Mental Health Outcomes Among International College Students in the COVID-19 Pandemic: Protocol for a Scoping Review.

Abstract

Background: International college students in the United States experience unique academic, cultural, financial, and immigration-related challenges that place them at increased risk of adverse mental health outcomes, including stress, anxiety, depression, and suicidal ideation. The COVID-19 pandemic further intensified these challenges through disruptions in education, travel restrictions, social isolation, and uncertainty regarding immigration and visa policies. Although numerous studies have examined international students' mental health during this period, the available evidence has not been comprehensively mapped to characterize the extent, nature, and methodological characteristics of the literature or to identify gaps requiring further investigation.

Objective: The objective of this scoping review is to systematically map the available evidence on stress, anxiety, depression, and suicidal ideation among international college students enrolled in US institutions during and following the COVID-19 pandemic, describe the characteristics of the existing literature, and identify knowledge gaps to inform future research, policy, and practice.

Methods: This protocol follows the Joanna Briggs Institute methodology for scoping reviews and the methodological frameworks. The completed review will be reported in accordance with the PRISMA-ScR, and the search strategy will be developed and reported following the PRISMA-S recommendations. Electronic searches will be conducted in PubMed (MEDLINE), PsycINFO, CINAHL Complete, Scopus, ERIC, and Web of Science Core Collection for peer-reviewed English-language studies published between January 1, 2020, and December 31, 2025. Eligible studies will include quantitative, qualitative, and mixed methods research examining stress, anxiety, depression, or suicidal ideation among international college students enrolled in US institutions. The 2 independent reviewers will screen studies, extract data on study characteristics, participant demographics, mental health outcomes, measurement instruments, COVID-19-related contextual factors, and key findings, and synthesize the evidence using descriptive and narrative approaches. Consistent with scoping review methodology, no formal risk of bias assessment will be conducted.

Results: The a priori protocol for this unfunded scoping review was registered with the Open Science Framework. We conducted the review from December 25, 2025, through April 17, 2026. After protocol registration, we added 2 additional reviewers to assist with study screening and data abstraction. After screening, 253 records underwent further eligibility assessment, and 16 studies met the eligibility criteria for inclusion. Data analysis and synthesis are complete, and the findings and discussion are being revised and formatted for manuscript submission. Publication of the completed review is tentatively anticipated by December 31, 2026.

Conclusions: This scoping review will provide the first comprehensive evidence map of stress, anxiety, depression, and suicidal ideation among international college students enrolled in US institutions during and following the COVID-19 pandemic. The completed review will identify research gaps, summarize methodological trends, and provide evidence to inform future investigations, institutional initiatives, and policies aimed at improving mental health support for international college students.