The Mental Health of International Students Studying in the U.S.

Xiang Zhou

Xiang Zhou, Steps to Leaps Research Collaborative member.

An estimated 1 million international students are enrolled in universities in the United States. What do we know about the well-being of international students? Although international students are heterogeneous in their country of origin, social class and languages spoken, many experience significant systemic barriers (e.g., linguistic, cultural, legal and xenophobia) during their higher education experience. At the same time, they demonstrate tremendous resilience and grit (for example, see this story about Purdue international students).

We examined the landscape of international student mental health and help-seeking behaviors using data from a large national sample of over 220,000 students from 233 U.S. universities. Roughly half of the international students screened positive for major depressive disorder, generalized anxiety disorder, eating disorder, non-suicidal self-injury or suicidal ideation. Contrary to common belief, prevalence rates for these common mental health concerns were slightly lower (except for a higher prevalence of eating disorders) among international students compared to domestic students. However, international students significantly underutilize mental health therapy and medication services compared to domestic students, even after controlling for gender, age, socioeconomic status, a perceived need for help, mental health stigma and using informal support.

These findings indicate that the mental health gap between international and domestic students lies in the help-seeking process. Thus, U.S. higher education institutions must provide more equitable mental health services (e.g., hiring more linguistic and culturally diverse clinicians, and providing culturally congruent mental health outreach). Recognizing the signs and impact of common mental health concerns and stigma associated with mental health may also help international students reach out for informal or formal help.


Zhou, X., Zhou, A. Q., & Sun, X. (2021). Prevalence of common mental concerns and service utilization among international students studying in the US. Counselling Psychology Quarterly, 1-21.