International student deaths by suicide will continue if gaps in delivering targeted mental healthcare aren’t addressed, research suggests.
The research, published by the University of Melbourne and Orygen in January, followed a 2021 Victorian coroner’s report that found 47 international student suicides had occurred in the state in the decade to 2019.
The report was commissioned after the 21-year-old Vietnamese student Nguyen Pham Dinh Le killed himself in 2018, showing no sign of mental ill health or consulting a GP before his death.
Samuel McKay, a lead author in the research, said evidence-based programs catering to international student suicide prevention still didn’t exist despite record numbers of students returning this year.
“We went to see what universities were doing and there was nothing,” he said. “No evidence-based programs available. We were really surprised.
“There’s going to be a huge push for students to get back and that’ll put massive pressure on housing and finances. There’s a real compounding perfect storm of factors right now that could increase the risks.”
McKay said international students already faced a number stressors that could impact mental health – “living in another country, losing support networks, financial pressure, housing and accommodation”.
“International students are also much less likely to access support services despite facing significant educational, cultural, and daily life stress,” he said.
McKay said culturally adapted services, improved risk screening and collaborative mental health services providing culturally sensitive care were needed to address the gap.
An Orygen report released in 2020 found despite experiencing an increased risk for poor mental health, international students underutilised available support services.
“Services aren’t adapted to international students,” McKay said. “When they walk in they might not find it’s a safe space or comfortable to them. Or they may not engage, because it doesn’t feel appropriate for them.
“We need to look at how we can make these spaces welcoming.”
McKay said while universities had counselling and mental health programs in place, access was also a barrier due to long waiting lists, while emergency departments lacked cultural training.
“A peer work program where we train international students in mental health would be a first step in a pathway to support,” he said.
“When the coroner looked at the data in Victoria, they found international students were less likely to engage with mental health services before they died by suicide and more likely to face financial stressors and academic pressure.
“This is a real time of opportunity for developing programs that engage students in mental health supports, give them opportunity to understand what’s available and that it’s OK to reach out … to break down negative stereotypes and normalise it.”
Phil Honeywood, chief executive of the International Education Association of Australia, said international students often feared reaching out due to concerns they would lose their visa or face judgment or prohibitive costs.
“It’s an important issue,” he said. “We need them to know it’s not regarded as a blight on your character or reported to authorities.
“Often services might be on campus but students think if they access an on-campus service it’ll be reported back to academics and administrators … This has to be overcome.”
Honeywood said urgent attention needed to be given in the educational community to addressing targeted mental health care for international students – particularly after the burden of Covid lockdowns.
“Mental health issues dramatically increased for the domestic student population and this would also impact access for international students when they’re returning in increasing numbers,” he said.
“If an immediate response to this can be established through training peer group mentors then this would be welcome, however in the medium to long term we need to increase the number of fully qualified intercultural mental health councillors.
“Compared to other student destination countries, Australia is a relative latecomer to comprehensive mental health counselling service provision … We need more of our education providers to see counselling as core business.”
• In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is at 988 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. Other international helplines can be found at befrienders.org
