Understandings of mental health, disclosure, help-seeking and psychological adaptation among Asian international students studying in Scotland: a sequential multi-method study

International students often face psychosocial, academic, financial and adaptation challenges within the Higher Education (HE) environment that may impact on their mental health. The current study explored the understandings and experiences of Asian international students (AISs) in terms of mental health, disclosure, help-seeking and adaptation specific to cultural relocation within Scotland. A sequential multi-method approach was adopted consisting of two studies: (1) a qualitative study using individual semi-structured interviews with AISs (n=10) (Study 1) and (2) a cross-section survey comparing AISs and non-AISs (n=172) in terms of mental health literacy and psychological adaptation within the Scottish context (Study 2). Qualitative data were audio-recorded, transcribed, and analysed using a thematic approach. Quantitative data were analysed using regression and mediation analysis. Study 1 revealed three themes: (1) Negative beliefs, stigma and fear of judgment impacting on understandings and disclosure of mental health issues, (2) Adaptation and acculturation difficulties (lack of sense of belonging), and (3) Barriers in communication and social disconnection. Study 2 showed that AISs reported lower levels of mental health literacy, which in turn resulted in poorer psychological adaption compared to non-AISs. Supporting AISs in HE institutions involves challenging negative judgements surrounding mental health, increasing mental health literacy and addressing barriers in overcoming adaptation, acculturation and communication difficulties that may inhibit disclosure and help-seeking behaviour. The importance of mental health policies, supports and services in embracing culturally diverse understandings of mental health, challenging stigma and having culturally competent staff supporting student mental health within a multicultural learning environment is emphasised.