1. Running Head: INTERNATIONAL STUDENT LITERATURE REVIEW
International Student Literature Review:
Social Integration, Academic Resources, and Mental Health
Daniel Cameron
EDLD 551
Eastern Michigan University
2015

2. INTERNATIONAL STUDENT LITERATURE REVIEW 2
Introduction
International students have been a part of the higher education community since
the early days of universities in the United States, and have been growing steadily since
the end of World War II (Kaplan, 2007). As the global economy is becoming more
mobile, many students are preparing to study abroad to gain international experience. In
the 2013/2014 school year, there were 886,052 international students in the United States,
totaling about 3-4% of total student population (IIE, 2014). There has also been a push in
recent years to get students more socially and academically engaged on campus and
utilize the different services available around the school. Research (Kuh, 2009; Tinto,
1975) shows that more engaged students are more like to persist to degree completion,
which is easier said than done for international students.
Looking at research from the past decade has shown a tendency to focus on three
themes: social integration, academic adaptation, and health issues, such as isolation and
stress. International students face issues integrating and typically have a harder time
feeling that they are part of the campus than domestic students. They are less likely to
make use of academic resources in the university and may have a harder time feeling
comfortable with talking to professors, finding writing or job centers on campus, or
meeting with classmates to discuss class work. International students are more likely to
face mental health issues like depression and isolation than domestic students, may have
different views on health services, are less likely to utilize services, and are more likely to
be overlooked by mental health professionals.
These trends are not a unanimous conclusion, with different research showing
different correlations between factors of academic adaptation, benefits of social

3. INTERNATIONAL STUDENT LITERATURE REVIEW 3
integration, and use of health services. This highlights a complex social and academic
integration process, and more research is needed to determine the satisfaction of
international students with their experiences in higher education.
Social Integration of International Students
One of the most common themes in research regarding international students in
higher education is how well they are able to socially integrate and the effects of
acculturation. Tinto (1975) and the NSSE (2014) suggested that all students need to
adjust to their environment socially and academically in order to succeed, but research on
international students has shown mixed results. Sovic (2009) found that a group of peers
gives international students a sense of belonging, and support from friends can help
students facing health and academic problems. These social support groups can be more
effective for student persistence as academic engagement. Students from abroad benefit
greatly from this support, but have a harder time integrating socially than domestic
students. Sovic sites another study (Ramsay et al. 2007) that showed that a peer group is
an essential factor to successfully integrate into university life. Zhao (2005) also found
that a strong social support system helped students in their adjustment to the culture and
campus more successfully.
University programs also have a complicated role in helping international students
adjusting socially to higher education in the United States. Zhao’s (2005) research
showed that a campus with more international students gave opportunities for students to
find others with a similar background and interests, but increased international student
numbers must be supported by increased programing by the university. Rienties et al.

4. INTERNATIONAL STUDENT LITERATURE REVIEW 4
(2011) agreed, showing that classes and housing are good, but more programming outside
of the class would help students integrate more. This is another complicated issue,
because Bradley (2000) interviewed students who said that while large formal social
events at the beginning of the year are good, but these can be intimidating and actually
counter-productive for shy students in an overwhelming new situation. Sovic (2009),
supported by Robinson et al. (2007), found that international students rely on the
university to help facilitate social opportunities with domestic students, compounding the
difficulty in finding the best way to service international students.
University faculty and staff should also be aware of their impact on social
integration for international students (Erichsen & Bolliger, 2011) as many students come
from fairly distant countries and cultures without a support system, and therefore rely on
the university for support (Sovic, 2009). Domestic students have an easier time
transitioning socially, because they often have a peer group or family system to support
them (Rienties et al. 2007) that international students do not always have. Zhao (2005)
also found that international students from more similar cultures to the host country have
easier time adapting than students who come from more culturally different countries.
Another complicated aspect of social integration is interactions with students
native to the host country. Students with more interaction with domestic students have a
better persistence rate, better English language growth, higher academic achievement,
and overall greater enjoyment (Sovic, 2009). International students prefer to make friends
with students from similar backgrounds (Zhao, 2005), even though adjusting to college
and the overall college experience is improved by more socialization with domestic
students. Rienties et al. (2011) interviewed students who did not persist, and found that

5. INTERNATIONAL STUDENT LITERATURE REVIEW 5
many of them reported that their social networks were not sufficient to help them
overcome issues and continue with their education. Mamiseishvili (2011) had different
results, showing that a higher social integration level actually correlated with lowered
persistence rates. This research shows that social adaptation is a complicated issue for
international students, and a challenging situation for universities.
Academic Integration and Adaptation
Along with social integration, international students can have a difficult time
adapting to a new learning culture. A student’s ability to successfully integrate
academically has a great impact on the likelihood of the student’s persistence
(Mamiseishvili, 2011; Rienties et al. 2011). Students from any background who figure
out the campus culture and utilize academic services are much more likely to persist
(Astin, 1993), which is especially important considering over 75% of international
students reported needing academic counseling (Russell et al. 2008). While international
students are more involved in “educationally purposeful activities” than American
students (Zhao, 2005) and spend less time relaxing, they also have higher academic
challenges and feel less satisfied than domestic students. International students face many
problems with acclimatizing to a new learning style, and unfortunately those students
taking remedial English classes or have worse English proficiency test scores are less
likely to persist in higher education (Mamiseishvili, 2011; Andrade, 2007). English
Language Learners are also prone to more misunderstandings with faculty, struggle more
with academic content, and stress more about class participation and presentations
(Sovic, 2009; Erichsen & Bolliger, 2011).

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One way to combat the problems associated with language and academic
adaptation is to have a better understanding of the expectations from the university,
faculty, and staff (Erichsen & Bolliger, 2011). Differences in expectations and a lack of
communication can leave students unprepared for academic challenges, and international
students are not as familiar with the academic culture of American campuses or what they
are supposed to be learning. This is not due to culture shock or language difficulties
alone, as first-year students reported feelings of being academically more respected than
second- or third-year students. Sovic (2009) interviewed international students regarding
expectations, and many reported that they desired to become more familiar and
knowledgeable with host institute expectations.
Cultural expectations and norms also played a role in academic adaptation as well
(Bradley, 2000), and a deeper understanding of culture may lead to more successful
learning, advising, and counseling. Different cultural cues such as eye contact, body
language, and proximity can inhibit communication as much as language when
interacting with international students. Understanding differences in learning styles,
teaching styles, and perspectives (McClure, 2007) can lead to a more successful academic
relationship.
Stress, Isolation, and Health Services
Perhaps even more of an issue for international students than social integration or
academic adaptation is the stress, isolation, and health problems faced by students
studying abroad in the United States. These physical and mental health issues affect, and
are affected by, social and academic integration, but the importance of the theme and its

7. INTERNATIONAL STUDENT LITERATURE REVIEW 7
prevalence in research warrant its own category. International students face higher levels
of interpersonal, personal, and acculturative distress integrating abroad (Reynolds &
Constantine, 2007; Rienties et al. 2011), leading to even more severe health problems
such as headaches, stomach problems, illnesses, and other health issues with no physical
cause (Mori, 2000). This is unfortunate because positive support and early intervention
can break the manifestation of stress in physical illness (Fumham, 1997). Erichsen and
Bolliger (2011) state “if a person’s physical and emotional needs are not tended to, then
he or she will not be fit for higher learning.” International students speaking English as a
second language may not able to communicate as well with professors, classmates, or
health professionals, leading to higher levels of stress and isolation, or not fully
integrating socially or academically.
The amount of stress involved in adapting to a new culture, country, social life,
and academic experience put international students in a difficult situation. Over 41% of
students reporting substantial stress levels related to homesickness, discrimination, and
culture shock (Rienties et al. 2011). Students also feel less connected to the social and
academic community when there are higher levels of stress (Russell et al. 2010), creating
a double-down effect of stress and isolation. Every experience for first-year international
students can be exciting, stressful, or both at the same time (Sovic, 2009). This culture
shock shows itself in anxiety, rejection, stress, and isolation (Zhao, 2005). International
students face that stress and anxiety along with loneliness, unfair treatment, and
discrimination, but most students show resilience and are committed to their educational
goals (Mamiseishvili, 2011).

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Isolation is major factor for international students, which can be compounded by
language barriers (Zhao, 2005) and distance from home culture (Bradley, 2000). With the
top three countries of origin being China (31%), India (12%), and South Korea (8%)
according to IIE (2014), and a growing increase in students from Saudi Arabia because of
government scholarships (Choudaha & Chang, 2012), cultural distance can be a
significant issue. Over 50% of the non-native speakers Zhao (2005) studied felt lonely,
anxious, and isolated, compounded by the conflicting feelings of personal and cultural
identity. Bradley states that international students feel similar types of stress and anxiety
as home students, but their inability to express themselves fully in English, along with
being far away from a support system, combine to produce more intense isolation. The
isolation due to the lack of a support system can be heightened when students attempt to
save face and not look weak by not contacting their family members (Okorocha, 1998).
Many students were found to show signs of coping mechanisms (Erichsen & Bolliger,
2011), stating that they are not isolated, but later described isolation as a problem. Less
than 75% of international students reported having a close group of friends to rely on,
meaning that over 25% state that they feel like that do not have friends to turn to in a
stressful or difficult situation.
Unfortunately, utilization of health services is low among international students
(Bradley, 2000; Carr et al. 2003; Russel, 2008). Over 40% of students interviewed by
Russell said they felt they need health services, but only 62.2% of those students reported
actually getting help. Over 25% of students said they needed counseling help, but less
than 20% actually got help. There are different reasons and prominent ideas about why
students do not get the help they need, but research shows that the need is there. Sovic

9. INTERNATIONAL STUDENT LITERATURE REVIEW 9
(2009) found that many international students relied on their social network for support
or escape from isolation and anxiety instead of getting help from the university. Bradley
(2000) found that many students were unsure about the role of a counselor and the
relationship with the students regarding confidentiality. That study also found that it was
harder for university professionals to pick up on smaller cues pointing to mental health
issues with international students when there is a different “normal” baseline than with
domestic students. Some universities are giving typical counseling roles to health
professionals more experienced with cross-cultural interactions, but avoiding titles that
describe the ties to mental health. Bradley found that additional cultural training was
needed for university professionals to better serve international students, but Russel et al
(2008) found that students’ personal attributes and integration were a better indicator of
seeking health services. While there are disagreements on the causes for the lack of
health service utilization by international students, almost all research agrees that it is an
important aspect of working with international students.
Relevance to Student Affairs
Persistence rates are similar to that of domestic students (Andrade, 2009), and
meta-data research from Mamiseishvili (2011) shows that 70% of first-year international
students came back for a second year. But the three main themes have been correlated
with a lower rate of persistence among college students and should be taken into
consideration when designing programs to ensure the highest degree completion rates
possible for international students. Many of the problems, though not all, listed by
students and found in the surveys were combatable with interventions by the university

10. INTERNATIONAL STUDENT LITERATURE REVIEW 10
faculty and staff. Many of the students studied reported that orientations specific to
international students, showcasing academic resources and expectations, would be
beneficial (Erichsen & Bolliger, 2011). Bradley (2000) found similar results, with
students desiring information on social and academic preferences and basic cultural
idiosyncrasies of the host nation.
International students also felt that the university should take some responsibility
to initiate a more personal and culturally aware approach to advising (Erichsen &
Bolliger, 2011) and develop more beneficial and proactive procedures and policies
benefiting the social and academic integration non-native students (Bradley, 2000). Sovic
(2009) says that integration responsibilities should be shared by the university, and
references a study by Lee and Rice (2007) that highlights the majority of research is
being done on the students’ ability to adjust and cope, giving them the responsibility of
acclimatizing instead of looking at what the university can do to help alleviate some of
the issues that they face.
The higher education system knows how important it is for students to adjust to a
new lifestyle when entering college. The expectations, the responsibilities, the course
load, and every aspect of life are all new experiences when entering such a different
phase of life. Colleges place an emphasis on helping students adjust and fit in, so the
formats are already in place for helping students acclimatize to a significantly more
different learning culture. But saying that there are systems in place to help students in
need and international students already have the basic resources and tools available is
insufficient for the specific and heightened challenges they face in social integration,
academic adaptation, and feelings of stress and isolation. Along with the mental health

11. INTERNATIONAL STUDENT LITERATURE REVIEW 11
initiatives listed in the Stress, Isolation, and Health Services section above, potential
programs include fireside chats where students can meet to discuss personal or academic
issues, mentoring programs with upperclassmen, a continued partnership with the office
of international students, language partners, cultural celebrations, and orientations
focusing on culture, social life, and the local area around the university.
The office of international students on campus is a great starting point for help in
these areas, but setting international students in their own community could lead to
increased isolation instead of helping to alleviate it. Such offices should work in
conjunction with first year programs, orientation, student organizations, and academic
and health services all over campus to show that international students are just as much a
part of campus as domestic students, while still providing the resources to help in their
cultural adjustment and success in the American higher education.

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References
Andrade, M. S. (2007). International student persistence: Integration or
cultural integrity. Journal of College Student Retention, 8(1), 57–81.
Andrade, Maureen S., and Norman W. Evans, Eds. 2009. International Students:
Strengthening a Critical Resource. Lanham: Rowman and Littlefield
Education.
Astin, A. W. (1993). What maters in college? Four critical years revisited. San
Francisco: Jossey-Bass.
Bradley, G. (2000). Responding Effectively to the Mental Health Needs of
International Students. Higher Education, 39(4), 417-433.
Carr, J. L., Koyama, M., & Thiagarajan, M. (2003). A woman's support group for Asian
international students. Journal of American College Health, 52(3), 131-134.
Choudaha, R., & Chang, L. (2012). Trends in International Student Mobility. World
Education Services.
Erichsen, E., & Bolliger, D. (2010). Towards understanding international graduate
student isolation in traditional and online environments. Education Tech
Research Dev Educational Technology Research and Development, 59(3).
Fumham, A. (1997). 'The experience of being an overseas student', in McNamara, D.
and Harris, R. (eds.), Overseas Students in Higher Education. London:
Routledge, pp. 13-29.
IIE. (2014). Open Doors Data. Retrieved July 20, 2015.
Kaplan, R. (2007). Letters: International Students. Academe, 93(6).
Kuh, G. (2009). What Student Affairs Professionals Need to Know About Student
Engagement. Journal of College Student Development, 50(6), 683-706.
Lee, J., & Rice, C. (2007). Welcome to America? International student perceptions of
discrimination. High Educ Higher Education, 381-409.Mamiseishvili, 2011
McClure, J.W. ( 2007). International graduates' cross-cultural adjustment:
Experiences, coping strategies, and suggested programmatic responses.
Teaching in Higher Education, 12(2), 199-21.
Mori, S. (2000). Addressing the mental health concerns of international students.
Journal of Counseling& Development, 78, 137-144.
NAFSA. (2015). What Factors Influence the Retention Rate of International Students?
Retrieved July 20, 2015.
National Survey of Student Engagement. (2011). Fostering student engagement campus
wide—annual results 2011. Bloomington, IN: Indiana University Center for
Postsecondary Research.
Okorocha, E. (1998). Counseling International Students. A summary of the findings
of a research survey on counseling international students in UK Higher
Education.
Ramsay, S., Jones, E., & Barker, M. (2007). Relationship between adjustment and
support types: Young and mature-aged local and international first year

13. INTERNATIONAL STUDENT LITERATURE REVIEW 13
University students. Higher Education, 54, 247-265.
Reynolds, A.L. & Constantine, M.G . (2007). Cultural adjustment difficulties and
career development or international college students. Journal of Career
Assessment, 15(3), 338-350
Rienties, B., Beausaert, S., Grohnert, T., Niemantsverdriet, S., & Kommers, P. (2011).
Understanding academic performance of international students: The role of
ethnicity, academic and social integration. High Educ Higher Education.
Rienties, B., Tempelaar, D. T., Waterval, D., Rehm, M., & Gijselaers, W. H. (2006).
Remedial online teaching on a summer course. Industry and Higher
Education, 20(5), 327–336.
Robinson, C, Le Riche, P., & Jacklin, A. (2007). Students' views of support in higher
education: A study of current practice and future directions. Higher
Education Review, 40(1), 3-17.
Russell, J., Thomson, G., & Rosenthal, D. (2008). International student use of
university health and counseling services High Educ Higher Education.
Russell, J., Rosenthal, D., & Thomson, G. (2010). The international student
experience: Three styles of adaptation. Higher Education, 60(2), 235–249.
Sovic, S. (2009). Hi-bye friends and the herd instinct: International and home
students in the creative arts. High Educ Higher Education, 747-761.
Tinto, V. (1975). Dropout from higher education: A theoretical synthesis of recent
research. Review of Educational Research, 45(1), 89–125.
Zhao, C., Kuh, G., & Carini, R. (2005). A Comparison of International Student and
American Student Engagement in Effective Educational Practices. The Journal
of Higher Education, 76(2), 209-231.