Identify Virtual And In-Person Providers If a staff on an exchange program encounters a student in need of mental health services, their main role should be to refer the individual to a professional.
Students who already have a relationship with a therapist may continue that treatment while overseas. In the situations where the licensing and liability laws of that state do not allow the continuation of the client/therapist relationship, or when a student is seeking treatment for the first time, it becomes necessary to find a new mental health provider. Your students may need assistance locating mental health services in the host country.
Check with your college's counseling center to identify the kinds of support that they may be willing to provide. Sometimes counseling centers, concerned about state licensing and liability laws, might not want to intervene except to provide a referral or to respond to an emergency.
There are a few different ways you can locate providers in the host country. If you work with an education abroad program provider, , consult them about identified mental health resources. Work directly with colleagues at host universities abroad to find providers. If a third-party consortium is not involved. Check with your travel sickness and accident insurance provider to identify the mental health services they offer and the host country providers that they could recommend. United States embassies also may keep lists of local providers.
In addition to in-person providers, there are an increasing number of resources online that can offer mental health support to students in need. Companies like 7 Cups or I Prevail provide free services from trained listeners. It may be possible to obtain services from a licensed therapist through such organizations for a fee. For example, Drexel University has an institutional account with 7 Cups that allows their students access to licensed therapists online. This resource also allows Drexel to access information on the kinds of things that students request help with.
Lafayette College started by getting their counseling Center, General Counsel and international education office together to put out a Request for Proposals ( RFP). Working together they were able to identify an organization with which they now have a contract to provide virtual mental health services on international programs. Lafayette's insurance plan also offers a digital mental health infrastructure.
According to Michelle Nathan from Lafayette College, “Many prefer being able to be in the comfort of their own environment during the sessions and particularly for students abroad, many prefer having a counselor that 'sounds like home.”
These services, however, have limitations and mayt not be effective at responding to more serious mental health concerns such as suicidal ideations. In other cases a local provider may need to make a prescription. This is because there may be instances in which medications would have to be prescribed by a local provider. They are illegal to send through the mail. There are limits on how much doctors can prescribe or pharmacies can sell. Countries also impose limitations on the amount of certain medications that can be imported.
Therefore, it is important to have a list of identified local mental health professionals and clinics, to train in-country faculty and staff on how to respond to emergency situations such as a student experiencing suicidal ideation, and to train in-country staff to make an appropriate referral. I'm Alive is an online resource specializing in suicide prevention. All of its volunteers are trained to respond to individuals in crisis, and it could be an option for students seeking a hotline to contact.
Universities wishing to establish an agreement with a mental health service provider should confer with their counseling center, legal counsel and travel insurance. It may be best to offer a list of options for students to make their own choice as opposed to a single mental health provider to mitigate legal risk for the institution. Considerations when choosing a mental health assistance provider include:
- the availability of counselors over different time zones,
- the qualifications of therapists or listeners,
- the confidentiality of the service,
- the ease or difficulty with which deaf or blind students might access the service,
- and the means (texting, telephone, face time) through which the services provided.
it is important to know where to refer students experiencing mental distress on an overseas program. In-person providers, including those where English is spoken, have always been a great option and can be located with the collaboration of travel insurers, host country staff or a university counseling center. As regulations and technology evolve, more states are allowing the provision of certain mental health services online. To learn more about this trend feel free to access a collegial conversation that was made available to the NAFSA community in 2020 (membership required). To learn more about other steps that International educators can take to support participants impacted by mental health concerns abroad, refer to the table of contents.