Mental health

29% of university students have mental illnesses.

78% think they have had a mental problem at some point.

1.5% disclose to HEIs.

75% disclose their mental health conditions to fellow students.

(UMHAN, 2017)

Warning signs of student distress:

  • Changes in mood e.g. elevated or decreased mood, increased anxiety
  • Irritability or tearfulness
  • Restlessness
  • Reduced appetite and weight loss
  • Reduced concentration and memory
  • Loss of initiative or desire to participate
  • Decrease or increase in speech speed
  • Increased difficulty making decisions
  • Placement non-attendance e.g. unexplained absence or sick leave
  • Reduced communication or withdrawal
  • Changes in presentation and cleanliness
  • Reduced performance
  • Poor organisation and time management
  • Changes in ability to think logically.

(UMHAN, 2017)

© Matthew Tizzard

Issues of non-disclosure

  • Fear they will not get in; stigma/fear of being judged

(UMHAN, 2017)

  • Cultural differences: Reliance on prayer or faith healers; belief that it is a Jinn possession or Evil Eye

(Ahmed, 2012)

  • Source of shame; distrust of the medical profession.

Additional risks for international students

  • High expectations
  • Lack of familiarity
  • Restrictive conditions
  • Home ways of learning don’t fit
  • Course selection mismatch
  • Pride hides vulnerability; stops help seeking
  • Working psychological over-time to fit in.


‘The move to a new environment is one of the most traumatic events in a person’s life and in most sojourners some degree of culture shock is inevitable’

(Brown and Holloway, 2008:33)

Symptoms associated with culture shock:

Low self-esteem Bitterness Depression Helplessness
Low morale
Social isolation
Dissatisfaction with
Role strain
Identity conflict
Personality dis-

 (Brown and Brown, 2013:396)

A key trigger

  • Real or supposed attacks on national identity.

(Brown and Brown, 2013:397)

© Matthew Tizzard

What to do:

  • ‘Perhaps the most important thing we ever give each other is our attention.’ (Remen, ISHI)
  • Listen with ‘unconditional positive regard’ (Carl Rogers);
  • Be aware of when you are moving out of your area of competence;
  • Encourage students to see one of the counsellors (through Gateway). If necessary, help them to organise an appointment;
  • If they are in university accommodation, ensure accommodation staff know of your concern;
  • Recognise that they may have cultural reasons for refusing help;
  • Suggest they go to the Listening Post.

© Matthew Tizzard

For international students:

  • Take your time and listen;
  • Consider the impact of culture shock;
  • Consult with colleagues or relevant professionals;
  • Consider using ‘cultural interpreters’;
  • Pay attention to your gut feelings;
  • Remember the impact on other students;
  • Do understand that a student might refuse help.
  • (UKCISA training: ‘Frontline skills in responding to mental health issues for international students’ 6 June 2017)

Further reading:

Ahmed, K. (2012) Feeling Stressed? A leaflet for Muslims at:

Brown, J. and Brown, L. (2013) ‘The international student sojourn: identity conflict and threats to well-being’ in: British Journal of Guidance & Counselling 41:4, pp.395-413

Brown, L. and Holloway, I. (2008) ‘The initial stage of the international sojourn: excitement or culture shock?’ in: British Journal of Guidance & Counselling 36:1, pp.33-49 UK Council for International Student Affairs (UKCISA)