Factors affecting mental health of South Asian international university students studying in high-income countries: A scoping review

Abstract

Objective

This scoping review aims to examine the extent and nature of evidence on factors influencing the mental health of South Asian international university students at the undergraduate and graduate levels who are studying in high-income countries. Moreover, this review aims to identify any notable gaps within the current evidence base in this area.

Design

In this review, we followed the JBI methodology for scoping reviews, as outlined in the JBI Manual for Evidence Synthesis. JBI is an international research organization that develops and supports evidence-based healthcare resources, including methodologies for systematic and scoping reviews.

Review methods

This scoping review included studies focusing on undergraduate or graduate international university students aged 18 years or older from South Asian countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka), of any sex or gender identity. The concept of interest was mental health, including related concerns such as stress, anxiety, depression, mood and eating disorders, fear, and phobias. The context was limited to high-income countries, as classified by the OECD and World Bank, including, but not limited to, Canada, the United States, the United Kingdom, Australia, and European nations. The databases Medline (OVID), PsycINFO (OVID), CINAHL (EBSCOhost), ERIC (EBSCOhost), and Scopus were searched for literature published in English from inception to the present, focusing on factors affecting the mental health of this population. Studies were excluded if they focused on students below university level, individuals under 18, were conducted in low- or middle-income countries, Arab or East Asian regions (e.g., China, Malaysia), or were review articles, books, or book chapters. The results are reported in accordance with the PRISMA-ScR guidelines.

Findings

A total of 2998 studies were identified, of which 29 met the inclusion criteria for this review. Key factors identified in the literature affecting the mental health of South Asian international students include acculturation, on-campus safety concerns, financial and academic stressors, and COVID-19-related challenges, especially social isolation, perceived social discrimination, and lack of social support. We have also identified a few barriers and facilitators to utilizing mental health services. A significant gap in the literature exists regarding the limited representation of South Asian countries beyond India and a scarcity of studies conducted in high-income countries outside the United States, United Kingdom, and Australia. Additionally, most studies were quantitative, highlighting a need for more qualitative research to gain in-depth insight into these issues.

Conclusion

This scoping review synthesizes existing knowledge on factors affecting the mental health of South Asian international students and identifies gaps in the literature. Based on our review findings, we have suggested recommendations for developing programs and policies that can enhance the well-being of international students and maximize their positive impact on global economies.