An Integrated Approach to Mental Health Support for International Graduate Students: A Curriculum for Student Affairs Professionals Open Access

Abstract

Background: International students constitute about 14% of the U.S graduate school enrollment. Research shows that in addition to typical stressors associated with college life, this student population faces stressors unique to their immigration and educational status. The culmination of different stressors can have an adverse impact on international students' mental health. Despite the increased stress and risk of mental health issues, international students are reported to have the lowest utilization rate of campus counseling services.

Purpose: The purpose of this special studies project is to create a three-part mental health curriculum for student affairs professionals to improve the provision of culturally appropriate mental health & wellbeing services for international students at the Rollins School of Public Health

Methods: A thorough review of literature on current approaches to mental health on college campuses and theories that better account for the unique experiences of international students was conducted. This review informed the selection of the Gatekeeper Training (GKT) model as the principal intervention strategy of the curriculum. The three parts of the curriculum are mental health awareness, cultural humility and compassion, and resource awareness. Didactic lectures, group discussions, and case studies will be the delivery techniques.

Discussion: This project addresses the gaps in literature on addressing international students' mental health, particularly those in graduate school. Additionally, this curriculum explores the role of compassion as a pathway for addressing reluctance and behavior maintenance in gatekeepers.

Table of Contents

CHAPTER 1: INTRODUCTION ...................................................................................................................... 1

Significance of the Health Problem .......................................................................................................... 1

Mental Health in the United States............................................................................................................. 2

Mental Health Among Graduate Students in the United States ..................................................................... 2

Mental Health Among International Graduate Students in the United States ................................................. 5

Mental Health Among Students at Emory University ................................................................................... 7

Mental Health Among International Graduate Students at Emory University.................................................. 8

Problem Statement................................................................................................................................... 9

Purpose Statement .................................................................................................................................. 10

Brief Overview ......................................................................................................................................... 11

Definition of Terms ................................................................................................................................. 12

CHAPTER 2: LITERATURE REVIEW ........................................................................................................... 13

Overview Of Current Approaches to Mental Health On College Campuses ........................................... 13

Move Towards a Comprehensive Approach to Mental Health on College Campuses ...................................... 13

Gatekeeper Training for Mental Health ..................................................................................................... 16

Peer Interventions to Mental Health ......................................................................................................... 26

Triage Model ........................................................................................................................................... 27

Telehealth Services.................................................................................................................................. 30

Theories in Addressing the Mental Health of International Students.................................................... 33

Berry’s Theory of Acculturation ................................................................................................................ 34

Yosso’s Theory of Community Cultural Wealth........................................................................................... 37

Cultural Humility...................................................................................................................................... 39

Summary .................................................................................................................................................. 44

CHAPTER 3: METHODS............................................................................................................................... 45

Summary .................................................................................................................................................. 45

Overview of Program Models and Theory ............................................................................................... 46

Gatekeeper Training Model ...................................................................................................................... 46

The Three “R’s” Model ............................................................................................................................. 46

RAND Model of Gatekeeping .................................................................................................................... 47

Conceptual Model of the Curriculum....................................................................................................... 49

Overview of the Conceptual Model.......................................................................................................... 50

1. Program Components .......................................................................................................................... 50

Mental Health First Aid (MHFA).................................................................................................................. 50

Question, Persuade and Refer (QPR) ......................................................................................................... 51

Cultural Humility .................................................................................................................................... 52

2. Factors that Influence the Behavior of Target Group ......................................................................... 53

Compassion ............................................................................................................................................ 54

Resource Awareness ................................................................................................................................ 55

Stakeholder Involvement......................................................................................................................... 56

Project Setting ......................................................................................................................................... 57

Target Population ................................................................................................................................... 57

More about Student Affairs Professionals for Gatekeeper Intervention in Universities ................................. 60 Recruitment............................................................................................................................................ 61

Pilot Testing ........................................................................................................................................... 61

Training Assessment............................................................................................................................... 62

Ethics and IRB considerations.................................................................................................................. 62

CHAPTER 4: DISCUSSION AND RECOMMENDATIONS .............................................................................. 64 

Curriculum Strengths and Limitations ................................................................................................... 64

Strengths ................................................................................................................................................ 64

Implications ............................................................................................................................................. 67

Recommendations for Improvements and Future Studies ..................................................................... 68

Program Implementation ........................................................................................................................ 68

Data for System-level Changes................................................................................................................. 68

Inclusion of CBCT ................................................................................................................................... 69

Trauma-informed Training ...................................................................................................................... 70 REFERENCES................................................................................................................................................ 72 

APPENDICES ............................................................................................................................................... 83

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Psychology, General Education, Curriculum and Instruction Health Sciences, Public Health
Keyword	Mental health Curriculum development International students International graduate students Gatekeeper intervention Student affairs professionals
Committee Chair / Thesis Advisor	Joanne A. McGriff, Emory University
Committee Members	Joanne Williams, Emory University

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