Mental health of students in higher education

Mental health issues faced by international studentsher life. In some cases, university accommodation will have to be vacated.Support services such as counselling may close down or operate at alower level of provision. Students who need to take a break from studiesto recover their health may be unable to afford to do this because offinancial pressures. This often increases mental distress. They may also facedifficulties in renewing their visas when they wish to return to the UK, andthis can provide a disincentive to take time out to recover fully.A student who develops a severe mental illness may have to drop outof university and return home. Psychiatric services are often poorly fundedin low- and middle-income countries and the more expensive psychotropicdrugs may not be available. If continuation or maintenance medication isrequired, recommendations for this should take account of what will beavailable in the student’s home country.Clinicians and counsellors should be aware of the possible impacts ofsome psychiatric diagnoses when students return to their home countries.In countries such as the USA, where healthcare is largely funded byprivate insurance, a diagnosis of schizophrenia or other severe mentalillness may lead to increased insurance premiums or difficulty in obtaininghealth insurance at all. In traditional cultures, diagnoses such as substancemisuse or problems arising from sexual identity or preference may lead tostigmatisation of young people. This is not to propose that diagnoses shouldbe withheld when this might be detrimental to the student but to suggestthat psychiatric diagnoses should be made with circumspection, especially ifthere is any uncertainty, and with awareness of the potential harm that canbe caused.Most higher education institutions employ international studentadvisors to help these students manage the many challenges they encounterwhen studying in an unfamiliar environment. Further information is availablefrom the UK Council for International Student Affairs (www.ukcisa.org.uk).Royal College of Psychiatrists63