Mental Health and International Education Bibliography

Advisors and overseas field staff will find information on specific strategies for working with either U.S. participants going abroad or international participants in the United States. The following books, articles, handouts, and slide presentations assembled in this annotated bibliography are listed alphabetically by title in each section:

Education Abroad Resources

International Student Resources

Education Abroad Resources

A World Awaits You – Students With Non-Apparent Disabilities Go Abroad (June 2006)

The journal explains how people with learning, speech, mental health or systemic disabilities have had successful experiences adjusting abroad. Parental encouragement is pivotal when a student makes the choice to go abroad. Managing stress, planning ahead, and choosing the right program will ensure a smoother transition into the host country. Past participants share input about whether and why they decided to disclose or not disclose their disabilities. Finally, the publication explores how culture and specific destinations can impact how accommodations will be met, what preparations must be considered, and legal issues.

By Scheib, Michele. Eugene, OR: Mobility International USA. Retrieved 4 May 2010.

Web: http://www.miusa.org/publications/books/nonapparentdisabilities

Assessing Our Resources: Mental Health Considerations for Students in Education Abroad Programs (2010)

This slideshow was presented to education abroad advisors and includes slides on case studies, self-disclosure, and predicting critical incidents. Common types of mental health-related prescription medication are listed on one slide for advisors’ reference. The remainder of the presentation focuses on mental health coverage in travel insurance, limitations of mental health services abroad, and using multiple resources to assist a program participant.

By Duston, Laurie. Presented at the Forum on Education Abroad on March 24, 2010. Available online.

Web: http://www.forumea.org/documents/ForumStandardsInstitute-LaurieDuston.pdf

Best Practices Addressing Mental Health Issues Affecting Education Abroad Participants (2006)

Education abroad professionals inside or outside the United States will gain a better understanding of how to identify and help education abroad participants who face mental health challenges. Read how to manage healthy transitions and culture shock (including reentry), managing relationships (including long-distance, dating, sexual relationships, and forming new relationships), coping with loss, and dealing with alcohol and drugs. It offers specialized considerations for specific mental health issues, including eating disorders, suicidal tendencies, depression, and others. The education abroad professional can also learn how to refer a student to counseling, what to do if the student is reluctant or refuses, how to collaborate with counseling services, encourage disclosure and manage accommodations. The publication also covers cultural differences in mental health treatment, managing a crisis (including suicide abroad) and legal concerns. For most of the above topics, a checklist is provided, listing specific actions and considerations.

By Lindeman, Barbara (Ed.). Washington D.C.: NAFSA Association of International Educators. Retrieved 15 July 2006.

Web: http://www.nafsa.org/MentalHealth

Building Bridges: A Manual on Including People with Disabilities in International Exchange Programs (2006)

Building Bridges includes a brief chapter on “Psychiatric Disabilities” and addresses common adaptations that may be appropriate for people with a variety of mental-health related disabilities. It comments on the range of terminology and accommodations that people with certain mental-health disabilities may use. Brief descriptions are given for common mental health disabilities, including bipolar disorder, depression, anxiety and panic disorders, post-traumatic stress disorder, and schizophrenia. The chapter addresses potential concerns such as legal issues and cultural attitudes toward people with psychiatric labels they may encounter in the host country. Tips for travelers and advisors, as well as resources on mental health disability organizations with overseas connections, are included.

By Sygall, S. and Lewis, C. (Eds.) Mobility International USA. Available for purchase online.

Web: http://www.miusa.org/publications/books/bbfree

Maintaining Mental and Emotional Health (no date)

The manual emphasizes transitional stress, recognizing stress and its manifestations, and applying coping mechanisms to manage stress. It distinguishes between poor and better coping choices. Strategies for developing intercultural skills are given to ensure a successful adjustment. Stress is normal, but when unhealthy signs or coping mechanisms persist, the participant should feel comfortable seeking help and support, and should be aware of whether help will be confidential.

By Safety Abroad First Educational Travel Information (SAFETI). SAFETI Adaptation of Peace Corps Resources: Pre-Departure Health Training Handbook. Retrieved 20 December 2008.

Web: http://www.globaled.us/peacecorps/maintaining.html

Managing Students in Crisis: Mental Health, Student Behavior, and Study Abroad Management (no date)

This case study presents the following scenario involving the resident director of a college study center in Europe: The director receives a late-night call from the host family of one of the American students on an international program. The caller reported a crisis occurring as a result of the student’s mental health condition. Experts in mental health counseling, litigation and education abroad weigh in with their perspectives on how the counselor, student and host family should proceed and how the program staff might have better prepared for an emergency situation.

From the Council on International Educational Exchange (CIEE). Retrieved 5 May 2010.

Web: http://www.ciee.org/study/advisors/managing-crisis.aspx

Mental Health and Crisis Management: Assisting University of Notre Dame Study Abroad Students (3rd ed.) (2002-2011)

This handbook for international educators gives basic notions about the typical problems faced by students, and some dos and don’ts when facing crisis situations. This publication also acknowledges that friends and fellow participants of students with mental health conditions might need support as well. Several suggestions are offered for supporting a student through culture shock, which is not a mental disorder but a development phase, whose symptoms can mimic those of more severe psychological disorders. The guide suggests how to refer a student who is depressed for evaluation and treatment and what to do if a student is suicidal, as well as the impact a suicidal student might have on other program participants. Learn how to recognize and approach a student with a suspected eating disorder, for which a combination of professionals may be contacted, such as a physician, counselor, or nutritionist. In addition, learn how to initiate a conversation about grief. The topics of alcohol poisoning/abuse, assisting a rape/sexual abuse survivor, and educating students on sexual harassment are outlined.

By Settle, W. (Ed.). Notre Dame: Notre Dame Counseling Center. Retrieved 17 June 2011.

Web: http://ucc.nd.edu/assets/37702/international_educators_handbook_3rd_edition_web.pdf

Mental Health and Study Abroad: Responding to the Concern (November 2005)

The rise of and awareness of mental health conditions have become increasingly relevant to those serving college students. Find statistics relating to mental illness, depression among students, and students taking psychiatric medication. More students than ever are seeking psychological care. Learn the definitions and signs of sound mental health. College life in the home country can be stressful enough, and study abroad may add an additional layer of stress on top of that which can exacerbate existing mental problems. Contributing stressors to psychological and mental factors are listed. Besides the stigma of disclosing a mental health condition, other challenges in identifying the conditions are identified. Find tips relating to insurance, prescreening, and asking mental health professionals to help evaluate the student participant.

By McCabe, L. International Educator, 14(6), 52-57. Retrieved 19 February 2010.

Web: http://studyabroad.msu.edu/safety/presentations/MentalHealthEducationAbroadNovDec05.pdf

Mental Health-Related Disabilities: Considerations for Exchange Participants (no date)

This tipsheet encourages those planning to travel with a mental-health related disability to consider a checklist of questions to prepare for their trip, relating to cultural differences, support networks, planning accommodations and services, and preparing medications.  Participants should also research legal issues associated with their privacy and their prescriptions. Past participants of exchange programs who have mental health-related disabilities give practical advice. Finally, the article discusses why someone might want to disclose their disability, and lists additional resources relating to mental disability rights.

A MIUSA publication

Web: http://www.miusa.org/ncde/tipsheets/mentalhealth

NAFSA’s Guide to Education Abroad for Advisors and Administrators (3rd ed.) (2005)

A section on emotional and mental disabilities makes recommendations for practices regarding screening, confidentiality, and making accommodations. Other legal and ethical issues relating to student privacy and disability policy are discussed. A chapter on underrepresented students includes several pages on disability issues. It will help advisors improve communication with students with disabilities with strategies like advising the whole student, discussing the benefits for one’s disability overseas, avoiding unintentional exclusion, and working with the student through his or her concerns. Advisors will also benefit from tips on common mental health conditions, tapping overseas disability resources, practical disability-related considerations that occur, and collaborating with the disability office and counseling offices.

By Brockington, J.L., Hoffa, W.W., and Martin, P.C. (eds.). Washington, DC: NAFSA Association of International Educators. To purchase the book or preview the contents, visit the NAFSA website.

Web: http://www.nafsa.org/interactive/core/orders/product.aspx?catid=2&prodid=71

Over-Stressed, Overwhelmed, and Over Here: Resident Directors and the Challenges of Student Mental Health Abroad (2009)

This article states the nature of issues arising from mental health challenges faced by students on overseas programs, examines the current research, and presents case studies of study abroad students with whom the author worked on a variety of mental health concerns. It identifies benefits of assessing mental health needs and treatment for students prior to a crisis situation and of “considering medical, psychological, and academic perspectives holistically.” Special considerations are given for addressing binge drinking, depression, suicide, anxiety, panic attacks, and post-traumatic stress. The recommendations offered to resident directors include how to document mental health interventions, develop a local network of resources, and enlist peer mentors to share and normalize their experiences with mental health disabilities.

By Lucas, J. Frontiers: The Interdisciplinary Journal of Study Abroad, XVIII, Fall 2009 p187-215. Available for purchase online.

Web: http://www.frontiersjournal.com/subscriptions.htm

Practical Strategies for Addressing Mental Health Issues Within Study Abroad (June 2008)

Download these handouts, which outlines procedures for addressing mental health issues within study abroad, includes a sample participant mental health disclosure form and program contract, distinguishes between advising and counseling, and provides case scenarios and response questions. Additional mental health resources for study abroad professionals are listed.

By Lindsey, J. and Struve, U. Presented at the BUTEX Conference. Slideshow and informative handout available online.

Web: http://www.butex.ac.uk/?q=node/32

Study Abroad and Mental Health: Identifying, Assisting, and Referring Students in Distress (2005)

This concise newsletter provides international education program directors with a checklist for recognizing signs of serious emotional distress in students living in a foreign culture, suggestions for working with the student, steps for making referrals, and guidelines for assisting a student who needs to withdraw from a program.

By Settle, W. Safety Abroad First Educational Travel Information (SAFETI) On-Line Newsletter 3(1). Retrieved 12 May 2010.

Web: http://www.globaled.us/safeti/v3n1_settle.html

Study-Abroad Misstep Reminds Colleges of Need to Train Trip Leaders (2010, May 26)

As this recent incident demonstrates, embarking on an international program without a sound pre-departure plan for crisis prevention and intervention may result in poor outcomes for the student with the mental health-related disability, other program participants, and trip leaders. Uninformed decision-making about a student's health can also have potentially legal consequences. The events in the article underscore the need for proper training on health and safety issues, including mental-health concerns, for faculty members and trip leaders. Read how other institutions and education abroad professionals prepare for and respond to similar situations.  

By Fischer, K. The Chronicle of Higher Education. Available online.

Web: http://chronicle.com/article/Study-Abroad-Missteps-Remind/65690/

The Americanization of Mental Illness (8 January 2010)

An article responding to theories raised in the recently published Crazy Like Us: The Globalization of the American Psyche, about the increasing American influence on the treatment and expression of mental illness in other cultures. The author discusses cultural implications towards mental conditions, including grounds for diagnosis, beliefs about what causes mental illness, and attitudes towards people affected.

By Watters, E. New York Times.

Web: http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?pagewanted=1

International Student Resources

Case Incidents in Counseling for International Transitions (2008)

This book explores the nature of cross-cultural transitions with clients from around the world and the challenges they face at various transitional stages from initial entry to the host culture to returning home. The chapters “Transition Trauma and Health Concerns” and “Managing Multiple Identities” bring attention to the mental health needs among these clients in transition.

By Arthur, N. and Pedersen, P. (Eds.). Alexandria, VA: American Counseling Association. Check for availability at your institution's library.

College Students in Distress: A Resource Guide for Faculty, Staff, and Campus Community (2006)

A chapter on “Specific Issues and Populations to Consider” addresses international students on campus, who not only face a set of unique stressors due to the new environment, but may demonstrate reluctance to seek counseling for cultural reasons. While the author recommends consulting faculty or staff who have lived in the student’s home country to act as consultants or interpreters, it is important to consider issues of confidentiality and consent. Additional considerations for international students involve abiding by Citizenship and Immigration Service regulations, financial sponsorship by a foreign government or agency, and language barriers. In addition, the chapter suggests preparing the student for reentry into the home country and researching mental health services available there. Scholarly resources are cited for additional research.

By Sharkin, B. Binhamton, NY: Haworth P. 92-94. This book is available for online purchase and may also be available on loan at your local or university library.

Comprehensive Resource on Crisis Management for the International Student and Scholar Services Office (May 2011)

This Web-based resource, developed by the Knowledge Community for International Student and Scholar Services (KC ISSS), contains recommended checklists of action items for responding to specific crises. A section on working with international students and scholars with mental health conditions covers warning signs that indicate an international student or scholar may be in deteriorating mental health or crisis, or that a mental health crisis may be imminent. A checklist of action items responding to the crisis situation is provided.

By the Knowledge Community for International Student & Scholar Services (KC ISSS) Task Force on Crisis Management. Retrieved 24 June 2011.

Web: http://www.nafsa.org/resourcelibrary/default.aspx?id=27161

Cross-Cultural Counseling with International Students (2007)

This article explores the issues for counselors working with international students, with an emphasis on Asian and minority groups of international students who are susceptible to alienation, depression, and paranoia. It provides guidelines for cross-cultural counseling and reviews a list published by the American Psychological Association for counseling culturally diverse populations and another list of implications for counselors as they engage these populations.

By Barletta, J., and Kobayashi, Y. Australian Journal of Guidance and Counselling. 17(2), 182-194. Search for the article online to download the PDF free of charge.

Web: http://www.atypon-link.com/

It Would Not Have Happened to Me at Home: Qualitative Exploration of Sojourns Abroad and Eating Disorders in Young Czech Women (2008)

This paper explores how “eating disorders can be triggered through life events involving migration and acculturation.” It features interviews with women who have had an eating disorder and who have been abroad for work as an au-pair or study abroad. The authors present different scenarios in which problems occur and can trigger an eating disorder, such as weight gain abroad, failure to “escape” from the illness, and other triggers experienced while abroad.

By Pavlova, B., Uher, R., and Papezova, H. European Eating Disorders Review, 16(3), 207-214. Retrieved 4 May 2010 from Wiley InterScience Database (full text in PDF). Available for purchase on PubMed.gov. Check for availability at your educational institution’s library.

Web: http://www3.interscience.wiley.com/cgi-bin/home (purchase or account login required)

Mental Health Need, Awareness, and Use of Counseling Services Among International Graduate Students (2007)

This study focuses on the unmet mental health need among international graduate students. According to this study’s results, over 40% of international graduate students surveyed reported an emotional or stress-related problem that significantly affected their well-being, although having a “functional” relationship with advisors and adequate financial support were protective factors against using counseling services. Although the authors emphasize the role of the academic advisor in international graduate student mental health, advisors may be able to use the findings to construct collaborative educational campaigns towards these students with graduate program administrators.

By Hyun, J., Quinn, B., Madon, T., and Lustig, S. Journal of American College Health. 56(2):109-118. Available for purchase online.

Web: http://www.ncbi.nlm.nih.gov/pubmed/17967756

New Challenges for Professional Counselors: The Higher Education International Student Population (2007)

Data collected from a questionnaire distributed to international students enrolled at an urban university (n=640) are reviewed as part of a needs assessment. The questionnaire also provided an opportunity for students to explain the changes they had experienced since arriving in the U.S. Implications for mental health counselors arising from the study’s results underscore the need for crisis prevention and the need for counselors to provide support based on the students’ country of origin. 

By Tidwell, R. and Hanassab, S. Counselling Psychology Quarterly. 20(4):313-324. Available for purchase online, or check for availability at your educational institution’s library.

Web: http://www.informaworld.com/smpp/content~db=all~content=a788295688  

Seeking Help in a Foreign Land: International Students' Use Patterns for a U.S. University Counseling Center (2008)

Research indicates that international students may tend to experience adjustment difficulties to a greater extent than their native-born counterparts, including those that are psychological in nature. This study reviews international students’ use of and primary reasons for using mental health services at one U.S. university counseling center during a five-year period (n=132) and examines the past patterns of utilization determined in past research. The authors conclude with a discussion on creating resource networks for counseling center staff and other professionals involved in the care of international students on campus, doing outreach to those students most likely to “fall through the cracks,” and preventing premature termination of services through cross-cultural understanding.

By Yakushko, O., Davidson, M.M., and Sanford-Martens, T.C. Journal of College Counseling. 11(1). Available for purchase online or request from WorldCat.

Web: http://www.worldcat.org/title/seeking-help-in-a-foreign-land-international-students-use-patterns-for-a-us-university-counseling-center/oclc/424874040&referer=brief_results