This presentation discusses student mental health in relation to cultural diversity on university campuses. It highlights research indicating that mental health problems are increasing in occurrence and severity. It also discusses the association of mental health with and safety and security; normalising mental health problems; and help-seeking and support services. The presentation also provides insights relating to Singaporean students’ perceptions of mental health.

1. Student mental health and cultural
diversity on campus
Dr Helen Forbes-Mewett
Campus Security & Safety Conference, Melbourne, May 8-9
MONASH
ARTS

2. 2
Topics covered
 Mental health problems increasing in occurrence and
severity
 Mental health, and safety and security
 Normalising mental health problems
 Help-seeking and support services
 Singaporean students’ perceptions of mental health

3. 3
Mental health: A reoccurring theme
 PhD study revealed that mental health problems are
increasing in occurrence and severity
 Four year ARC project relating to safety and crime
reinforced the above
 Honours study by Jamie Gan Jia Min provides insights
relating to Singaporean students
 Experience as a unit coordinator/lecturer provides
everyday evidence of student mental health

4. 4
Findings from background studies
 The mental health of adolescents and university students has deteriorated
over recent decades (Twenge et al. 2010)
 In Australia, heads of university counselling services report a rise in students
presenting with serious psychological problems (Stallman 2012)
 University students significantly more vulnerable to high levels of distress
than non-university students (Stallman & Shochet 2009)
 From a Western perspective, the peak period for onset of mental health is
between 12-25 (McGorry 2011)
 Social scientists argue that economic, social and cultural change has
contributed to the deterioration of mental health among young people
– They live in a more rapidly changing and unstable personal and social environment and are
confronted by much more information about more and graver problems…at a much earlier age
than previous generations (Eckersley, 2008, p. 12).

5. Increasing in occurrence and
severity

6. 6
 We’re finding it’s becoming more and more frequent. We’ve
had a number . . . of international students who are clearly
mentally ill. They come to Australia with something which you
would think would be diagnosed back in their home country, it
is so pronounced. . . . we’ve sent three or four students home
in that time knowing that they are not coping. We had one
student who arrived here and actually lived under her doona.
Refused to come out and would sit in her bedroom and rock
back and forward with a doona over her head. And when we
spoke to the parents, they said ‘Yeah, yeah. We know she was
like that. We knew she was [unwell] when we sent her but we
believed that she would get far better health care in Australia
than what we could ever give her in China’. But she lasted less
than three months with us. (P51 University Security, Australia)

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Mental health and crime
 I’ve got a client who we are going to court for a plea and
she has been charged with two counts of theft. Different
times; different informants. And more than likely, she will
get a conviction. But the problem is that if you read the
background to her story, it is really a sad case. The
woman is suffering from some form of mental disorder,
she has got an eating disorder – anorexia – and God
knows what else. She doesn’t eat, she is depressed, she
is from Peru and the parents left the children when they
were teenagers – she was 14 – so they could go to
America to try and earn a better living for the children. . .
She hasn’t seen her parents for at least five or six years .
. .it is really quite sad. (P50 International Student Legal Advisor)

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 I had a student two weeks ago who stopped speaking
because she was so socially isolated. She just stopped
speaking… We have countless international students
coming in here and telling us they are contemplating
suicide. Isolation can cause a lot of distress within
students, which could lead them to then dealing with it in
non-traditional ways like getting into illegal activities like
spending all their time at the casino or getting into drug
abuse to deal with it. (P75 Student Rights Officer, Australia)

9. Mental health, and safety and
security

10. 10
 They’re not wanted at home, frankly. They’ve actually
often been to another overseas university… It is a marker
of high risk if we are the second or third international
university in a person’s history, particularly as
Undergraduate but Postgraduate too… That’s part of the
trail, over and over. It’s very common … they are often
not well. Some of the biggest problems we have are
perpetrators who are mentally quite unwell and would’ve
been when they got here. They don’t disclose their ill
health in order to make sure they can still come.
(P114 University Security, Australia)

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 Psychologically, you’re always the burden
because you can’t really open up to anyone… So
I think it gets really difficult and at some point you
just break down … or you [resort] to other
measures, like you get into a fight on the street
or start creating trouble, or try to get some easy
money. (P118 Indian International Student from America,
Australia)

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Safety and security of university staff
 We could give you a number of cases where students are very ill with
a disorder, an abnormal complainant, where it becomes like an
obsessive compulsion. They can’t actually stop themselves from
constantly harassing either personally, emails, calls… We’ve seen
cases where the damage has been horrendous. We’d meet with
entire staff groups. It’s a bit more Postgrad… It’s your older students
and where there’s research involved and so on. There’s been this
lovely extension of care and hospitality to them. They fail something
and that’s not allowed to happen. [They think] it couldn’t possibly
have anything to do with them… They can be extremely troubling
because the way they write these things. There are veiled threats
and threats of litigation, threats of punishment in other ways,
(including) threats of self-harm. (P14 University Security, Australia)

13. Normalising mental health problems

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A healthy shift in attitudes towards mental illness
 Mental health issues are commonly a part of life
 Need to be prepared for mental health problems
 Normalising mental health problems means more
supports are needed in the university
 Students more commonly mentioning mental health
issues
 Universities playing a crucial role in educating students
on mental health
 Becoming increasingly normalised in a Western setting
 Need to cater for culturally diverse mental health needs

15. 15
 A student response to the question, “What does the term
‘security’ mean to you?”:
 “The mental health support network which is present in
my life;
 My family (i.e. being able to talk about issues, knowing
my fiancé is there for me, etc);
 Because I’ve struggled with mental health concerns since
the age of 10, being able to stay mentally healthy through
various means allows me to feel secure”
(undergraduate student 2016)

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 Another student commented in class about the hurdles
faced in the casual workforce:
 “Not only am I considered too old for a job at 18 but I also
have mental health issues that affect my employment
opportunities”
 This comment was made in a class discussion in the
presence of more than 70 students
 Signs of a healthy shift in attitudes towards mental health

17. Help-seeking and support services

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Perceptions
 Despite the healthy shift, seeking help for mental health
problems remains “a real taboo”
 Physical medical conditions are ok but severe
psychological problems are not
 Students differentiate between mental health problems
caused by everyday issues and serious psychological
illness
 Seeking counseling often still thought to be for only the
seriously mentally ill
 Often don’t seek help until the last minute
 Number of available counseling sessions thought to be
inadequate

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What can universities do?
 Respond to the erosion of common activities:
“Greater time pressures, a larger range of courses and
accompanying time-tabling complexities, and the growth
of casual and part-time jobs in the 24/7 economy mean
that “common” lunch-hours and the like are a thing of the
past. This is an issue for all university students.
“Orientation” or “Faculty” lunches, now part of
consciously designed retention practices, were previously
part of the taken-for-granted fabric of university life.”
(Forbes-Mewett & Sawyer 2016, p.672)

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What can universities do?
 Provide a clear overview of the healthcare system
 Introduce mental health support services in first lectures
along with all other information provided
 Create a greater sense of belonging
 Consider cultural differences towards mental health
 Choose language that is not viewed negatively

21. Singaporean students’ perceptions of
mental health
Study by Jamie Gan Jia Min (2016)

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Singaporean students’ perceptions
 Mental health services thought to be essential but not
necessarily useful
 Experiences in Australia brought a more positive
perceptions towards help-seeking
 ‘Mental health’ viewed more positively than ‘mental
illness’
 Culture and environment a key influence on perceptions
of mental health
 “We don’t want to lose to others ... There’s this motto of
getting number one. (Charles)”
 Stigma still exists for many

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 My personal opinion is that, in countries like Singapore, it
is under-diagnosed. We definitely have more people with
depression, anxiety, schizophrenia that we don’t know of.
On the other hand, in countries like Australia, because
there is so much of it, too many people have depression,
anxiety and schizophrenia. And a lot of people turn to it
as a limp. So like oh, I’m not coping well with this
because I have depression. It becomes like an excuse
that people hold on to in Australia. This is an
overgeneralisation as I am sitting through GP clinics but I
feel that Australia is on one end of the spectrum and
Singapore is on the other. (Medical student)

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 We need to put rice on the table. You can worry about
your thoughts another time... When you are living in
Singapore, it’s very fast paced. The general attitude or
atmosphere is that we don’t have time to sort out your
mental problems. It’s like we are so busy, and so their
thinking is that if they take time out to seek a professional
for help, it’s going to take too much time away from
whatever it is I’m doing. And I think in Singapore, the
mind-set is always “if it doesn’t work, try or work
harder”. (Tiffany)

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Sudent’s perceptions on help-seeking
 Participants valued the way they were seen by their
peers and ‘feared judgement’ as their ‘image’ was
important to them.
 Many had negative attitudes towards help-seeking and
thought that it was ‘embarrassing’, ‘less capable’,
‘something wrong’, ‘weak’, and ‘lazy’.
 Almost every participant indicated that their community
back home had stereotypical perceptions of mental
health or mental illness and that Singaporeans constantly
try to portray a positive image of themselves.
 Performance thought to be more important than health
 BUT perceptions shifting due to education in Australia!

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Useful reference material
 Forbes-Mewett, H. and Sawyer, A-M. (2016) International Students
and Mental Health. Journal of International Students, 6(3): 661-
677. IGA Global USA.
 Forbes-Mewett, H., McCulloch, J. and Nyland, C.
(2015) International Students and Crime. Palgrave Macmillan,
Houndmills. (In particular, pages 88 -98)
http://www.palgrave.com/page/detail/international-students-and-
crime-helen-forbesmewett/?K=9781137034960
 All other material in this presentation should be cited as:
Forbes-Mewett, H. (2017) Student mental health and cultural
diversity on campus. Presentation to the Campus Security & Safety
Conference, Melbourne, May 8-9.

27. Thank you
Helen.ForbesMewett@monash.edu