a growing experience - Student Services - University of Melbourne

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HEALTH AND WELL-BEING OF INTERNATIONAL STUDENTSPREDICTING SERVICE USE FROM PERCEIVED NEEDThere is a marked gap between the number of students who said they needed helpfrom either medical or counselling services between February and mid-May and thenumber who actually went to the services for help. The gap was much greater in thecase of the counselling service. If students’ perceived need of help was a genuine andrealistic appraisal of their situation, then it is of concern that a substantial percentageof students did not take action to obtain the help they needed. There is particularconcern about the 26 students who thought they needed help with problems in morethan one area of counselling but did not seek help; these students needed help in twoor all three of the areas of academic-educational, career-vocational and personalsocial-emotionalcounselling.Two approaches were employed to try to gain some insight into this issue: explorationof the factors that predict which students took positive action and examination of thereasons students gave for not taking action.In the case of both the medical service and the counselling service, a significant,positive predictor of students’ decision to act on their perceived need for help washaving friends who were known to have used that service themselves. This mightseem to be an obvious and expected association, likely to be the same for any groupof students. However, it is possible that it is particularly important for internationalstudents. Carr and her colleagues (2003) point out that communication from membersof students’ own national or ethnic group can provide valuable information forinternational students who have less experience of the host culture. Kilinc & Granello(2003) found that 50 per cent of their sample of Turkish students in the USA wouldseek informal help, largely from friends, when in need of help. Fallon (2005), in astudy of international students participating in a Foundation Studies program inMelbourne, found that students placed considerable reliance on family and friends formedical advice.The information friends can provide concerns not only factual matters about locationof services, hours of opening, and absence of fees, but also the more subjectiveaspects that are likely to intimidate the inexperienced, such as what to expect, howclients are treated and how helpful the service is. If we are looking for a means ofincreasing the proportion of international students who actually seek help when inneed of it, then the power of the friendship network would seem to be something to beharnessed.While having friends who have used the health or counselling services is a positivepredictor of international students’ decision to seek help themselves when in need,being very depressed (in the case of the health service) or highly stressed (in the caseof the counselling service) are negative predictors. At first sight, it seems counterintuitivethat depression and stress should reduce the likelihood of seeking help.Depressed or stressed students would seem to be the ones most in need of help.A possible interpretation is that the more depressed a person becomes, the stronger thesense of inertia and the less likely that decisions or actions will be taken. In fact theDepression scale includes the concept of inertia, illustrated by the item “I found itdifficult to work up the initiative to do things.”. Similarly, the more stressed a personbecomes, the more anxious they become if their work is interrupted and the lessRosenthal, Russell & Thomson, 2006 159
HEALTH AND WELL-BEING OF INTERNATIONAL STUDENTStolerant they are of having to leave the tasks that are causing them such stress. TheStress scale incorporates this notion; one of the items illustrating it is “I was intolerantof anything that kept me from getting on with what I was doing.” Several studentswho offered reasons for not seeking counselling help when they felt they needed itsaid that they did not have enough time.The final variables predicting use of the university health and counselling servicesappear to relate to cultural issues. Being a student from PR China was found to be anegative predictor of seeking the help of the health service when in need. At firstsight, this might seem to suggest a cultural reluctance to seek help. However, theliterature discusses the reluctance of Asian international students to seek help frompsychological not medical services. Furthermore the concept of somaticisation ofproblems suggests the view that there is not a reluctance on the part of Asian studentsto use health services. It is possible to look at the reasons given by the 50 Chinesestudents who did not act on their perceived need for medical help. While the generalpattern of the reasons students from PR China gave for not going to the health servicewas similar to that of other students, Chinese students tended to indicate that they hadrelatively less information about the health service – the existence of the service, itslocation, and the absence of fees - than other students. Fallon (2005) found that pretertiarystudents from PR China placed greatest emphasis in their explanations for notaccessing medical help on having, and presumably using, their own medication.The final variable predicting use of the counselling service by international students,cultural stress, does concern acculturation. The Cultural Stress scale measures theperceived discomfort of international students in an unfamiliar cultural setting, theirfeelings of being lonely, less important than at home, being treated differently and notbelonging. These feelings are discussed in the literature as typical responses to thenew personal, social and cultural environment early in the acculturation process(Sandhu & Asrabadi, 1994; Ward, Okura, Kennedy & Kojima, 1998; Ward & Rana-Dueba, 1999). The stronger these feelings are, the higher the score on the CulturalStress scale, with a high score indicating a low level of adjustment to the new culture.Students who acted on their need for counselling help had, on average, a significantlylower score on the Cultural Stress scale than those who felt they needed help but didnot visit the service. This indicates that those who sought help were moreacculturated, that they had achieved some adaptation to the Australian culture. Lackof acculturation could affect knowledge about service availability, discomfort at thethought of seeking help, belief that the counsellor would not understand or help thestudent, and perhaps concern about possible stigmatisation.STUDENTS’ REASONS FOR NOT SEEKING HELPThe exploration of the factors that predict students’ use of health and counsellingservices helps us to understand why some students chose not to seek help even whenthey felt in need of it. An examination of the reasons given by students themselvesfor not seeking help provides another approach to understanding their decision. Oneof the most common reasons given by international students for not taking action wasthat they thought their problem was not important enough. Over 60 per cent of thesestudents endorsed this as one of their reasons for not seeking medical or counsellinghelp when needed. This was also found to be one of the most common reasons givenby Foundation Studies international students for not seeking medical help whenneeded (Fallon, 2005).Rosenthal, Russell & Thomson, 2006 160
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a growing experience - Student Services - University of Melbourne

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