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1. Addressing common mental health stressors
In Understanding the mental health of international PhD students, we looked at six common stressors for international PhD students: misaligned expectations, cultural adaptation, language difficulties, loneliness, career pathway/development worries, and supervisor relationships.
Four of these issues also affect other international students, hence it is worth looking at the following topics for a general understanding of how to address these stressors for all students:
- Managing Expectations contains information that can help you identify and resolve international PhD students’ misaligned expectations before they set foot in the country, which will help reduce the risk of PhD disruptions and delays.
- Understanding Intercultural Dynamics contains more information about how to specifically help students adapt to their host country’s culture quickly and successfully.
- Meeting the language needs of international students contains more information about how to specifically help students who are having language difficulties.
- Fostering international student inclusion contains more information about how to specifically help students feel more included and less lonely.
Similarly, Supporting the professional development of international PhD students provides in-depth information on how to support international PhD students going through the stressful challenge of preparing for a career alongside and after their PhD.
Supporting the non-academic side of life for international PhD students is also a useful resource for supporting additional non-academic stressors (e.g. financial, employment and family) that most international PhD students encounter.
Below, we will outline some social actions shown to significantly help alleviate multiple stressors simultaneously, along with some actions that can help address issues with supervisor-student relationship dynamics.
1.1 Provide more opportunities for social connections
For addressing and reducing mental health concerns arising from cultural adaptation, language difficulties and loneliness (Lee, 2021), simply offering more social opportunities for international PhD students to establish connections with domestic peers can have wide-reaching positive effects.
Research by Bethel, Ward, & Fetvadjiev (2020) shows that connecting with locals is a three-for-one win. It boosts the success of students’ cultural adaptation, counterbalances the negative mental health impact of language difficulties, and directly reduces students’ isolation and loneliness.
1.1.1. Regular, inclusive networking events for PhD students
Hence, providing and supporting culturally inclusive inter- and intra- departmental networking events for international PhD students to make and strengthen their social connections with local peers can pay dividends in terms of mental wellness and therefore PhD productivity.
Case study: Thesis Group, Te Herenga Waka Victoria University of Wellington.
The School of Linguistics and Applied Language Studies (LALS) at Te Herenga Waka Victoria University of Wellington has a regular social Thesis Group. for graduate students.
It is run by students, for students. Every week throughout each semester, the group meets to have informal discussions about PhD life in general, as well as get feedback on aspects of their research, such as practising conference presentations or trialling surveys.
“I participated in the Thesis Group at LALS and for me it was a big plus of being part of my school at this university. It really created a good community where we felt safe to get advice from peers who were on an equal footing to us. The contacts you make there are probably your future peers in the profession so it is valuable in that sense too, but the overall best part is just the regular personal socialising. I really benefited from this extremely social aspect and from knowing that I could ask others for advice on pretty much anything without judgement." - Lucia, former PhD student
Your institution or department can also support social connections more effectively through valuing diversity and implementing strong diversity and inclusion policies (Ward & Kim, 2020).
Learn more:
Understanding mental health and wellbeing principles and tools provides more information about valuing diversity and implementing inclusive policies to strengthen social connections.
1.1.2 Pair students with mentors
A peer mentoring programme can be a highly effective way to help students establish good connections with locals. Mentors can provide empathy and informal advice to incoming students based on lived experience of overcoming hurdles in PhD progress, finances, job hunting or family wellbeing. The mentor can also help the student build friendships more easily by introducing them to others who they may have more in common with.
Case study: International Mentor Programme, University of Otago
The International Mentor Programme at the University of Otago matches international students – including postgraduate – with mentors on-campus to help provide them with more informal support.
A unique aspect of this programme is that it doesn’t just pair students with domestic peers. It also pairs new arrivals with more experienced international students, as well as introducing them to all participants of the multi-national programme and thus the wider student community as a ready-made social network.
“One of the positive concepts is a sense of connectedness and improved social adjustment.
More and more postgraduate international students are arriving with families, for example. Therefore their range of questions may be different and as wide ranging as childcare, schooling and how to get their partner interacting with the community. Linking such people with students who have been through similar experiences can be invaluable.”
– Rebecca, international student adviser
Pairing international PhD students with peers does not have to be via a special university-wide mentorship programme. Even just putting newly accepted students in contact with current international PhD students will help alleviate the stress of arriving, settling, and adapting, especially if the current student welcomes them on arrival and is proactive around orientation. As a bonus, it can also help provide a new friendship and mutual support for the current student.
Providing students with mentors can also help identify any mental health concerns early and, especially if the peer is of a similar cultural background, help the student feel more comfortable around recognising that they may need to get professional mental health support and seeking it.
1.2 Create positive supervisor-student relationships
A key factor in a strained relationship between student and supervisor is a wide difference between their values and expectations, as illustrated in the example of Shu-Yi and Karen in the previous topic.
This can be circumvented by allowing students to have a say in the choice of supervisor. For example, they may prefer supervisors who are most similar to them, either religiously/ethnically (e.g. Muslim, Chinese, etc) or in their work preferences (independently vs collaboratively) at the time of applying to do the PhD. You can support the student in this process - whether you are their potential supervisor or not - by directing them to a useful checklist of what to ask potential supervisors to help flag up any problematic dissimilarities for the student before they finalise their choice. A good example of a useful checklist for potential PhD students can be found at the University of Toronto website.
If it is not possible for the student to choose (e.g. they have already starting the PhD), referring both the supervisor and student to cultural training courses, or online cultural information resources, as soon as possible can help mutual understanding and accommodation of each other’s cultural values and thus significantly improve the relationship for the rest of the time.
It is also critical for the supervisor to communicate to the student from the outset their preferred way of supervising and what they are willing to compromise on/provide more support on with respect to the student’s values and expectations. The Cultural Atlas website is a good resource for the supervisor to understand the students’ home culture’s values and modify their supervision style to accommodate these appropriately.
For many international PhD students, ‘hands off’ PhD supervision – in which there is high independence with minimal interaction beyond academic queries and guidance – is not supportive enough. Research by Gruzdev, Terentev & Dzhafarova (2020) showed that PhD students with ‘hands off’ supervisors reported the lowest level of satisfaction, higher levels of stress, and took longer to complete their doctorate.
Hence, supervisors who adopt a more ‘hands on’ or holistic model of support can make a world of difference in terms of improving satisfaction, stress and speed. Below is an example of how supervisors can incorporate a more holistic supervision style to provide better all-round support while still ensuring high productivity and good performance.
Case study: Prof Tania Ka'ai– supervision through a cultural lens
Abridged excerpt from ‘Professor Tania Ka’ai – supervision excellence through a cultural lens’. Reproduced here with permission from Prof Tania Ka’ai.
Professor Tania Ka‘ai, known simply as ‘Prof’ to her students, is passionate about supervising postgraduate students.
“I enjoy seeing my students grow intellectually through the postgraduate journey” she says. “Seeing them become experts in their fields, and then applying this knowledge to transform their communities after graduating. I also enjoy meeting their whānau along the way and seeing the pride in their hearts on their child’s/mokopuna’s/mother’s achievement”.
Professor Ka‘ai suggests that her Māori and Pacific heritage and her understanding of Indigenous world-views are partly why students seek her out. However, in speaking with her students, both past and present, it’s clear that it goes beyond that. Students and graduates have highlighted her reputation and track-record of seeing students through to completion, her style of supervision, and her strong advocacy for students as major drawcards.
The care and attention she affords her students has been noted repeatedly by current students and by graduates, one of whom said, “Professor Ka'ai has a caring nature and will go the extra mile to help her students”. The awards she has received for postgraduate supervision, most notably from students’ associations, are testament to this.
When reflecting on the supervision she provides her students, Professor Ka‘ai says, “My style of supervision can be described as values-based, in that I take a holistic approach to supervision. I also project-manage my students through the whole process”.
She is notorious for having her supervision meetings booked in up to a year in advance, to ensure her students get guaranteed time with her during the busy academic year. That type of project management was referred to by several of her students, including a Master of Education graduate who said, “Her persistence and no-nonsense approach never allowed me to deviate from the task at hand. I’d still be mucking around if it wasn’t for Prof”.
For the full text, see: Te Ipukarea: Professor Tania Ka’ai
If adopting a holistic model is too difficult for some supervisors, consider providing mentors – either as part of a group or as a pairing (see above) – as an advisor on personal or career development aspects that supplements the supervisor’s PhD-specific guidance. These can be either other staff in the same faculty/department/office (e.g. postdoctoral researchers) or student peers who are more familiar with and/or are further along the PhD journey.
Some universities have adopted a different supervision model that addresses issues relating to the one-to-one nature of the supervisor and student relationship. For example, the University of Otago uses a team supervision model, in which solo supervision is only permitted when the candidate is supported by a committee (Spronken-Smith, Cameron & Quigg, 2018). In this approach, new supervisors undergo mandatory training as part of Otago University’s comprehensive programme of support for supervisors and are rewarded and recognised for excellent supervision through university-wide annual awards.
2. Addressing common barriers to getting mental health support
In Understanding the mental health of international PhD students, we looked at two types of barriers that prevented international PhD students from seeking mental health help:
- Individual barriers, mostly relating to students’ internal attitudes towards mental illness or seeking help, which are shaped and underpinned by their home culture’s values and norms;
- Institutional barriers, mostly relating to an institution’s/host culture’s values and practices around talking about and seeing help for mental health concerns.
The actions below can help to address these barriers.
2.1 Addressing individual barriers.
Lee (2021) suggests that multilingual and culturally familiar counsellors would significantly benefit students in securing initial trust and making it easier for international students to share their problems.
For example, students from Asia prefer to seek help from Asian peers or elders rather than health professionals due to the shared cultural understanding. Hence, a helpful resource that caters for the specific needs and values of Asian students is the Asian Family Services. This support service provides comprehensive and culturally specific support services nationwide. They also offer a suite of online resources to support international students and regularly host workshops and webinars on wellbeing.
Similarly, The Mental Wealth interactive site is designed to normalise mental health issues. Its Māori and Pacific viewpoint presents a plain language, community-centric approach that international students may relate with better than official Ministry of Health information.
Your institution or department/school should also have student support staff who can be readily approached by students of similar values/cultures (e.g. Muslim). They do not need to be to mental health specialists, just make students feel culturally included and safe in talking about mental health and can support them (possibly as a chaperone) while referring them to mental health services.
Learn more:
Understanding mental health and wellbeing principles and tools provides more information on how to refer students to culturally inclusive mental health support services, along with other effective actions to take such as:
- Normalising mental illness in your communications so that students do not feel shame or stigmatised in seeking help or being diagnosed.
- Ensuring students know that seeking mental health support is fully confidential
- Identifying the symptoms of – and tailoring responses to – students experiencing mild, moderate or severe/urgent mental health concerns.
2.2 Addressing institutional barriers
2.2.1 Ensure that the latest Education Code of Practice on pastoral care is implemented effectively
All student-facing staff at tertiary education providers should already be aware of the 2021 Education (Pastoral Care of Tertiary and International Learners) Code of Practice, which moves towards a more holistic ‘whole of service’ model of care. If not, direct them to the Ministry of Education’s webpage about the 2021 Education Code of Practice, which explains what is now required.
The full document (PDF) is available from the Code Administrator’s (NZQA) website:
Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021
Of note is Part 6 in this document, titled: ‘Additional wellbeing and safety practices for tertiary providers (signatories) enrolling international learners’ (begins on page 25).
Importantly, the Code states that supervisors and other student orientation and support staff need to ensure that international students are comprehensively informed on their rights and what actions they can take if the Code is breached. Historic research (Sawir et al., 2009) showed that most international students were unaware of the Code and thus did not complain when it was breached.
It is also critical that those who speak English as a second language can understand all information about the Code (Sawir et al., 2009). Hence, tertiary education provider staff should refer these students to translations (E.g. the NZQA translated summaries of the Code). If a translation is not yet available in their language, provide them with the NZQA’s plain English summary (pdf download).
Learn more:
Meeting the language needs of international students contains more information about how to ensure your information about the Code for students is clear enough for speakers of English as a second language.
Student-facing staff should also inform students clearly about how they can make an internal complaint (i.e. complaining to the education provider itself) if they do not receive adequate pastoral care. According to the Code, your institution must have transparent, accessible, and effective processes in place to resolve any complaints, as well as easily accessible and understandable information about where, to whom, and how to complain.
If international PhD students have worked with tertiary education provider staff to try and resolve their concerns in line with the Code but still do not feel better supported, they have the right to make a formal complaint with the NZQA. For example, when a student has approached senior staff but their faculty continues to have a culture that discourages, avoids, minimises, dismisses or creates/reinforces stigma around talking about, seeking help for or being diagnosed with a mental health problem.
Information to provide to students:
- Tertiary and International Learners Code of Practice now the Code: tertiary learners – general information for students about the Code.
- Know the Code – videos. All videos have captions available, which are known to help speakers of English as a second language understand what is being said.
- Translated written summaries of the Code – for speakers of English as a second language.
- Report that an education provider is not meeting the Code of Pastoral Care – students can make a formal complaint to NZQA using the form on this page of the NZQA website.
2.2.2 Adopt an institution-wide integrated student support model
For students to have better access to the mental health services they need, student services not inherently considered mental health services, such as finance or career support, should work hand-in-hand with counselling services as part of a holistic, institution-wide support system.
Having all the student services working together firstly makes seeking help less noticeable for students and, secondly, helps the other services direct students to mental health advisers more subtly and quickly when a student is having difficulties with their finances or accommodation, for example. Providing students with more integrated services also fulfils the 2021 Education Code of Practice’s specification for a ‘whole of provider’ approach to pastoral care.
“I could not have been better supported. My supervisor and faculty took the view that my wellbeing had to come first. I had immediate access to free and first-class counselling, and hardship support when I couldn't pay my fees on time, and accommodation support when the situation at home was so difficult that I needed respite. Knowing that all these people have my back motivates me to succeed. I could not have asked for a better support structure.”
– PhD student (abridged quote from Metcalfe et al., 2018)
Some tertiary education providers are achieving this by placing counsellors within individual schools, departments or colleges, instead of having all their mental health services as a separate unit.
The case study below reveals how successful integrated models of care can be for tertiary education providers.
Case study: the University of Michigan
This story is based on two articles by Hummer (2015) and Brekke (2015). You can read these articles at The Michigan Daily and HuffPost respectively.
In 2014, the University of Michigan’s Counseling and Psychological Service (CAPS) experienced an almost 20% increase in demand. They decided to use this need to expand to also rethink how to provide better support, not just more support. They saw that students needed a local, direct access.
After putting some of their counsellors into four schools and colleges as a trial, they found that the number of students seeking initial consultations had risen by more than a third (34%), proving that their new ‘embedded model’ was reaching more students.
Director Dr. Todd Sevig said that this was due to tailoring support to each school/college’s unique culture. “We have seen students who probably would have come to Central (Campus), that’s good because it makes it easier for students. The other beauty, based on the data, is we know that we are reaching students who wouldn’t have come and received help.”
Sevig pointed out, however, that retaining the central campus service was also critical. “If a student feels uncomfortable with seeing the person in that school or college – maybe they’re uncomfortable because someone will see them go to that staff member’s office, let’s say – the beauty of that model and approach is that they can always come to Central,” he said.
Emily Hyssong, an embedded social worker, said that being “down the hall” from students instead of across campus helps her be more aware of students' needs. "That's really been something that we've seen to be helpful in getting more students in, getting them in sooner, getting them to identify their needs to really point them in the right direction of getting resources," she says.
Jeffrey Yu, president of the student body at the Ross business school, said that the embedded model would particularly benefit graduate students: “A large student population here consists of MBA and masters students who will rarely leave the business campus. Putting a CAPS counselor in Ross will make it more convenient for these students to access help if they need it.”
CAPS now has integrated the new embedded model in 18 schools/colleges across the university, including the Ross business school.
2.2.3 Train staff on identifying and addressing mental health concerns
Having all staff in student-facing faculties and services undergo mental health and cultural training would make them much more effective in their jobs – particularly in terms of directing students from certain cultures to more inclusive mental health advisors or services. If it is not possible to train all staff simultaneously, it should at least be included as a mandatory part of the induction process for new staff, so that student support becomes more inclusive and effective as staff turnover occurs.
“At times, I didn’t know where to turn when my students had mental health challenges. I never learnt where to send them and there was no training in what you could do to get them help.”
– Emilia, senior lecturer at a New Zealand University
Mental health outcomes for PhD students specifically would be significantly improved if deans of schools, supervisors and other academic staff are trained in both intercultural competencies and mental health awareness. It is important for supervisors especially to be able to identify the main symptoms of mental health concerns, raise and discuss mental health appropriately with students, and refer them to the most appropriate mental health services for their unique needs and preferences (Metcalfe et al., 2018, Lee, 2021).
Training supervisors is particularly important because their relationship with the student means they are potentially the first to detect early warning signs of mental unwellness (Hyun et al., 2007). Being fully informed/trained also puts supervisors in a much stronger position to appropriately discuss and provide the much-needed education to PhD students on topics such as what is normal mental health, the differences between good and bad stress, coping and stress-relief strategies, self-awareness of mental health problems, and how and where to seek help.
Learn more:
Understanding mental health and wellbeing principles and tools contains more information that can help inform your staff training plans.
3. Conclusion
This topic has highlighted a range of ways to support international PhD students in relation to specific stressors and barriers to seeking help for mental health issues. PhD supervisors and other student support staff at tertiary education providers should now understand how to support international PhD students’ mental health needs appropriately and effectively.
4. References
Bethel, A., Ward, C. & Fetvadjiev, V. H. (2020). Cross-Cultural Transition and Psychological Adaptation of International Students: The Mediating Role of Host National Connectedness. Frontiers in Education. 5:539950. Open access: https://doi.org/10.3389/feduc.2020.539950
Brekke, K (2015). This Program Could Drastically Improve Mental Health On Campus. HuffPost.
https://www.huffpost.com/entry/embedded-campus-counseling_n_5609556ee4b0768126fe1d7f
Gruzdev, I., Terentev, E. & Dzhafarova, Z. (2020). Superhero or hands-off supervisor? An empirical categorization of PhD supervision styles and student satisfaction in Russian universities. Higher Education. 79, 773–789. https://doi.org/10.1007/s10734-019-00437-w
Hummer, G. (2015). CAPS adds specialized staffers for University colleges. The Michigan Daily. https://www.michigandaily.com/news/ross-caps-counselor/
Hyun J, Quinn B, Madon T, Lustig S. (2007) Mental health need, awareness, and use of counseling services among international graduate students. J Am Coll Health. 56:2, 109-18. https://doi.org/10.3200/JACH.56.2.109-118
Lee, J. J. (2021). Unique challenges and opportunities for supporting mental health and promoting the wellbeing of international graduate students [Report]. Council of Graduate Schools. Retrieved from: https://cgsnet.org/graduate-student-mental-health-and-well-being/
Metcalfe, J., Wilson, S. & Levecque, K. (2018). Exploring wellbeing and mental health and associated support services for postgraduate researchers [report]. Vitae. Retrieved from: https://www.vitae.ac.uk/doing-research/wellbeing-and-mental-health/HEFCE-Report_Exploring-PGR-Mental-health-support/view
Sawir, E., Marginson, S., Nyland, C., Ramia, G., & Rawlings-Sanaei, F. (2009). The social and economic security of international students: a New Zealand study. Higher Education Policy. 22, 461–482. https://doi.org/10.1057/hep.2009.4
Spronken-Smith, R., Cameron. C., & Quigg, R. (2018). Factors contributing to high PhD completion rates: A case study in a research-intensive university. New Zealand, Assessment & Evaluation in Higher Education, 43(1), 94-109. 10.1080/02602938.2017.1298717 https://www.tandfonline.com/doi/abs/10.1080/02602938.2017.1298717?journalCode=caeh20
Ward, C. & Kim, I. (2020). Does diversity-receptiveness in educational institutions predict international students’ psychological and social well-being? Unpublished report to Oakley Mental Health Foundation. https://docs.google.com/document/d/1Oto9lv0On7peeT1OJIxAvNNcms61YQXr/
