking for help Common Adjustment Issues
- 10. Barriers To Treatment •Lack of mental health literacy • Unaware of services • Language barriers • Role of psychiatry in other cultures • Stigma (Family & friends) • Location of counseling center • US therapists lacking cultural understanding • Lack of support Yeung A, Kung W. Psychiatric News. 2004; 21(1): 34-36. Kim BSK, Omizo MM. Couns. Psychol. 2003; 31:343–46.
- 11. Counseling is for “crazy”people. "Everyone will know I saw a counselor.” I can handle my own mental health problems. If I can't, that means I'm weak. Only someone from my home country will understand my problem. I could lose my visa status. Common Myths
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- 13. Supporting Your Students 1.Help Create A Community 1. Connecting students prior to their arrival in the U.S. 2. Awareness of clubs, teams and organizations on campus 3. Scheduling events regularly, and especially during holidays/holiday breaks 2. Regular Check-Ins 1. Being able to identify students who are struggling 2. Noticeable changes in dress, appearance, demeanor 3. Being available to talk 3. Internal Training 1. Identify and respond to students in distress 2. When and how to connect students to resources (we are not counselors!) 3. How to listen actively, empathetically, and without judgment
- 14. • Dispel themyths: What is mental health and counseling • Know the facts about cultural differences around counseling • Invite on-campus counselors/psychologists to orientation and meet & greets • Educate counselors/psychologists on how to communicate across cultures • Normalize students’ concerns and stress • Demystify seeking treatment (i.e., types of providers, where to go, what to expect) • Acknowledge that helping looks different across cultures How to Reduce Stigma
- 15. Culture of Care:Supporting Students Advisors can support students by: • Being available/open door policy • Learn how to pronounce names correctly • At times of crisis, be part of the support team • Support the community, not just the affected student/family • Knowing resources on/off campus and provide a “warm hand-off” • Do not avoid difficult conversations
- 16. Mental Health outsideof the Mental Health sphere: • Depression screening event on campus/Depression screenings on website • Encourage participation at “lunch and learns” focused on stress management, time management, sleep, etc. • Highlight Counseling Center events through newsletters, social media, etc. • Know the services offered around campus and in your community, and form connections - Support groups/medical practitioners who speak other languages - Student Health Center - Counseling Center - Chapel and community religious/spiritual support centers Building Bridges
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- 18. Building the Trust– Creating the Connection “The first day of a student’s orientation is too late to be discussing student mental health for the first time.” Lee Burdette Williams, “It’s Never Too Soon To Talk About Mental Health,”The Chronicle of Higher Education, 10/14/2016, p. A56. Send or have available on website as Pre-Departure Materials: • Testimonials from current students about homesickness, culture shock, stress, anxiety, and depression (perhaps in video format) • Quotes about acceptance of mental health and counseling (like “Common Myths”) • Materials about the Counseling/Wellness available on campus with pictures and contact information
- 19. • Inform studentsof challenges and cultural adjustment • Invite Counseling Center or other mental health professionals to introduce mental health service/host a luncheon • Educate students about campus/community resources • Parent and Partner programs • Train your peer leaders and mentors to be knowledgeable enough about these issues to help guide students • Collaborate with residence halls on outreach programming Mental Health in Orientation
- 20. “...the quality ofthe social support system can have both a direct and a buffering effect when international students undergo psychological stress.” Meirong Liu, “Addressing the Mental Health Problems of Chinese International College Students in the United States,” Advances in Social Work Vpl. 10 No. 1 (Spring 2009), p. 74.
- 21. • Buddy/Peer mentorprograms • Workshops (e.g., “Decoding U.S. Culture”, “Lost in Translation”, “Culture Shock”) • “Let’s Talk” Drop-in Hours * Celebrating IEW - International Ed Week • University 101-type courses * Newsletter from International Dept • Social organizations/student clubs * Monthly Cultural events that celebrate diversity • Summer/Holiday programs * Monthly Dinners/Coffee Breaks to connect Programming that helps
- 22. ❖ Syracuse University -Connections Mentoring Program - English Conversation Groups - Family Hospitality Suite ❖ University of Minnesota - International Parent Orientation - Chinese Parent Orientation Program - NISS: New International Student Seminar - ISUCCESS (week long International Pre-Academic) ❖ University at Buffalo - International Student Wellness Day ❖ What about yours? Programs that work
- 23. Marketing Your Program Howmany of your international students want to go to a special event where they are going to talk about mental health? Instead, think about ways to approach the topic indirectly: - Making friends in the US - Managing stress - Time management - Eating healthy - Staying fit on campus
- 24. Resources & Hotlines Pre-departure,Orientation, Online
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- 27. NAFSA Resources Best Practicesin Addressing Mental Health Issues Affecting Education Abroad Participants https://shop.nafsa.org/detail.aspx?id=102E Crisis Management in a Cross Cultural Setting: ISSS http://www.nafsa.org/wcm/Cust/Custom_Cart/Product_Detail.aspx?prodid=450 Available May 2019, NAFSA Book/E-book: Mental Health Issues and International Students Other Resources Massachusetts General Hospital Center for Cross-Cultural Student Emotional Wellness (MGH CCCSEW) https://www.mghstudentwellness.org/consortium Resources
- 28. Hotlines ● National SuicidePrevention 1-800-273-TALK www.suicidepreventionlifeline.org ● The National Domestic Violence Hotline 1-800-799-SAFE http://www.thehotline.org/ ● It Gets Better Project (LGBTQ) 1-866-4-U-TREVOR www.itgetsbetter.org/pages/get-help Services ● Crisis Text Line http://www.crisistextline.org/ Text 741-741 ● Online and phone counseling services Services & Hotlines
- 29. Questions? “International students whoreported a more functional relationship with their advisors were less likely to report having an emotional or stress-related problem in the past year.” (Source: Hyun, Quinn, Madon, & Lusting, 2010)
- 30. With a partner,discuss: 1. A challenge you have faced when working with international students and mental health. 2. A success you’ve seen on campus that has been helpful when dealing with mental health Breakout Activity
Editor's Notes
- #2 Jenny
- #3 My name is Sally McLeod and I am a Marketing Coordinator and licensed insurance agent at International Student Insurance. I work with international students and advisors on a daily basis, discussing insurance needs. This can range from minor issues to more serious claims, such as their in and outpatient mental health care. It has allowed me to see firsthand how prevalent this topic is for the current student population and also given me the opportunity to participate in creating resources to better educate students on these topics. I’m very honored to share the floor with two very experienced individuals in the industry who both share a unique perspective on the topic.
- #4 Before we get into our Agenda for today’s session, I would like to begin by watching a video that introduces emotional wellness and mental health to get us thinking about the topic. This video interviews 11 international students discussing their biggest challenges when adjusting to the US, and how they worked to overcome some of these difficulties. The video is around ten minutes, so go ahead and make yourselves comfortable and we will see you shortly. After video: : I think this is a powerful video that really sets the stage for the topic that we will be discussing today. It shows the struggles international students are facing when it comes to culture shock and stress and how they were each able to deal with their issues in various, yet constructive ways. Make note to point out culture shock is no longer pc. In partnership with the Massachusetts General Hospital Center for Cross-Cultural Student Emotional Wellness, (MGH) our company has created a complete training package, including this video, designed to better educate your international students on Emotional wellness and mental health and how to overcome stigmas and seek treatment. The MGH center is really a one of a kind resource comprised of an incredible group of individuals whose main focus is promoting emotional wellness and mental health awareness among international populations. I will touch more on the MGH center later and some of this training will also be included at the end of the presentation.
- #5 Here is a look at our agenda for today’s session. -We will highlight the problem at hand that our students and campus’ are facing by looking at recent numbers and published research. - We will then get into Discussing the current challenges and barriers to seeking treatment and how you can guide your students to seek care and overcome these challenges, by discussing Effective programming for your students and staff, also giving you the opportunity to discuss your campus’ experiences -We will then highlight some great on campus and off campus resources that are always available for you and your students, this is where we will discuss our new training packet that we have created specifically for International Students on Emotional Wellness -And finally, we will end the presentation with opening the floor to discuss any questions that you may have.
- #6 So, let’s look at some statistics to see what is really going on with our students. https://www.nami.org/getattachment/Learn-More/Mental-Health-by-the-Numbers/childrenmhfacts.pdf Our first statistic is that 1 in 5 children ages 13-18 will have a serious mental illness. This study also found that suicide is the 3rd leading cause of death in youth ages 10 - 24. According to an American College Health Association survey of more than 63,000 students at 92 schools, nearly 40% of college students said they had felt so depressed in the prior year that it was difficult for them to function, and 61% of students said they had “felt overwhelming anxiety” during the same time period. http://www.acha-ncha.org/docs/NCHA-II_SPRING_2017_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf Overall, 13.9% of entering freshmen anticipate a “very good chance” of seeking personal counseling while in college. This percentage has increased steadily since the early 1990s, from a low of 3.5% in 1991 https://www.heri.ucla.edu/monographs/TheAmericanFreshman2016.pdf These statistics show that it may come as no surprise that college counseling centers continue to experience a rise in the number of students using their services (Misner, 2014).
- #7 Still current One such study, from the Journal of American College Health in 2010, surveyed hundreds of graduate students at UC Berkeley, both domestic and international students. In this study similar numbers of international and domestic students indicated that within the past year, they had struggled with a serious emotional or mental issue – which was about half of the study population. But when it came to seeking care, the numbers were very different, and that’s what you see up on the slide. -79% of domestic students were aware of campus counseling resources, whereas only 61% of internationals were. -56% of the domestic students considered seeking care, whereas only 33% of the international students did. -And again when we look at those students that actually sought care, 36% of the domestic students went for help, whereas only 17% of the international students did. International students are by and large not seeking the help they need to address their mental wellness needs.
- #8 Let’s dig a little deeper now and understand the specific challenges that International Students might be facing when it comes to seeking treatment.
- #9 Culture impacts all aspects of a mental health illness. What does this mean exactly? Culture impacts our disposition, how we handle things, and how we internalize things. Our culture can impact how we express our symptoms of illnesses and also how we experience things like stress. Think about how a Chinese student might handle a mental health issue differently than a US student. While it would of course depend on the person, it is likely that you would see commonalities between different groups of people. One example, that we learned from the center, may be that a Chinese student manifests anxiety or a mental health issue through physical symptoms such as a stomach ache, where as a US student may be comfortable and open about discussing their mental health issue. Not only does culture impact the way that we express symptoms but also the way that we cope, Some students may be more inclined to go to the counseling center while others may have certain stigmas around seeking treatment and how to manage their mental illness. It’s important to understand these nuances especially as advisors are working with students from all over the world, and the struggles are becoming more prevalent than in the past.
- #10 There are also common issues that arise while a student is in college and especially when they decide to study away from home. As one might expect, students may face anxiety when it comes to learning a second language, they can run into barriers on a daily basis when going about their routine and could also be more importantly, not knowing how to ask for help. Other issues that arise could be communication styles. Perhaps their culture has different ways of communicating, which are perceived negatively in another culture or the underlying message is not received based on the way it is communicated. Interpersonal such as personal space, boundaries. Cultural differences in relationships Career planning. A common issue or stress point could be finances. Spending an extravagant amount of money to get an education in another country and maintaining good grades or perhaps a scholarship. This can be very stressful on a student, with high expectations set on them to do well, while navigating an entirely new academic system. Speaking of academic, this is another issue in that presentation styles can differ, along with different ways of writing, the type of classroom set up, along with different ways in measuring success. Students can also be struggling with their identity. Dealing with issues such as acculturation, and blending with cultures instead of being a part of just one, along with an array of issues including race, discrimination and political oppression. (Need help elaborating on this)
- #11 It’s clear that there is a need for mental health support and international students are particularly susceptible to stress and challenges. Some barriers to actually visiting the counseling center or seeking treatment include a lack of mental health literacy, students being unaware of the services available, language, along with stigma and the role of psychiatry in other cultures causing them not to ask for help or seek treatment. This could also include stigmas surrounding someone with a mental health issue in the workplace, marrying into the family, or having an authoritative position. Other barriers include not being knowledgeable of where the counseling center is on campus and what kind of services are provided, a lack of cultural understanding from therapists themselves, and an overall lack of support.
- #12 Although we have touched on stigma already, here are just a few common examples of myths that’s important to demystify with our students that may have been imbedded since early development. These myths include the following: Counseling is for crazy people, losing my visa status, only someone from my home country will understand, I can handle my own mental health problems, if I can’t that means I’m weak and Everyone will know I saw a counselor. There are a multitude of challenges around seeking treatment for a mental health issue, particularly when it comes to international students, I will now hand it off to my co-presenters who will be discussing ways for overcoming these challenges.
- #13 Betania
- #14 Betania
- #15 Betania
- #16 Betania
- #17 Betania
- #18 Betania
- #19 Betania
- #20 Betania
- #21 Betania
- #22 Betania
- #24 https://www.everydayhealth.com/depression/mental-health-stigma-and-prejudice-strong-around-the-world-8505.aspx http://newsroom.ucla.edu/releases/study-shows-stigma-around-mental-health-on-campus-correlates-with-students-not-seeking-treatment Since its launch in 2007, the survey has been conducted at more than 150 colleges and universities, with more than 175,000 people responding.a
- #25 Jenny
- #26 Jenny While there hasn't been a whole lot of resources dedicated to international students dealing with mental illness, we are seeing more and more schools devoting time and resources to this, since it's more prevalent than ever before. Which is why we have been so focused on this topic, as well. International Student Insurance (ISI) and the MGH Center have partnered to create a free comprehensive, multimedia training package for US schools intended to help promote emotional wellness and mental health awareness among international students. I spoke a little bit about the center earlier, but they are really a unique organization comprised of clinicians, educators, and researchers who are passionate about understanding and promoting the emotional health and psychological resilience of students and scholars from diverse cultural backgrounds. Our training package includes five key components. The first is a PowerPoint presentation that will guide you and your students through the training. The packet also includes interactive activities that you will be able to do with your students that focus on reinforcing the material and encouraging important dialogue. Two videos are also included - the first is the Student Story video that we watched at the beginning of this session. As you saw, the video includes real footage of international students discussing the challenges of studying in a new country and the stressors they faced. The second video we’ve created, is a 5-minute video specifically for international students, which takes a straightforward approach to introduce the concepts of we’ve discussed today. Also included, is a complete proctor guide, that will provide you with a full script and talking points to walk you through the entire training. The last thing the training includes is a brochure that you can share with your students, which you have hopefully had a chance to look at by now. In addition to the MGH center collaborating with us on this training, they also have just launched their Consortium for the 2018 – 2019 academic year. This is a year-long program that brings together schools and organizations committed to building their cross-cultural competencies and advocacy of their students’ mental health and wellness. Consortium members will have ongoing access to the Center’s clinicians, which you can learn more about on their website. If this is something you are interested in providing for your students, feel free to leave me your business card after the presentation and I would be happy to send it to you.
- #27 Jenny As part of the video resources included, I wanted to mention our second video once more in that this video is available with subtitles in eight different languages and covers mental health awareness and warning signs, along with dispelling myths, and showing ways to seek treatment. Its available for free, and you can show either video separately at your orientations or have embedded onto your school’s website.
- #28 Jenny NAFSA, of course, produces excellent resources. Their Best Practices in Addressing Mental Health Issues Affecting Education Abroad Participants focuses on study abroad and concerns for US students going outbound. Crisis Management in a Cross-Cultural Setting is also available for purchase, and touches on Mental Health Issues of Students who Cross Borders in Crisis Management. Some sections within this book are relevant to mental health for international students inside the US. We are very excited as NAFSA will be releasing their newest booklet which will focus specifically on mental health awareness for international students. This will be available in 2019, and we along with other co-authors, have worked together in creating content which examines mental illness from a number of different perspectives. I also encourage you to check out the MGH consortium, which I had mentioned earlier.
- #29 Jenny There are several hotlines that you can share with your students as well – which allow students to remain anonymous. Here are a few of these examples that you can keep on hand. The Suicide prevention hotline, Substance Abuse and Mental Health Services hotline, it gets better project – all staffed by counselors trained to deal with people in crisis, not as ongoing counseling. The most notable on this page, The Crisis Text Line – is a free, 24/7 support for those in crisis. You may text the number from anywhere in the US and a trained volunteer Crisis Counselor will assist. They have has over 42 million messages processed to date. There are also many online phone counseling services, such as Morneau Shepell and Talkspace that are available. You may often see them included in your school’s insurance plan or they can be purchased separately. This may be a good option if your school doesn’t have a counseling center or has limited resources, allowing students to seek care confidentially.
- #30 Jenny This wraps up our presentation and I hope that this has helped raise awareness along with equipping you with additional tools and resources for educating your international students on emotional wellbeing and mental health awareness. I’d like to leave you with this quote before opening up the floor for questions (read quote) and again thank you for your time and being here today.