From Isolation to Integration: The Mental Health Journey of International Students in Turkey

From Isolation to Integration: The Mental Health Journey of International Students in Turkey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article From Isolation to Integration: The Mental Health Journey of International Students in Turkey Thseen Nazir This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5349000/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective This study aimed to examine the mental health status, coping strategies, perceived social support and barriers in mental health help seeking behaviour among first-year international students enrolled in Turkish language learning programs in Turkey. Participants: The study included undergraduate, graduate, and Ph.D. international students studying at Turkish language institutions. Methods A mixed-methods approach was utilized. Quantitative data were collected through surveys administered during the winter and spring terms of 2024, comprising the Warwick-Edinburgh Mental Wellbeing Scale, the Multidimensional Scale of Perceived Social Support, the Brief COPE Inventory, and a demographic questionnaire. Qualitative data were gathered through one-on-one and group interviews with 60 participants. Results Among the 381 participants from 48 countries, 45.93% reported optimal mental health, 45.14% exhibited moderate mental health, and 8.92% experienced low mental health. High levels of perceived social support from family and friends were significant predictors of mental well-being. Thematic analysis of the qualitative data identified three main themes: barriers to mental health help-seeking, perceived social support from sources beyond family and friends, and coping strategies used by students. Institutional and cultural barriers, including limited access to counseling and cultural stigma, were highlighted as critical challenges impacting mental health. Conclusions The findings reveal that while perceived social support significantly enhances mental well-being, institutional and cultural barriers severely hinder help-seeking behaviors among international students. These results underscore the urgent need for culturally competent counseling services and more accessible mental health resources in universities to support the unique needs of this student population. Barriers International students Mental Health Perceived Social Support Introduction Mental health has emerged as a growing concern within higher education, particularly among students navigating the complexities of adapting to a new academic and social environment. The transition from a native country to a host country presents numerous challenges for international students, including adjustments to unfamiliar environments, shifts in social support systems and role identities, living away from family, and managing an increased academic workload (Ranasinghe, 2023 ). These challenges can exacerbate difficulties in acclimatization, often leading to mental health issues such as psychological distress, anxiety, feelings of life imbalance, social isolation, and an overwhelming sense of being unable to cope (Goodman, 2017 ). The impact of these mental health challenges extends beyond personal well-being, significantly affecting students' quality of life, physical health, and overall well-being. Moreover, mental health problems among university students have been linked to a decline in academic performance and adverse educational outcomes, including reduced Grade Point Averages (GPA), increased substance use such as alcohol consumption and smoking, withdrawal from academic programs, and in severe cases, suicidal ideation (Serras et al., 2010 ; Wörfel et al., 2016 ). The detrimental effects of mental health issues may ultimately lead to students discontinuing their studies, thus failing to complete their degrees (Sverdlik et al., 2018 ). Given these profound implications, examining the mental health status of university students and identifying factors contributing to mental health problems have become essential areas of focus within international education research. Turkey has emerged as a significant destination for international students, firmly establishing itself in the global higher education market (Oz, 2021 ). This expansion has been driven by several macro-level initiatives, leading to a marked increase in the number of international students, from 43,251 in 2013 to 301,694 in 2023 (Education, 2023 ). As the number of international students in Turkey continues to grow, their mental health has not received adequate attention, particularly for those in their first year of the Turkish Language program. These students often face unique stressors during their transition that significantly impact their mental health and well-being. International students experienced significantly higher levels of stress and anxiety compared to their Turkish counterparts (Altıntaş et al., 2024 ). Integration into social life in Turkey and proficiency in the Turkish language were significant factors, explaining 32.8% of the variance in psychological distress levels among international students (Cetinkaya-Yildiz et al., 2011 ). Research indicates that international students often experience higher levels of psychological distress compared to domestic students, with major contributing factors including cultural adjustment, loneliness, isolation, language barriers, and limited access to mental health resources (Huang et al., 2020 a; LaMontagne et al., 2023; Browne V, Munro J, Cass J. 2017). Additionally, international students are less likely to seek support due to language and cultural barriers, stigma, lack of awareness about available services, limited mental health knowledge, maladaptive coping strategies, and self-limiting beliefs (e.g., thinking support services are only for severe issues) (LaMontagne et al., 2023b ; Newton et al., 2021 ). This reluctance is concerning, especially considering that only 47% of domestic students in Turkey are aware of available mental health services (Çebi & Demir, 2020 ), suggesting the situation may be even worse for international students. This lack of engagement with mental health services can lead to reliance on maladaptive coping strategies, potentially worsening stress in the long term. The mental health of international students has received limited attention despite the significant rise in their numbers globally. Previous research has primarily focused on their lived experiences, help-seeking behaviors, and psychological distress. Studies conducted in countries such as the United States, Canada, Turkey and Australia have highlighted that international students often face conflicts between their cultural values and the mental health norms of their host countries (Hyun et al., 2007 ; Mbous et al., 2024 ; Özenç-Ira et al., 2023 ). Consequently, they tend to avoid university counseling services and prefer seeking support from family, friends, or close relatives (Cogan et al., 2024 ; Smith & Khawaja, 2011 ; Xiong et al., 2024 ). A pervasive belief among many international students is that seeking psychological help signifies weakness and failure, leading to self-stigmatization. This stigma makes them more reluctant to disclose their issues to mental health professionals and less likely to utilize mental health services (Papadaki, 2024 ; Tikhonova et al., 2021 ). Research has shown that factors such as poor physical health, limited social support, reduced religious involvement, and negative attitudes toward seeking professional help are associated with heightened psychological distress, including anxiety and depression, among international students (Nahidi et al., 2018 ; Rosenthal et al., 2008 ). Theoretical Model The current study employs an integrated theoretical framework that combines the Transactional Model of Stress and Coping (Lazarus & Folkman, 1984 ) and the Integrated Model of Mental Health Help-Seeking (Hammer et al., 2024 ). These models are utilized to comprehensively examine the complex interplay between mental health well-being, perceived social support, coping strategies, and barriers in help-seeking behaviors among university students. By integrating these two models, the study aims to provide a holistic understanding of how students navigate mental health challenges within the context of higher education and mental health help seeking behaviours. The Transactional Model of Stress and Coping, developed by Lazarus & Folkman ( 1984 ), conceptualizes stress as a dynamic process that involves an individual’s appraisal of stressors and their coping responses. This model emphasizes two key appraisal processes: primary appraisal, which involves evaluating whether a situation is perceived as threatening, challenging, or benign, and secondary appraisal, which assesses the available coping resources, including coping strategies and social support. In the context of this study, the model applies to several variables. Mental health well-being is directly influenced by how students perceive their Turkish language learning and social challenges; negative appraisals, especially when combined with ineffective coping, can lead to mental health issues. Coping strategies play a crucial role, as effective coping methods, such as problem-focused or emotion-focused coping, can alleviate stress, while maladaptive strategies, like avoidance, can exacerbate mental health issues. Additionally, perceived social support enhances coping resources and reduces perceived stress, enabling students to view their challenges as more manageable. The Integrated Model of Mental Health Help-Seeking (IMHHS) examines the factors that influence individuals' decisions to seek mental health support, including personal attitudes, perceived need for help, social norms, and barriers. This model is particularly useful in understanding why students may not access mental health services. In the context of this study, the IMHHS applies to several key variables. Barriers in help-seeking behaviors, such as stigma and lack of awareness, can significantly hinder students from seeking necessary support, contributing to unmet mental health needs. Perceived social support plays a crucial role in this model, as positive social norms and supportive networks can facilitate help-seeking by reducing stigma and providing encouragement. Finally, mental health well-being is indirectly impacted by these barriers, as failure to seek appropriate help can lead to unaddressed mental health issues and a subsequent decline in overall well-being. Integrating the Transactional Model of Stress and Coping with the Integrated Model of Mental Health Help-Seeking (IMHHS) provides a comprehensive understanding of the factors influencing student mental health. The Transactional Model elucidates how students appraise and cope with stress, while the IMHHS focuses on internal and external factors that influence help-seeking behaviors. Together, these models highlight the cyclical nature of mental health challenges: coping strategies directly impact mental well-being, perceived barriers affect the likelihood of seeking help, and inadequate help-seeking behaviors can perpetuate poor mental health outcomes. The significance of this integrated framework lies in its ability to explain the complex interactions among coping strategies, social support, and help-seeking barriers. By examining these interconnected processes, the study offers valuable insights for developing targeted interventions that enhance coping skills, strengthen social support networks, and reduce barriers to accessing mental health services. This approach ultimately aims to support the mental well-being of students in Turkish higher education contexts. The current study In reviewing the numerous factors that influence the mental health of international students, coping skills and social support emerge as particularly critical. Given the limited perspective in existing literature on international students' mental health, along with inconsistencies in findings on coping strategies and social support, this study seeks to address these gaps. The research questions guiding this study are: (1) What is the mental health status of international students in these programs? (2) To what extent do coping skills and social support predict the mental well-being of these students? (3) What barriers hinder these students from seeking mental health support?” Methodology Research Design This study employs a mixed-methods research design, integrating both qualitative and quantitative approaches to gain a comprehensive understanding of the mental well-being, perceived social support, and coping strategies of first-year international students in Turkey. The quantitative component involves the use of standardized scales to measure mental health and related constructs, while the qualitative component uses semi-structured interviews and focus groups to explore the lived experiences and perspectives of the students related to mental health wellbeing seeking behaviour. Participants Sampling A purposive sampling strategy was used to select participants. Participants were selected based on their willingness to participate, their status as international students, and enrolment in first-year Turkish language learning programs. The sample size for the quantitative study consisted of 381 participants, determined by power analysis to ensure sufficient statistical power. Table 1 presents the demographic characteristics of the students involved in the quantitative study (N = 381). Table 1 Demographic characteristics of students who participated in the quantitative study (N = 381) Demographics n % Mean Std. Deviation Age Age Between 17–22 64.57 1.425 .622 Age Between 23–28 28.35 Age Between 29–34 7.09 Gender Female 44.88 1.449 .498 Male 55.12 Education level Undergraduate 228 1.504 .675 Post-graduate 114 PhD 39 While Table 2 below outlines the characteristics of the students who took part in the qualitative study (N = 60). Table 2 presents the characteristics of students who participated in the qualitative study. Regions Countries Academic Level f South Asia Afghanistan, Bangladesh, India, Pakistan Undergraduate 2 Master 2 Doctrate 2 South East Asia Cambodia, Indonesia, Malaysia, South Korea, Thailand Undergraduate 2 Master 2 Doctrate 2 Central Asia Kazakhstan, Tajikistan, Turkmenistan, Uzbekistan Undergraduate 2 Master 2 Doctrate 2 West Asia Iraq, Iran, Lebanon, Jordan, Palastine, Syria, Yemen Undergraduate 2 Master 2 Doctrate 2 North Africa Algeria, Chad, Egypt, Libya Undergraduate 2 Master 2 Doctrate 2 West Africa Cameroon, Ghana, Niger, Nigeria, Senegal Undergraduate 2 Master 2 Doctrate 2 East Africa Ethopia, Madagascar, Kenya, Rwanda, Sudan, Tanzania Undergraduate 2 Master 2 Doctrate 2 South Africa Zimbabwe, Zambia Undergraduate 2 Master 2 Doctrate 2 Eastern Europe Albania, Belarus, Bosnia and Herz, Macedonia, Montenegro, Romania, Russia Undergraduate 2 Master 2 Doctrate 2 South America Venezuela, Costa Rica, Colombia Undergraduate 2 Master 2 Doctrate 2 Total 60 Data Collection Methods Quantitative Data Collection Research Tools: The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) was utilized to evaluate the mental wellbeing of international students. Developed by (Tennant et al., 2007 ), this scale consists of 14 positively worded items, with higher scores indicating greater mental wellbeing. Participants rate each item on a scale from 1 (never) to 5 (always). The scale demonstrated strong internal consistency, with Cronbach's alpha levels of .89 and .91, and showed good test-retest reliability with a correlation of r = .83. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess the social support received by international students. Developed by Zimet et al., ( 1988 ), the scale comprises 12 items divided into three subscales that measure support from family, friends, and significant others. Participants respond on a 7-point Likert scale, ranging from 1 ("Very Strongly Disagree") to 7 ("Very Strongly Agree"). The scale is recognized for its reliability and validity, with internal consistency for the subscales ranging from .85 to .91. The Brief COPE Inventory was employed to examine how international students cope with challenges in the current research. Developed by Carver ( 1997 ), this scale assesses adaptive and maladaptive coping strategies in a concise manner. It consists of 28 items grouped into three dimensions: problem-focused coping, emotion-focused coping, and avoidant coping. Participants respond to each item on a 4-point Likert scale, ranging from 0 ("I haven’t been doing this at all") to 3 ("I’ve been doing this a lot"). The demographic information questionnaire included variables such as age, gender, level of degree perusing, country of origin, duration of stay in Turkey, and academic faculty. Procedure Prior to conducting the study institutional ethics approval was obtained from the Ethics Committee of Ibn Haldun university, and all procedures adhered to the ethical standards outlined by the Ibn Haldun University. Participants were recruited through one of Turkey’s largest scholarship agencies. They were invited via the scholarship agency and were provided with a detailed briefing on the research, along with clear instructions. Participation was voluntary, and individuals had the option to withdraw from the study at any time. Data were collected through a web-based survey, with all instruments administered in English. The survey was available to participants for approximately one month and included the WEMWBS, MSPSS, Brief COPE, and a socio-demographic questionnaire. Ethical Considerations Informed consent was obtained from all participants before data collection. Participants were informed about the purpose of the study, the procedures involved, their rights to withdraw at any time, and the measures taken to ensure confidentiality. Participant confidentiality was maintained by anonymizing the data and securely storing all collected information. Only the research team had access to the data, and all identifiable information was removed during transcription. Debriefing Participants were debriefed after data collection, and resources were provided for those who might have found discussing their mental health distressing. Qualitative Data Collection Interviews Participants for quantitative study was also selected through same scholarship agencies and was voluntary. To maximise the understanding of mental health seeking behaviour, students whose mental health wellbeing was low according to the quantitative data was invited to be part of qualitative study. However, almost half of the new students was added who was not a part of quantitative study. Students was debriefed about the purpose of the interviews and focus group interviews and permission for recording of interviews was sought from students and was assured that the data will be used only for research purposes and the confidentiality was assured to participants. 20 individual interviews was conducted and 5 semi-structured group interviews were conducted with a subset of the survey participants to gain deeper insights into their mental health experiences, perceptions of social support, and coping strategies. Interviews was conducted in the scholarship providing agencies offices. Each focus group consisted of 12 participants and both individual and focus group interviews lasted approximately 40 to 50 minutes. The focus group discussions allowed for the exploration of themes that emerged from the quantitative data and individual interviews. Data Analysis Methods Quantitative Data Analysis Statistical Analysis The quantitative data were analysed using SPSS. Descriptive statistics were calculated to summarize the data given in table 3. Table 3 the descriptive analysis of Mental health wellbeing, Perceived social support and coping strategies. Mental health Wellbeing Perceived Social Support Coping Strategies High 45.93 High Family 79.43 Problem Focused 38.29 Friends 77.14 Emotion Focused 16 Others 61.71 Avoid Focused 40.57 Medium Family 17.71 Problem Focused 55.43 Friends 18.29 Emotion Focused 78.86 Others 29.14 Avoid Focused 57.14 Low Family 2.86 Problem Focused 6.29 Friends 4.57 Emotion Focused 5.14 Others 9.14 Avoid Focused 2.29 Medium 45.14 High Family 51.74 Problem Focused 34.88 Friends 51.74 Emotion Focused 16.86 Others 44.19 Avoid Focused 31.4 Medium Family 37.21 Problem Focused 54.65 Friends 36.05 Emotion Focused 75 Others 40.7 Avoid Focused 65.7 Low Family 11.05 Problem Focused 10.47 Friends 12.21 Emotion Focused 8.14 Others 15.12 Avoid Focused 2.91 Low 8.92 High Family 17.65 Problem Focused 17.65 Friends 23.53 Emotion Focused 8.82 Others 29.41 Avoid Focused 14.71 Medium Family 26.47 Problem Focused 50 Friends 32.35 Emotion Focused 50 Others 50 Avoid Focused 85.29 Low Family 55.88 Problem Focused 32.35 Friends 44.12 Emotion Focused 41.18 Others 20.59 Avoid Focused 0 The descriptive data analysis indicated that among first-year Turkish language learning international students, 45.93% exhibit optimal mental health, 45.14% are experiencing medium levels of mental health, and 8.92% have low mental health. Further analysis revealed significant relationships between mental health well-being, perceived social support, and coping strategies. Individuals with high mental well-being received the strongest support from family (79.43%), friends (77.14%), and others (61.71%). In terms of coping strategies, this group showed a moderate reliance on problem-focused coping (38.29%), a lower engagement with emotion-focused coping (16%), and a notable use of avoidance-focused coping (40.57%), suggesting that they may manage stress by selectively avoiding it when needed. For individuals with medium mental well-being, family and friends offered moderate support, with 17.71% and 18.29%, respectively, perceiving high levels of support. Support from others was slightly higher at 29.14%. This group showed a substantial increase in the use of problem-focused coping (55.43%) and a sharp rise in emotion-focused coping, with 78.86% of individuals using this strategy. Avoidance-focused coping remained moderately high at 57.14%, indicating that avoidance was still a common way of handling stress. In contrast, individuals with low mental well-being reported the lowest levels of perceived social support, with only 2.86% receiving strong family support, 4.57% supported by friends, and 9.14% receiving support from others. These individuals engaged the least in problem-focused coping (6.29%) and emotion-focused coping (5.14%), and had minimal reliance on avoidance-focused coping (2.29%), suggesting significant difficulties in managing stress through any of the coping strategies. Overall, individuals with medium well-being exhibited the highest engagement with both problem-solving and emotional regulation, while those with high well-being balanced their strategies by incorporating avoidance. In contrast, individuals with low well-being struggled the most with all forms of coping and received the least social support. A multiple regression analysis was conducted to examine the influence of gender, perceived social support, and coping strategies on mental health well-being (see Table 4 ). Table 4 Regression Analysis Predicting Mental Health Well-being Mental Well-being Coef. St.Err. t-value p-value [95% Conf Interval] Sig Family Perceived Support (base) Low PSS . . . . . . Family Medium PSS .506 .142 3.56 0 .226 .786 *** Family High PSS .764 .145 5.26 0 .478 1.049 *** Friends Perceived Support (base) Low PSS . . . . . . Friends Medium PSS .284 .138 2.06 .04 .014 .555 ** Friends High PSS .486 .139 3.50 .001 .213 .759 *** Other Perceived Support (base) Other Low PSS . . . . . . Other Medium PSS − .031 .124 -0.25 .805 − .274 .213 Other High PSS .102 .127 0.81 .421 − .147 .352 Problem Focused Coping (base) A Little . . . . . . Medium Amount − .132 .136 -0.97 .333 − .399 .136 A Lot − .169 .147 -1.15 .252 − .459 .121 Emotion Focused Coping (base) A Little . . . . . . Medium Amount .369 .134 2.76 .006 .106 .632 *** A Lot .254 .166 1.53 .126 − .072 .58 Avoidant Focused Coping (base) A Little . . . . . . Medium Amount − .01 .23 − .04 .966 − .463 .443 A Lot .059 .234 0.25 .803 − .402 .519 Age − .056 .02 -2.76 .006 − .095 − .016 *** Gender : Base Male . . . . . . Female .367 .076 4.83 0 .217 .516 *** Constant 3.208 .464 6.92 0 2.296 4.119 *** Mean dependent variable 3.511 SD dependent variable R-squared 0.313 Number of obs. 381 F-test 10.349 Prob > F 0.000 Akaike crit. (AIC) 789.521 Bayesian crit. (BIC) 856.548 *** p < .01, ** p < .05, * p < .1 The multiple regression analysis in the table 4 revealed that most significant predictors of mental health wellbeing are high family (.764) and friends (.486) perceived social support, as well as medium family (.506) and friends (.284) perceived social support. On the coping side, emotion focused coping strategy at medium level (.369) significantly effects the mental wellbeing. All of these effects are positive, indicating that with increase in these variables the mental health wellbeing increases. Additionally age (- .056) negatively effects the mental health wellbeing at 1% significance level indicating that with the increase in age the mental health wellbeing decreases. On the gender side, females are having higher mental health wellbeing as compared to males at 1% significance level. To get the most parsimonious model, the general to specific methodology was used (detailed output in appendix ) and the final results are shown in table 5. Table 5 shows the parsimonious model for mental health wellbeing Linear regression Mental Wellbeing Coef. St.Err. t-value p-value [95% Conf Interval] Sig base Family Low PSS . . . . . . Family Medium PSS .492 .131 3.75 0 .234 .75 *** Family High PSS .756 .133 5.67 0 .494 1.018 *** base Friends Low PSS . . . . . . Friends Medium PSS .236 .132 1.79 .074 − .023 .496 * Friends High PSS .494 .134 3.70 0 .231 .757 *** base A Little . . . . . . Medium Amount .346 .125 2.78 .006 .101 .591 *** High .231 .15 1.54 .124 − .063 .526 Age − .054 .02 -2.75 .006 − .093 − .015 *** Gender: base Male . . . . . . Female .345 .074 4.68 0 .2 .489 *** Constant 3.152 .4 7.87 0 2.364 3.939 *** Mean dependent var 3.511 SD dependent var 0.788 R-squared 0.304 Number of observations 381 F-test 16.151 Prob > F 0.000 Akaike crit. (AIC) 782.361 Bayesian crit. (BIC) 825.732 *** p < .01, ** p < .05, * p < .1 From table 5 it can be observed that family perceived social support, friends perceived social support and emotion focused coping strategy along with age and gender are significant determinants of mental health wellbeing. Qualitative Data Analysis Thematic Analysis The qualitative data were analysed using thematic analysis, following the six-phase approach outlined by Braun & Clarke, ( 2012 ). The process involved familiarizing with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. This analysis was facilitated by NVivo software, which was used to organize and code the data. Findings of qualitative data The qualitative data revealed three major themes The qualitative data was analysed under three major categories: barriers in mental health help-seeking behaviors, perceived social support from sources other than family and friends back home (Others), and the coping strategies employed by international students. I. Barriers in mental health help-seeking behaviours The qualitative data revealed two primary sub-themes under the category of mental health help-seeking behaviors, which can be classified into: (1) Institutional barriers and (2) Personal barriers. Institutional Barriers a. Lack of Counseling Facility One of the key issues highlighted by participants was the lack of counseling facilities and counselors in Turkish hospitals. Many students shared their experiences, noting that their attempts to seek counseling through government hospitals often led them to appointments with psychiatrists instead of counselors. This distinction is important, as psychiatrists primarily focus on medication management, while many students were seeking talk therapy or other counseling services. One student expressed this frustration: " I ended up meeting with a psychiatrist in the hospital who prescribed me medication, but what I actually needed was to speak with a counselor and receive therapy ." (Student 23) This statement reflects a systemic gap in Turkey’s healthcare system, where counseling services are often unavailable in government hospitals. As a result, students are funnelled toward psychiatric care, even when their needs might be better addressed through counseling and therapeutic support. Another student described their experience with a Turkish online healthcare app, noting the absence of counseling services: " I kept searching the Turkish online app (e-nabız) for a counseling appointment, but I couldn’t find any counseling services, and it left me feeling even more frustrated ." (Student 12) This lack of easily accessible counseling services, both in hospitals and online, has become a significant barrier for students seeking mental health support. Many international students, in particular, who may already be struggling with the challenges of living in a foreign country, found themselves in desperate need of mental health care but unable to access appropriate resources. The absence of counseling services exacerbates their feelings of isolation and helplessness, as they are left with few options to address their mental health concerns. This shortage of counseling services is a major setback for international students who are actively seeking mental health support. Without access to these services, they are often left exploring alternative options or feeling forced to navigate the system without receiving the kind of help they truly need. b. Financial burden Participants highlighted the significant financial challenges associated with seeking counseling services in Turkey. Many students reported that when help was not readily available in government hospitals, they sought private counseling services. However, the cost of private therapy was so high that it became unaffordable for many. One student shared their experience: " When I calculated the cost per session at private counseling centers, I couldn’t believe it—it was nearly my entire monthly scholarship ." (Student 23) For undergraduate students, in particular, the financial burden of private counseling is even more overwhelming. The high cost of therapy sessions often exceeded their limited financial resources. As one undergraduate participant explained: " My scholarship isn’t even enough to cover half of the sessions ." (Student 40) This reflects a common struggle among students, where the cost of mental health support creates a barrier to accessing necessary care. The financial strain is compounded by the fact that many students are living on tight budgets, relying on scholarships or family support, making private counseling unaffordable. Moreover, a lack of insurance coverage for mental health services was a recurring concern among the participants. Many students discovered that their health insurance policies did not cover mental health treatments, forcing them to bear the full cost of seeking therapy. This financial burden left students in a difficult position, where they had to choose between their mental health and their financial stability. One student shared their frustration: " I realized that my insurance doesn’t cover therapy sessions, so I had to pay out of pocket, which is really expensive ." (Student 30) This statement underscores a broader issue in Turkey’s healthcare system, where mental health services are often excluded from insurance coverage. As a result, students face significant financial barriers, making it difficult for them to access the help they need. The lack of affordable and accessible mental health care exacerbates the mental health crisis for students, who are already dealing with academic and personal pressures. c. Lack of Multicultural Counseling Perspectives Participants expressed concerns about the absence of a multicultural perspective in their counseling experiences. Many felt that their cultural backgrounds were not fully understood or acknowledged by their counselors, which affected the quality of the sessions. One student, for example, shared their frustration: "It's challenging to connect with a counselor who doesn't grasp my cultural background. At times, I feel like she doesn’t fully understand me, and the blank expression on her face leaves me feeling disconnected and uncertain." (Student 12) This statement highlights the emotional distance created when counselors are unable to engage with the cultural context of their clients. A lack of cultural sensitivity in counseling can lead to feelings of isolation, making the therapeutic process less effective for students from diverse backgrounds. Furthermore, some participants pointed out that language barriers compounded this issue, as counselors often lacked proficiency in the English languages. This limitation hindered meaningful communication and made the students feel as though their cultural experiences were being dismissed. One participant shared: "While I was explaining to my counselor how much I miss my family, my relatives, and the open fields and greenery of our home, the counselor gave me a blank look, as if I wasn't supposed to feel that way. It felt like he wasn’t listening and quickly changed the subject." (Student 19) This student's experience illustrates how cultural disconnect and inadequate communication can prevent counselors from understanding the emotional significance of certain cultural references, leaving the client feeling unheard and misunderstood. In addition to these concerns, some students reported feeling stereotyped or judged based on their appearance. As one participant described: " I felt that because of the way I dress, the counselor was judging me. I didn’t feel comfortable at all. The way the counselor looked at me made me feel even more uneasy ." (Student 27) This comment sheds light on the importance of addressing biases within the counseling environment. When counselors unintentionally project judgments based on appearance or cultural differences, it undermines trust and creates barriers to effective therapy. Participants emphasized the need for counselors to be aware of and sensitive to diverse cultural backgrounds to foster an inclusive and supportive atmosphere. d. Counseling Centres Many participants reported facing significant challenges in accessing counseling services, whether through university counseling centers or private providers. One of the most common issues students encountered was finding a counselor or therapist who could communicate effectively in English. Since many new commers international students rely on English as a primary language, they often experienced frustration when counselors lacked fluency. As one participant explained: " It’s hard to communicate with a counselor who doesn’t understand English well, which makes it difficult to explain my problems ." (Student 15) This language barrier poses a serious obstacle to effective communication in therapy sessions, where understanding nuances and emotions is crucial for progress. Students who are unable to fully express themselves may feel their concerns are misunderstood or not addressed adequately, leaving them without the support they need. Another challenge frequently mentioned by participants was the difficulty in securing timely appointments. University counseling centers, which are often overcrowded, tend to have long waiting times. One student shared their experience of needing urgent support but being unable to receive it in a timely manner: " I was struggling and needed help, but they gave me an appointment two months later. By then, I didn’t even feel like going anymore ." (Student 27) This delay in receiving help can have a profound impact on students' mental health, as many feel discouraged or demotivated by the long waiting periods. Timely access to counseling is critical, especially for students dealing with immediate emotional or psychological distress. The shortage of staff at counseling centers was also a major concern. With too few counselors to meet the growing demand, students found it difficult to schedule appointments. One student remarked: " There aren’t enough counselors, so getting an appointment is really tough ." (Student 19) This scarcity of available professionals exacerbates the problem, as students are left feeling that there simply isn’t enough support to address their mental health needs. Additionally, for first-year students who are still in language learning programs, the logistical challenges of accessing counseling centers further complicate the situation. Some centers are located far from the main campus, making them difficult to reach. One student shared: " The counseling center is too far from my dormitory, and when I checked on Google Maps, it showed a two-hour travel time each way. I just gave up ." (Student 55) This comment illustrates the additional burden that distance and accessibility place on students. For those who are new to the country and still adapting to their surroundings, the lack of nearby mental health resources becomes a significant deterrent. The physical distance, combined with other barriers such as language and long waiting times, creates a situation where students may feel forced to forgo seeking help altogether. 2. Personal Barriers a. Language barrier A significant barrier identified in the participants' willingness to seek mental health assistance was the challenge posed by language barriers. Participants shared that the internal conflicts encountered due to difficulties in effectively communicating emotions in the Turkish language, which contributed to reluctance to express mental health concerns: " You feel very shy; although you may understand Turkish somehow, you may not know how to articulate your emotions and feelings... so it can be very embarrassing. I don’t know how to express my emotions in Turkish, and I am always worried about making mistakes " (Student 10). These language barriers were reported to impact participants on multiple levels, ranging from difficulties in self-expression to adverse effects on their self-confidence and self-identity. A. Student highlighted this struggle: " I feel strange... I am not who I used to be because of this language. It becomes difficult to convey what I truly feel. I don’t feel like myself when I switch to Turkish " (Student 44). For many participants, these barriers led to a sense of social isolation. They perceived themselves as struggling to establish meaningful social connections, feeling unable to " fit in " (Student 23) and form " connections " (Student 29). Despite efforts to build new interpersonal relationships during their language program, communication with peers was further constrained by underlying cultural differences. As Student explained: " I don’t know, I just can’t engage... after all, I am an African student... and I don’t know the culture... I just listen, and at that moment, I feel very lonely because I cannot participate in the conversation " (Student 38). As a consequence, participants found it challenging to be open and authentic with their peers. This inner conflict often led them to avoid burdening their friends with their issues, as they perceived seeking help or support for their mental health as " being a burden " (Student 22). Consequently, they frequently withheld their problems and expressed a reluctance to initiate social contact or seek help. Student 36 described how this reluctance led to social withdrawal: " I tried to solve the problems on my own, but I failed... I tried my best to avoid sharing with other people and tried to avoid socialization... I became very lonely and depressed " (Student 36). Many participants expressed a profound sense of " loneliness " (Student 3), " feeling alone " (Student 27), and " being different from others " (Student 11), which further intensified their feelings of isolation and disconnection from their host country and its culture. b. Navigating Support Services The majority of participants expressed uncertainty about where to seek mental health support, highlighting a significant lack of information regarding available services. This gap in knowledge was particularly pronounced among students from African and Asian countries. For instance, Student 55 questioned: " Are there any such services in our campus? " (Student 55). Similarly, another student expressed confusion about accessing services: " How do I make an appointment with a counsellor? Are these services free, and are they included in our health insurance ?" (Student 61). The process of accessing information online was reported to be highly complicated, with several participants acknowledging that they had attempted to do so but found it too " complex " (Student 9). There was also confusion about the distinctions between a therapist and a counsellor, further complicating their efforts to seek help. These challenges were exacerbated for those from distant regions of Africa and Asia, making it even more difficult to be aware of mental health resources and how to access them. Participants also admitted that their universities did not provide them with the necessary information to navigate these services effectively. c. Mental Health Perceptions Participants consistently highlighted the negative connotations and perceptions associated with mental health issues. Mental health was predominantly linked to adverse beliefs such as " weakness " (Student 5), " failure " (Student 9), " being mad " (Student 17), " a taboo " (Student 31), or representing " bad emotions " (Student 36). The notion that mental health concerns were " shameful " (Student 42) and " frowned upon and shoved under the rug " (Student 7) was widely recognized and often internalized. The majority of participants reported that studying abroad posed challenges to their mental health; however, they were reluctant to disclose these difficulties due to the fear of being " negatively judged " (Student 28) by their peers in the host country (Turkey) and by their social circles back home through " loss of face " (Student 21). Student articulated his personal thoughts and fears about acknowledging and addressing his mental health concerns: " I didn’t perceive that was problematic at all. In fact, I think I was scared to seek help, that I was scared to be aware of the problem... I worried how others would react " (Student 22). Similarly, Student 8 recounted being told that " the way I’m thinking is wrong " when he disclosed his mental health challenges to a family member. Student expressed " fear " that she would be sent to a psychiatric hospital if she voiced her mental health concerns or sought help within her university. There was also concern among participants that disclosing personal struggles with mental health could adversely " impact on [their] education " and lead to the possibility of being " sent home " (Student 16). These negative perceptions surrounding mental health issues led participants to believe that students from similar cultural backgrounds often lacked awareness and possessed limited knowledge about mental health. This sentiment is reflected in Students observation: " In our culture, discussing mental health openly isn't encouraged, as we tend to view it as a very private matter " (Student 21). As a result, participants emphasized their apprehension about sharing their mental health concerns with others, fearing judgment, potential consequences, and bringing shame upon themselves or their families. Participants also reported dealing with constant feelings of " being very low " (Student 45) and navigating the " really stressful " (Student 60) environment of socio-cultural and lifestyle differences in Turkey, such as differences in food, living in dormitories, weather, and understanding various Turkish dialects and accents. They described a tendency to downplay the severity of their mental health issues to avoid " bothering " (Student 11) their peers or " bringing shame to [their] family " (Student 19). Another student expressed concern that discussing her mental health issues might amplify them: " I feel like if I seek help for my mental health, I'm turning a small issue into a much bigger problem. Why should I do that when everyone else here is dealing with similar challenges? " (Student 7). Participants viewed seeking mental health support as being at odds with their desire to "succeed academically" (Student 18). They feared that disclosing mental health issues would bring " shame to family " (Student 13) and negatively impact their self-identity as being " self-sufficient " (Student 23), "intelligent" (Student 33), and " academic " (Student 41). Moreover, some participants believed that accessing mental health support was reserved exclusively for individuals with "serious" (Student 28) mental illnesses. This belief, coupled with the notion that stress and anxiety are issues to be managed independently or with the assistance of family and friends, further discouraged seeking professional intervention. Student 54 commented: " Mental health is a synonym for mad or insanity in our culture, and stress and anxiety are life things, something small that goes away with time or talking to family or friends ." (Student 54). Such attitudes may contribute to the underutilization of mental health services, as individuals may feel reluctant to seek help unless they perceive their condition as severe enough to warrant it. This mindset can exacerbate the stigma associated with mental health, reinforcing the idea that professional help is only necessary in extreme cases, thereby discouraging early intervention and preventive care. II. Perceived social support from sources other than family and friends (Others) The quantitative data indicated that international students predominantly seek support from their family and friends back home. The data revealed that 24.41% of students sought support from their families, while 23.24% relied on friends back home. Notably, 16.67% received support from fellow international students, 14.32% from language learning teachers, 14.08% from senior international students from their home country, and only 6.57% sought help from their scholarship agency. In line with it, qualitative phase of the study aimed to further explore the effectiveness of this support and investigate the reasons behind the limited utilization of social support services within the host country. This exploration focused on sources such as language learning institutes, scholarship agencies, and university counseling services. The thematic analysis highlighted that students perceived social support within the host country as insufficient, particularly due to the unavailability of professional mental health services. One key finding was the absence of professional counselors in language learning centers, a gap that significantly impacted students' ability to seek proper mental health support. This lack of formal resources often left students relying on informal networks. For example, one student shared: " When I was not able to understand anything in my language class, I felt so depressed and was looking for help. I called my mother back home, but she couldn’t understand my problems because she had no context. So I looked for help at the language learning institute and spoke with one of my teachers. Although she’s not a counselor, sharing my issues with her made me feel relaxed. " (Student 51) Another student expressed the challenges of seeking professional help due to language barriers: "I kept crying on the phone while talking to my friend about my problems, and my friend suggested I seek professional help. But I don't have enough Turkish language skills to explain my emotions and feelings." (Student 2) The analysis further revealed that many students began to feel uncomfortable sharing all their problems with their family, as the geographical distance made it difficult for family members to provide tangible support. Some students feared burdening their loved ones with their struggles, leading them to internalize their issues or seek alternative coping strategies. One student explained: "I started feeling guilty when my mother became stressed after hearing that I was struggling here. Over time, I stopped sharing my problems with her because I didn’t want to make her worry. I started trying to figure things out on my own, which helped me for the moment." (Student 34) In summary, the qualitative data underscores the limited availability of social support from institutional sources within the host country, compelling many students to rely on personal networks. However, the reliance on informal support from family and friends back home often proves inadequate, especially given the lack of professional mental health services and language barriers. This leaves students feeling isolated and unsupported, potentially contributing to their use of both adaptive and maladaptive coping strategies to manage their emotional well-being. III. Coping Practices Participants reported employing various strategies to cope with stress, yet they often lacked awareness or knowledge of effective coping mechanisms that could genuinely mitigate their stress. The qualitative data further highlighted the diverse strategies these international students typically adopted, without recognizing the long-term efficacy of such approaches. For instance, one participant shared that when feeling stressed, they tend to " sleep " or " keep surfing the internet ," (Student 8) which helps them temporarily forget their problems. Another student mentioned: " I keep watching movies to divert my attention " (Student 17). However, this participant also acknowledged the negative impact of these habits: " I keep watching movies, surfing the internet, or watching never-ending series and consume a lot of junk food, which makes me gain weight and increases my stress " (Student 17). In addition to these behaviors, participants pointed out that in their families and cultures, prayer is often a common response to stress. As student noted: " When we struggle with problems, we often pray " (Student 22). Another student admitted: " To be honest, I don’t know what to do in such situations, so I pray " (Student 60). Another student further expressed a tendency to withdraw completely when stressed: " Whenever I feel stressed, I feel no energy and choose to sleep all day, avoiding talking to anyone... I feel somewhat better when I wake up, but the cycle continues " (Student 8). This lack of awareness regarding maladaptive coping strategies can prolong their struggles with mental health, potentially exacerbating the issues rather than addressing them effectively. Discussion Discussion of Quantitative Data Results: The results indicate that nearly half of the first-year Turkish language learning international students maintain normal mental health, while a similar proportion experience moderate mental health challenges. A smaller percentage faces low mental health, highlighting the need for targeted support, particularly for those struggling with adjustment and coping strategies. This distribution suggests varying levels of mental well-being among students, potentially influenced by social support, coping skills, and the barriers they face in accessing mental health services. The study revealed that high level of perceived social support (family and friends) plays a crucial role in mental health wellbeing higher outcomes. International students with high mental health wellbeing had the highest perceived support from family (79.43%) and friends (77.14%), accompanied by moderate problem-focused coping (38.29%) and avoidance-focused coping (40.57%). This suggests that while students rely on active problem-solving coping strategies, they also selectively disengage from stressors through avoidance when necessary. In contrast, individuals with medium well-being reported moderate levels of social support from family (17.71%) and friends (18.29%), but they exhibited a significant increase in both problem-focused (55.43%) and emotion-focused (78.86%) coping. This suggests a stronger reliance on emotional regulation and problem-solving, possibly indicating a heightened need for coping mechanisms to maintain mental health at this level. The low well-being group received the least social support, with only 2.86% perceiving high family support, and they engaged minimally with all coping strategies, including problem-focused coping (6.29%), emotion-focused coping (5.14%), and avoidance-focused coping (2.29%). This implies a severe deficit in both external resources (social support) and internal strategies for managing stress, contributing to poorer mental health outcomes. The finding that social support is a critical determinant of mental well-being is consistent with the buffering hypothesis of social support, which posits that support from family and friends can alleviate the negative effects of stress, improving overall well-being (Lubarsky, 2024 ; Negi & Sattler, 2024 ). The current data reinforces this theory, showing that individuals with high and medium levels of perceived social support have correspondingly better mental health. Moreover, the significant role of problem-focused coping aligns with previous research suggesting that active problem-solving strategies are associated with better mental health outcomes (Lazarus & Folkman, 1984 ). However, the data also indicate that avoidance-focused coping, while generally considered maladaptive, plays a notable role in the high well-being group, suggesting that selective disengagement from stressors may also be an adaptive strategy in certain contexts (Leis et al., 2024 ). Several studies support these findings. For example, Thoits, ( 2011 ) emphasizes that social support not only buffers against stress but also provides emotional and instrumental resources that enhance coping capabilities. The elevated use of emotion-focused coping in the medium well-being group is also supported by (Folkman & Moskowitz, 2004 ), who suggest that emotional regulation becomes crucial when individuals are dealing with situations that cannot be immediately changed, thereby reducing emotional distress. However, the reliance on avoidance-focused coping in the high well-being group presents an interesting contradiction. While avoidance coping is often linked to poorer mental health outcomes (Holahan et al., 2005 ), the data here suggest that it might serve a protective role when balanced with other coping strategies. This finding could reflect a nuanced view of avoidance, where temporary disengagement from stressors can prevent emotional overload, thus contributing to better mental health (Montero-Marin et al., 2014 ; Reh et al., 2021 ). The regression analysis underscores the importance of family and friends' perceived social support as significant predictors of mental well-being. High perceived support from family (Coef. = 0.764) and friends (Coef. = 0.486) emerged as the strongest positive predictors, indicating that the presence of close relational networks significantly improves mental health outcomes. These findings align with Ramos et al., ( 2022 ), who highlight the protective effects of familiar support on psychological resilience. Furthermore, the positive impact of emotion-focused coping at a medium level (Coef. = 0.369) suggests that emotional regulation, rather than mere avoidance or problem-solving, plays a key role in maintaining mental health. This aligns with the transactional model of stress, which posits that individuals can modulate their emotional responses to stress, thereby mitigating its negative effects (Lazarus & Folkman, 1984 ). The contrast in coping strategies between high and low well-being individuals highlights the nuanced role of avoidance-focused coping. Interestingly, those with high mental health well-being had a moderate use of avoidance-focused strategies, indicating that strategic avoidance can be a functional method of managing stress in certain contexts. This is consistent with studies showing that avoidance, while generally maladaptive, can sometimes provide temporary relief in high-stress situations​ (Aloka et al., 2024 ; Kadir, 2024 ). However, individuals with lower well-being had the lowest levels of all coping strategies. This may suggest that they are either unaware of effective coping mechanisms or are disengaged from attempting to manage their stress. This finding echoes studies that emphasize the importance of awareness and education about mental health management among international students, particularly those from cultures where mental health is stigmatized (Cogan et al., 2024 ; Subu et al., 2024 ). Such students may face internalized stigma that hinders them from seeking help or developing effective coping mechanisms. On the other hand, age was found to have a negative effect on mental health (Coef. = -0.056), which is consistent with research indicating that older individuals may face cumulative stressors, including health-related concerns, that negatively affect their well-being (Whitehead & Blaxton, 2021 ; Yang & Hedeker, 2020). Lastly, the gender effect (Coef. = 0.367 for females) reveals that women, in this sample, reported better mental health outcomes than men, which could be attributed to stronger social networks and greater emotional expressiveness (Bedrov & Gable, 2023 ; Hugh-Jones et al., 2023 ). Discussion of Qualitative Data Results: Institutional Barriers Thematic analysis of qualitative interviews revealed significant institutional barriers that prevent international students from seeking mental health care. The lack of culturally competent counselors and language barriers were the most frequently cited issues. This mirrors findings from studies conducted in other countries, where international students reported similar challenges in accessing mental health services. For example, research on international students in Iran and the United Kingdom has emphasized that students often feel alienated when they cannot find counselors who understand their cultural background, leading to ineffective counseling experiences (Farokhian, 2024 ; Tajvar et al., 2024 ). Students in qualitative study were not only struggling with linguistic barriers but also felt culturally misunderstood. This sentiment aligns with findings from Tajvar et al., ( 2024 ), who highlighted that international students at Iranian universities also reported feeling disconnected due to the lack of cultural sensitivity in counseling services​. Similarly, Cruter, ( 2024 ) found that suppressive coping, which involves denying or avoiding problems, was a common response among students facing such barriers. Without culturally competent support, students may continue to rely on these ineffective coping strategies, further worsening their mental health outcomes. Personal Barriers and Cultural Perceptions The qualitative data also shed light on the personal and cultural barriers preventing students from seeking help. Many participants cited the stigma associated with mental health issues in their home countries, where mental health problems are often viewed as a sign of weakness or failure. This finding resonates with existing literature, such as studies on Asian and African international students, which suggest that mental health stigma and fear of judgment can severely limit help-seeking behaviors (Rudra, 2024 ; Xu, 2024 ). One significant insight from the qualitative data was the frequent mention of social isolation, which was compounded by language difficulties and cultural differences. These findings are consistent with research on international students’ well-being in countries like the UK and Canada, where feelings of isolation are prevalent due to communication challenges and cultural misunderstandings (Astley, 2024 ; Bai & Wang, 2024 ; Oliso, 2024 ; Tavares, 2024 ) also emphasized that cultural group plays a significant role in how students cope with these challenges. For example, Asian students in their study were more likely to use suppressive coping styles, potentially due to cultural norms around emotional self-control​ (Robinson, 2024 ; Yausheva, 2024 ). Counseling Practices and Institutional Gaps Another recurring theme was the lack of easily accessible information on mental health resources, as well as the financial burdens associated with seeking care. Several students mentioned that their insurance did not cover mental health services, echoing findings from other studies where financial constraints posed a significant barrier to accessing mental health care​ (Alsalman et al., 2024 ; Kuzhabekova & Amankulova, 2024 ). Universities, therefore, need to provide clearer guidance and financial support for international students to navigate these services, a point made by multiple researchers studying international student populations (Bai & Wang, 2024 ; Zhao & Schartner, 2024 ). Integration of Quantitative and Qualitative Data The integration of quantitative and qualitative data provides a more nuanced understanding of the complex relationships between social support, coping strategies, and mental health well-being among international students. The quantitative findings showed that individuals with high mental health well-being benefited from strong social support networks, particularly from family and friends, and effectively used problem-focused coping strategies. However, the qualitative data revealed that institutional barriers—such as the lack of counseling services and financial constraints—prevented many students from accessing the mental health support they needed. Even for those who sought help, the lack of multicultural competence in counseling services often left students feeling misunderstood and disconnected from their therapists, further hindering their ability to cope with stress. For students with medium mental health well-being, the quantitative analysis indicated higher use of emotion-focused coping, suggesting that these individuals may rely more on emotional regulation strategies in response to stress. However, the qualitative findings revealed that many participants were unaware of effective coping mechanisms, often resorting to maladaptive behaviors such as avoidance or distraction. This reliance on less effective coping strategies may contribute to the moderate mental health outcomes observed in this group. Participants with low mental health well-being reported the lowest levels of perceived social support and struggled the most with all forms of coping. The qualitative data supported these findings, with many participants describing feelings of isolation, language barriers, and a lack of awareness about available mental health resources. This combination of institutional and personal barriers left these individuals particularly vulnerable to psychological distress, as they lacked both the social support and coping mechanisms necessary to effectively manage their mental health. Implications This study has implications for policy makes, scholarship agencies, language learning institutions and concerned universities in Turkey. Arguably, the scholarship agencies and Turkish language learning institutions could be more supporting by providing perceived social support and access to mental health services. For example, Turkish language learning institutions must provide counsellors in their institutions and easy access to them while keeping multicultural environment in consideration. To reduce the language barriers the institution must provide a multi lingual counselors to the students during their initial months. Culturally sensitive, mental health awareness and mental health help seeking workshops, seminars must be provided to the incoming international students. Turkish higher education institutions, including universities and language learning centers, must recognize the critical mental health challenges faced by international students. Immediate action is required to reduce institutional barriers and address personal challenges related to mental well-being. Raising awareness is essential not only among students but also among faculty and staff who interact with international students, to ensure comprehensive support and understanding. Conclusion The results of our study align with a broader body of research highlighting the critical role of social support and adaptive coping strategies in maintaining mental health among international students. Those with higher well-being benefit from stronger family and friend support and employ more balanced coping strategies, while those with lower well-being struggle with both social support and effective coping mechanisms. The qualitative data further emphasizes the institutional and cultural barriers that exacerbate mental health challenges. Universities need to prioritize providing culturally competent counseling services and more accessible mental health resources. Addressing the stigma around mental health in the international student population is also vital for encouraging early intervention and fostering an environment where students feel comfortable seeking help. Declarations Ethics approval and consent to participate Ethics approval for the study was obtained from the Ethics Committee of Ibn Haldun University (Approval No: E-71395021-050.06.04-30552), and all procedures were conducted in accordance with the ethical standards set by the university. Consent to participate was obtained from all participants prior to their involvement in the study. Consent for publication Not applicable Availability of data and materials The data that support the findings of this study are available on request from the corresponding author, [XX]. The data are not publicly available due to restrictions e.g. their containing information that could compromise the privacy of research participants. Competing interests The authors declare that there is no conflict of interest regarding the publication of this article. Author have no financial, personal, or professional relationships that could be perceived as influencing the content or conclusions of this work. Funding Not applicable Authors' contributions The author was solely responsible for all aspects of this research. This includes the conceptualization and design of the study, data collection, analysis, and interpretation. The author also conducted the literature review, developed the research methodology, and wrote the entire manuscript. All revisions and final approvals were completed by the author, ensuring the integrity and accuracy of the research presented. Acknowledgements This research was supported by the Ibn Haldun University Bilimsel Araştirma Projesi (BAP) under project number 2217. The author would like to express gratitude to Ibn Haldun University for their valuable support in making this study possible. References Aloka, P. J. O., Ooko, M., Onyango, T. K. O., & Orao, R. (2024). Maladaptive Coping Mechanisms to Stress Among University Students From an Integrative Review (pp. 201–217). IGI Global. https://doi.org/10.4018/979-8-3693-0708-3.ch012 Alsalman, Z., Shafey, M. M., Al-Khofi, A., Alessa, J., Bukhamsin, R., Bokhuwah, M., Aljumaiah, R., Al-makhaitah, N., & Almaslami, M. (2024). Barriers to mental health service utilisation among medical students in Saudi Arabia. Frontiers in Public Health , 12 . https://doi.org/10.3389/fpubh.2024.1371628 Altıntaş, S., Çelik, S., Karahan, E., Uçar, Ö., & Yücel, M. (2024). Investigation of the relationship between the self-efficacy levels in clinical practice and coping behaviors with stress among international nursing students. Nurse Education Today , 143 , 106366. https://doi.org/10.1016/j.nedt.2024.106366 Astley, M. (2024). Cross-cultural challenges faced by international students. Journal of International Students , 14 (4), 971–988. https://doi.org/10.32674/jis.v14i4.6765 Bai, L., & Wang, Y. X. (2024). Combating language and academic culture shocks—International students’ agency in mobilizing their cultural capital. Journal of Diversity in Higher Education , 17 (2), 215–228. https://doi.org/10.1037/dhe0000409 Bedrov, A., & Gable, S. L. (2023). Thriving together: the benefits of women’s social ties for physical, psychological and relationship health. Philosophical Transactions of the Royal Society B: Biological Sciences , 378 (1868). https://doi.org/10.1098/rstb.2021.0441 Braun, V., & Clarke, V. (2012). Thematic analysis. In APA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological. (pp. 57–71). American Psychological Association. https://doi.org/10.1037/13620-004 Carver, C. S. (1997). You want to measure coping but your protocol’ too long: Consider the brief cope. International Journal of Behavioral Medicine , 4 (1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6 Çebi, E., & Demir, A. (2020). Help-Seeking Attitudes of University Students in Turkey. International Journal for the Advancement of Counselling , 42 (1), 37–47. https://doi.org/10.1007/s10447-019-09385-7 Cetinkaya-Yildiz, E., Cakir, S. G., & Kondakci, Y. (2011). Psychological distress among international students in Turkey. International Journal of Intercultural Relations , 35 (5), 534–539. https://doi.org/10.1016/j.ijintrel.2011.04.001 Cogan, N. A., Liu, X., Chin-Van Chau, Y., Kelly, S. W., Anderson, T., Flynn, C., Scott, L., Zaglis, A., & Corrigan, P. (2024). The taboo of mental health problems, stigma and fear of disclosure among Asian international students: implications for help-seeking, guidance and support. British Journal of Guidance & Counselling , 52 (4), 697–715. https://doi.org/10.1080/03069885.2023.2214307 Cruter, S. (2024). From Strain to Strength: The Stressful Realities and Coping Mechanisms of Black Student Affairs Professionals in Predominantly White Institutions. [University of Georgia]. https://www.proquest.com/dissertations-theses/strain-strength-stressful-realities-coping/docview/3065527684/se-2?accountid=191732 Education, C. of H. (2023). Statistics. Higher Education Information Management System . https://istatistik.yok.gov.tr/ Farokhian, M. (2024). Exploring the Transitional Experiences of International Students at Community Colleges . The University of Houston. Folkman, S., & Moskowitz, T. (2004). Coping: Pitfalls and promise. Annual Rev. Psychology , 1 (55), 745–774. Goodman, L. (2017). Mental Health on University Campuses and the Needs of Students They Seek to Serve. Building Healthy Academic Communities Journal , 1 (2), 31–44. https://doi.org/10.18061/bhac.v1i2.6056 Hammer, J. H., Vogel, D. L., Grzanka, P. R., Kim, N., Keum, B. T., Adams, C., & Wilson, S. A. (2024). The integrated behavioral model of mental health help seeking (IBM-HS): A health services utilization theory of planned behavior for accessing care. Journal of Counseling Psychology . https://doi.org/10.1037/cou0000754 Holahan, J., Moos, R., Holahan, K., Brennan, L., & Schutte, K. (2005). Stress generation, avoidance coping, and depressive symptoms: a 10-year model. Journal of Consulting and Clinical Psychology, 4 (73), 658. Huang, L., Kern, M. L., & Oades, L. G. (2020). Strengthening University Student Wellbeing: Language and Perceptions of Chinese International Students. International Journal of Environmental Research and Public Health , 17 (15), 5538. https://doi.org/10.3390/ijerph17155538 Hugh-Jones, S., Wilding, A., Munford, L., & Sutton, M. (2023). Age-gender differences in the relationships between physical and mental health. Social Science & Medicine , 339 , 116347. https://doi.org/10.1016/j.socscimed.2023.116347 Hyun, J., Quinn, B., Madon, T., & Lustig, S. (2007). Mental Health Need, Awareness, and Use of Counseling Services Among International Graduate Students. Journal of American College Health , 56 (2), 109–118. https://doi.org/10.3200/JACH.56.2.109-118 Kadir, M. (2024). Does Acculturative Stress Always Lead to Negative Outcomes? Understanding the Role Acculturative Stress Plays in Fostering Social Behaviors and Improved Well-Being Among International Students [Pace University]. https://www.proquest.com/dissertations-theses/does-acculturative-stress-always-lead-negative/docview/3067750693/se-2?accountid=191732 Kuzhabekova, A., & Amankulova, Z. (2024). International Student Agency in Emergency. Journal of International Students , 14 (3), 131–148. https://doi.org/10.32674/jis.v14i3.6107 LaMontagne, A. D., Shann, C., Lolicato, E., Newton, D., Owen, P. J., Tomyn, A. J., & Reavley, N. J. (2023a). Mental health-related knowledge, attitudes and behaviours in a cross-sectional sample of australian university students: a comparison of domestic and international students. BMC Public Health , 23 (1), 170. https://doi.org/10.1186/s12889-023-15123-x LaMontagne, A. D., Shann, C., Lolicato, E., Newton, D., Owen, P. J., Tomyn, A. J., & Reavley, N. J. (2023b). Mental health-related knowledge, attitudes and behaviours in a cross-sectional sample of australian university students: a comparison of domestic and international students. BMC Public Health , 23 (1), 170. https://doi.org/10.1186/s12889-023-15123-x Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping . Springer publishing company. Leis, O., Sharpe, B. T., Pelikan, V., Fritsch, J., Nicholls, A. R., & Poulus, D. (2024). Stressors and coping strategies in esports: a systematic review. International Review of Sport and Exercise Psychology , 1–31. https://doi.org/10.1080/1750984X.2024.2386528 Lubarsky, S. (2024). Social Support in the Digital Age: A Re-examination of the Buffering and Main Effect Models of Social Support [The Vanderbilt University]. http://hdl.handle.net/1803/19213 Mbous, Y. P. V., Mohamed, R., & Rudisill, T. M. (2024). International students challenges during the COVID-19 pandemic in a university in the United States: A focus group study. Current Psychology , 43 (9), 8325–8337. https://doi.org/10.1007/s12144-022-02776-x Montero-Marin, J., Prado-Abril, J., Piva Demarzo, M. M., Gascon, S., & García-Campayo, J. (2014). Coping with Stress and Types of Burnout: Explanatory Power of Different Coping Strategies. PLoS ONE , 9 (2), e89090. https://doi.org/10.1371/journal.pone.0089090 Nahidi, S., Blignault, I., Hayen, A., & Razee, H. (2018). Psychological Distress in Iranian International Students at an Australian University. Journal of Immigrant and Minority Health , 20 (3), 651–657. https://doi.org/10.1007/s10903-017-0590-8 Negi, S., & Sattler, K. M. P. (2024). Protective effect of social support: A longitudinal application of Family Stress Model. Children and Youth Services Review , 164 , 107864. https://doi.org/10.1016/j.childyouth.2024.107864 Newton, C., Tomyn, A., & LaMontagne, D. (2021). Exploring the challenges and opportunities for improving the health and wellbeing of international students: Perspectives of international students. Journal of the Australian and New Zealand Student Services Association, 1 (29), 18–34. Oliso, Z. (2024). International Students’ Intercultural Interaction with Canadian Domestic Students: Observations from Literature Review. SDU International Journal of Educational Studies , 11 (1), 19–33. https://doi.org/10.33710/sduijes.1399266 Oz, Y. (2021). The Emergence of Turkey as a Regional Hub for International Students: A Macro-Level Analysis. In Annual Review of Comparative and International Education 2020 (pp. 307–328). Emerald Publishing Limited. https://doi.org/10.1108/S1479-367920210000040017 Özenç-Ira, G., Üzar-Özçetin, Y. S., & Çelik, S. (2023). “What doesn’t defeat me makes me stronger” A Qualitative Study drawing on the Perspectives of Syrian Refugee University Students in Turkey. Psychology, Health \& Medicine , 1–16. Papadaki, A. (n.d.). The self-stigma of seeking professional psychological help among undergraduate students and associations with attachment style . Retrieved September 21, 2024, from https://sphere.acg.edu/jspui/handle/123456789/2499 Ramos, G., Ponting, C., Bocanegra, E., Chodzen, G., Delgadillo, D., Rapp, A., Escovar, E., & Chavira, D. (2022). Discrimination and Internalizing Symptoms in Rural Latinx Adolescents: The Protective Role of Family Resilience. Journal of Clinical Child & Adolescent Psychology , 51 (6), 997–1010. https://doi.org/10.1080/15374416.2021.1923018 Ranasinghe, R. (2023). Challenges experienced by international students while doing their graduate studies at Memorial University of Newfoundland [Memorial University of Newfoundland]. http://research.library.mun.ca/id/eprint/16313 Reh, S., Wieck, C., & Scheibe, S. (2021). Experience, vulnerability, or overload? Emotional job demands as moderator in trajectories of emotional well-being and job satisfaction across the working lifespan. Journal of Applied Psychology , 11 (106), 1734. Robinson, H. (2024). Cross-Cultural Differences in Emotional Regulation Strategies in United States. International Journal of Psychology , 9 (3), 1–14. https://doi.org/10.47604/ijp.2622 Rosenthal, D. A., Russell, J., & Thomson, G. (2008). The health and wellbeing of international students at an Australian university. Higher Education , 55 (1), 51–67. https://doi.org/10.1007/s10734-006-9037-1 Rudra, K. (2024). The Relationship Between Acculturation Levels, Help-Seeking Attitudes, and Self-Stigma of International Students [Capella University]. https://www.proquest.com/dissertations-theses/relationship-between-acculturation-levels-help/docview/3069551445/se-2?accountid=191732 Serras, A., Saules, K. K., Cranford, J. A., & Eisenberg, D. (2010). Self-injury, substance use, and associated risk factors in a multi-campus probability sample of college students. Psychology of Addictive Behaviors , 24 (1), 119–128. https://doi.org/10.1037/a0017210 Skromanis, S., Cooling, N., Rodgers, B., Purton, T., Fan, F., Bridgman, H., Harris, K., Presser, J., & Mond, J. (2018). Health and Well-Being of International University Students, and Comparison with Domestic Students, in Tasmania, Australia. International Journal of Environmental Research and Public Health , 15 (6), 1147. https://doi.org/10.3390/ijerph15061147 Smith, R. A., & Khawaja, N. G. (2011). A review of the acculturation experiences of international students. International Journal of Intercultural Relations , 35 (6), 699–713. https://doi.org/10.1016/j.ijintrel.2011.08.004 Subu, M. A., Dias, J. M., Mottershead, R., Ahmed, F. R., Narulita, S., Maryuni, M., Zakiyah, Z., Nurbaeti, I., Mohamed Al Marzouqi, A., & Al-Yateem, N. (2024). Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. International Journal of Qualitative Studies on Health and Well-Being , 19 (1). https://doi.org/10.1080/17482631.2024.2327103 Sverdlik, A., C. Hall, N., McAlpine, L., & Hubbard, K. (2018). The PhD Experience: A Review of the Factors Influencing Doctoral Students’ Completion, Achievement, and Well-Being. International Journal of Doctoral Studies , 13 , 361–388. https://doi.org/10.28945/4113 Tajvar, M., Ahmadizadeh, E., Sajadi, H. S., & Shaqura, I. I. (2024). Challenges facing international students at Iranian universities: a cross-sectional survey. BMC Medical Education , 24 (1), 210. https://doi.org/10.1186/s12909-024-05167-x Tavares, V. (2024). Feeling excluded: international students experience equity, diversity and inclusion. International Journal of Inclusive Education , 28 (8), 1551–1568. https://doi.org/10.1080/13603116.2021.2008536 Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes , 5 (1), 63. https://doi.org/10.1186/1477-7525-5-63 Thoits, P. A. (2011). Mechanisms Linking Social Ties and Support to Physical and Mental Health. Journal of Health and Social Behavior , 52 (2), 145–161. https://doi.org/10.1177/0022146510395592 Tikhonova, E. V., Kosycheva, M. A., & Efremova, G. I. (2021). Primary Professionalization of Foreign Students: Barriers, Stigmatization, Adaptation. Integration of Education , 25 (4), 608–628. https://doi.org/10.15507/1991-9468.105.025.202104.608-628 Whitehead, B. R., & Blaxton, J. M. (2021). Daily associations among aging perceptions, perceived health, and perceived stress in older adults. Aging & Mental Health , 25 (12), 2255–2264. https://doi.org/10.1080/13607863.2020.1855625 Wörfel, F., Gusy, B., Lohmann, K., Töpritz, K., & Kleiber, D. (2016). Mental health problems among university students and the impact of structural conditions. Journal of Public Health , 24 (2), 125–133. https://doi.org/10.1007/s10389-015-0703-6 Xiong, W., Radunz, M., Ali, K., King, D., Kyrios, M., Zhao, Y., & Fassnacht, D. (2024). Comparing the mental health and wellbeing of domestic and international tertiary students. Journal of International Students , 14 (4), 702–740. https://doi.org/10.32674/jis.v14i4.6647 Xu, Y. (2024). Decoding Factors Influencing Mental Health Help-Seeking in Asian International Students: A Correlational Survey Study. Graduate Student Journal of Psychology , 22 . https://doi.org/10.52214/gsjp.v22i1.12171 Yausheva, A. (2024). International students’ perspectives on social-emotional competences in the context of. University of Turku. Zhao, X., & Schartner, A. (2024). Revisiting the ‘U-curve’ hypothesis: international students’ academic, sociocultural, and psychological adjustment trajectories at a British university. European Journal of Higher Education , 14 (2), 343–366. https://doi.org/10.1080/21568235.2023.2193702 Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment , 52 (1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2 Additional Declarations No competing interests reported. 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The transition from a native country to a host country presents numerous challenges for international students, including adjustments to unfamiliar environments, shifts in social support systems and role identities, living away from family, and managing an increased academic workload (Ranasinghe, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These challenges can exacerbate difficulties in acclimatization, often leading to mental health issues such as psychological distress, anxiety, feelings of life imbalance, social isolation, and an overwhelming sense of being unable to cope (Goodman, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The impact of these mental health challenges extends beyond personal well-being, significantly affecting students' quality of life, physical health, and overall well-being. Moreover, mental health problems among university students have been linked to a decline in academic performance and adverse educational outcomes, including reduced Grade Point Averages (GPA), increased substance use such as alcohol consumption and smoking, withdrawal from academic programs, and in severe cases, suicidal ideation (Serras et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; W\u0026ouml;rfel et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The detrimental effects of mental health issues may ultimately lead to students discontinuing their studies, thus failing to complete their degrees (Sverdlik et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Given these profound implications, examining the mental health status of university students and identifying factors contributing to mental health problems have become essential areas of focus within international education research.\u003c/p\u003e \u003cp\u003eTurkey has emerged as a significant destination for international students, firmly establishing itself in the global higher education market (Oz, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This expansion has been driven by several macro-level initiatives, leading to a marked increase in the number of international students, from 43,251 in 2013 to 301,694 in 2023 (Education, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). As the number of international students in Turkey continues to grow, their mental health has not received adequate attention, particularly for those in their first year of the Turkish Language program. These students often face unique stressors during their transition that significantly impact their mental health and well-being. International students experienced significantly higher levels of stress and anxiety compared to their Turkish counterparts (Altıntaş et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Integration into social life in Turkey and proficiency in the Turkish language were significant factors, explaining 32.8% of the variance in psychological distress levels among international students (Cetinkaya-Yildiz et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eResearch indicates that international students often experience higher levels of psychological distress compared to domestic students, with major contributing factors including cultural adjustment, loneliness, isolation, language barriers, and limited access to mental health resources (Huang et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003ea; LaMontagne et al., 2023; Browne V, Munro J, Cass J. 2017). Additionally, international students are less likely to seek support due to language and cultural barriers, stigma, lack of awareness about available services, limited mental health knowledge, maladaptive coping strategies, and self-limiting beliefs (e.g., thinking support services are only for severe issues) (LaMontagne et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023b\u003c/span\u003e; Newton et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This reluctance is concerning, especially considering that only 47% of domestic students in Turkey are aware of available mental health services (\u0026Ccedil;ebi \u0026amp; Demir, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), suggesting the situation may be even worse for international students. This lack of engagement with mental health services can lead to reliance on maladaptive coping strategies, potentially worsening stress in the long term.\u003c/p\u003e \u003cp\u003eThe mental health of international students has received limited attention despite the significant rise in their numbers globally. Previous research has primarily focused on their lived experiences, help-seeking behaviors, and psychological distress. Studies conducted in countries such as the United States, Canada, Turkey and Australia have highlighted that international students often face conflicts between their cultural values and the mental health norms of their host countries (Hyun et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Mbous et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; \u0026Ouml;zen\u0026ccedil;-Ira et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Consequently, they tend to avoid university counseling services and prefer seeking support from family, friends, or close relatives (Cogan et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Smith \u0026amp; Khawaja, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Xiong et al., \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). A pervasive belief among many international students is that seeking psychological help signifies weakness and failure, leading to self-stigmatization. This stigma makes them more reluctant to disclose their issues to mental health professionals and less likely to utilize mental health services (Papadaki, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Tikhonova et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Research has shown that factors such as poor physical health, limited social support, reduced religious involvement, and negative attitudes toward seeking professional help are associated with heightened psychological distress, including anxiety and depression, among international students (Nahidi et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Rosenthal et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2008\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eTheoretical Model\u003c/h3\u003e\n\u003cp\u003eThe current study employs an integrated theoretical framework that combines the Transactional Model of Stress and Coping (Lazarus \u0026amp; Folkman, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1984\u003c/span\u003e) and the Integrated Model of Mental Health Help-Seeking (Hammer et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These models are utilized to comprehensively examine the complex interplay between mental health well-being, perceived social support, coping strategies, and barriers in help-seeking behaviors among university students. By integrating these two models, the study aims to provide a holistic understanding of how students navigate mental health challenges within the context of higher education and mental health help seeking behaviours.\u003c/p\u003e \u003cp\u003eThe Transactional Model of Stress and Coping, developed by Lazarus \u0026amp; Folkman (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1984\u003c/span\u003e), conceptualizes stress as a dynamic process that involves an individual\u0026rsquo;s appraisal of stressors and their coping responses. This model emphasizes two key appraisal processes: primary appraisal, which involves evaluating whether a situation is perceived as threatening, challenging, or benign, and secondary appraisal, which assesses the available coping resources, including coping strategies and social support. In the context of this study, the model applies to several variables. Mental health well-being is directly influenced by how students perceive their Turkish language learning and social challenges; negative appraisals, especially when combined with ineffective coping, can lead to mental health issues. Coping strategies play a crucial role, as effective coping methods, such as problem-focused or emotion-focused coping, can alleviate stress, while maladaptive strategies, like avoidance, can exacerbate mental health issues. Additionally, perceived social support enhances coping resources and reduces perceived stress, enabling students to view their challenges as more manageable.\u003c/p\u003e \u003cp\u003eThe Integrated Model of Mental Health Help-Seeking (IMHHS) examines the factors that influence individuals' decisions to seek mental health support, including personal attitudes, perceived need for help, social norms, and barriers. This model is particularly useful in understanding why students may not access mental health services. In the context of this study, the IMHHS applies to several key variables. Barriers in help-seeking behaviors, such as stigma and lack of awareness, can significantly hinder students from seeking necessary support, contributing to unmet mental health needs. Perceived social support plays a crucial role in this model, as positive social norms and supportive networks can facilitate help-seeking by reducing stigma and providing encouragement. Finally, mental health well-being is indirectly impacted by these barriers, as failure to seek appropriate help can lead to unaddressed mental health issues and a subsequent decline in overall well-being.\u003c/p\u003e \u003cp\u003eIntegrating the Transactional Model of Stress and Coping with the Integrated Model of Mental Health Help-Seeking (IMHHS) provides a comprehensive understanding of the factors influencing student mental health. The Transactional Model elucidates how students appraise and cope with stress, while the IMHHS focuses on internal and external factors that influence help-seeking behaviors. Together, these models highlight the cyclical nature of mental health challenges: coping strategies directly impact mental well-being, perceived barriers affect the likelihood of seeking help, and inadequate help-seeking behaviors can perpetuate poor mental health outcomes. The significance of this integrated framework lies in its ability to explain the complex interactions among coping strategies, social support, and help-seeking barriers. By examining these interconnected processes, the study offers valuable insights for developing targeted interventions that enhance coping skills, strengthen social support networks, and reduce barriers to accessing mental health services. This approach ultimately aims to support the mental well-being of students in Turkish higher education contexts.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eThe current study\u003c/h2\u003e \u003cp\u003eIn reviewing the numerous factors that influence the mental health of international students, coping skills and social support emerge as particularly critical. Given the limited perspective in existing literature on international students' mental health, along with inconsistencies in findings on coping strategies and social support, this study seeks to address these gaps. The research questions guiding this study are: (1) What is the mental health status of international students in these programs? (2) To what extent do coping skills and social support predict the mental well-being of these students? (3) What barriers hinder these students from seeking mental health support?\u0026rdquo;\u003c/p\u003e \u003c/div\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eResearch Design\u003c/h2\u003e \u003cp\u003eThis study employs a mixed-methods research design, integrating both qualitative and quantitative approaches to gain a comprehensive understanding of the mental well-being, perceived social support, and coping strategies of first-year international students in Turkey. The quantitative component involves the use of standardized scales to measure mental health and related constructs, while the qualitative component uses semi-structured interviews and focus groups to explore the lived experiences and perspectives of the students related to mental health wellbeing seeking behaviour.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSampling\u003c/h2\u003e \u003cp\u003eA purposive sampling strategy was used to select participants. Participants were selected based on their willingness to participate, their status as international students, and enrolment in first-year Turkish language learning programs. The sample size for the quantitative study consisted of 381 participants, determined by power analysis to ensure sufficient statistical power. Table\u0026nbsp;1 presents the demographic characteristics of the students involved in the quantitative study (N\u0026thinsp;=\u0026thinsp;381).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of students who participated in the quantitative study (N\u0026thinsp;=\u0026thinsp;381)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDemographics\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003en %\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eMean\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eStd. Deviation\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eAge\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eAge Between 17\u0026ndash;22\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e64.57\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003e1.425\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003e.622\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eAge Between 23\u0026ndash;28\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e28.35\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eAge Between 29\u0026ndash;34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e7.09\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eFemale\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e44.88\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e1.449\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e.498\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eMale\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e55.12\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eEducation level\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eUndergraduate\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e228\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003e1.504\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003e.675\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePost-graduate\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e114\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePhD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e39\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhile Table\u0026nbsp;2 below outlines the characteristics of the students who took part in the qualitative study (N\u0026thinsp;=\u0026thinsp;60).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003epresents the characteristics of students who participated in the qualitative study.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCountries\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcademic Level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ef\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSouth Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAfghanistan, Bangladesh, India, Pakistan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSouth East Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCambodia, Indonesia, Malaysia, South Korea, Thailand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCentral Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKazakhstan, Tajikistan, Turkmenistan, Uzbekistan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWest Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIraq, Iran, Lebanon, Jordan, Palastine, Syria, Yemen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNorth Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAlgeria, Chad, Egypt, Libya\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWest Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCameroon, Ghana, Niger, Nigeria, Senegal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEast Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEthopia, Madagascar, Kenya, Rwanda, Sudan, Tanzania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSouth Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eZimbabwe, Zambia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEastern Europe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAlbania, Belarus, Bosnia and Herz, Macedonia, Montenegro, Romania, Russia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSouth America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eVenezuela, Costa Rica, Colombia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDoctrate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Methods\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eQuantitative Data Collection\u003c/h2\u003e \u003cdiv id=\"Sec10\" class=\"Section4\"\u003e \u003ch2\u003eResearch Tools:\u003c/h2\u003e \u003cp\u003e \u003cem\u003eThe Warwick-Edinburgh Mental Wellbeing Scale\u003c/em\u003e (WEMWBS) was utilized to evaluate the mental wellbeing of international students. Developed by (Tennant et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), this scale consists of 14 positively worded items, with higher scores indicating greater mental wellbeing. Participants rate each item on a scale from 1 (never) to 5 (always). The scale demonstrated strong internal consistency, with Cronbach's alpha levels of .89 and .91, and showed good test-retest reliability with a correlation of r\u0026thinsp;=\u0026thinsp;.83.\u003c/p\u003e \u003cp\u003e \u003cem\u003eThe Multidimensional Scale of Perceived Social Support\u003c/em\u003e (MSPSS) was used to assess the social support received by international students. Developed by Zimet et al., (\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e1988\u003c/span\u003e), the scale comprises 12 items divided into three subscales that measure support from family, friends, and significant others. Participants respond on a 7-point Likert scale, ranging from 1 (\"Very Strongly Disagree\") to 7 (\"Very Strongly Agree\"). The scale is recognized for its reliability and validity, with internal consistency for the subscales ranging from .85 to .91.\u003c/p\u003e \u003cp\u003e \u003cem\u003eThe Brief COPE Inventory\u003c/em\u003e was employed to examine how international students cope with challenges in the current research. Developed by Carver (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e1997\u003c/span\u003e), this scale assesses adaptive and maladaptive coping strategies in a concise manner. It consists of 28 items grouped into three dimensions: problem-focused coping, emotion-focused coping, and avoidant coping. Participants respond to each item on a 4-point Likert scale, ranging from 0 (\"I haven\u0026rsquo;t been doing this at all\") to 3 (\"I\u0026rsquo;ve been doing this a lot\").\u003c/p\u003e \u003cp\u003e \u003cem\u003eThe demographic information questionnaire\u003c/em\u003e included variables such as age, gender, level of degree perusing, country of origin, duration of stay in Turkey, and academic faculty.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cp\u003e Prior to conducting the study institutional ethics approval was obtained from the Ethics Committee of Ibn Haldun university, and all procedures adhered to the ethical standards outlined by the Ibn Haldun University. Participants were recruited through one of Turkey\u0026rsquo;s largest scholarship agencies. They were invited via the scholarship agency and were provided with a detailed briefing on the research, along with clear instructions. Participation was voluntary, and individuals had the option to withdraw from the study at any time.\u003c/p\u003e \u003cp\u003eData were collected through a web-based survey, with all instruments administered in English. The survey was available to participants for approximately one month and included the WEMWBS, MSPSS, Brief COPE, and a socio-demographic questionnaire.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003eInformed consent was obtained from all participants before data collection. Participants were informed about the purpose of the study, the procedures involved, their rights to withdraw at any time, and the measures taken to ensure confidentiality. Participant confidentiality was maintained by anonymizing the data and securely storing all collected information. Only the research team had access to the data, and all identifiable information was removed during transcription.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eDebriefing\u003c/h2\u003e \u003cp\u003eParticipants were debriefed after data collection, and resources were provided for those who might have found discussing their mental health distressing.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eQualitative Data Collection\u003c/h2\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003eInterviews\u003c/h2\u003e \u003cp\u003eParticipants for quantitative study was also selected through same scholarship agencies and was voluntary. To maximise the understanding of mental health seeking behaviour, students whose mental health wellbeing was low according to the quantitative data was invited to be part of qualitative study. However, almost half of the new students was added who was not a part of quantitative study. Students was debriefed about the purpose of the interviews and focus group interviews and permission for recording of interviews was sought from students and was assured that the data will be used only for research purposes and the confidentiality was assured to participants. 20 individual interviews was conducted and 5 semi-structured group interviews were conducted with a subset of the survey participants to gain deeper insights into their mental health experiences, perceptions of social support, and coping strategies. Interviews was conducted in the scholarship providing agencies offices. Each focus group consisted of 12 participants and both individual and focus group interviews lasted approximately 40 to 50 minutes. The focus group discussions allowed for the exploration of themes that emerged from the quantitative data and individual interviews.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis Methods\u003c/h2\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eQuantitative Data Analysis\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eThe quantitative data were analysed using SPSS. Descriptive statistics were calculated to summarize the data given in table 3.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ethe descriptive analysis of Mental health wellbeing, Perceived social support and coping strategies.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMental health Wellbeing\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003ePerceived Social Support\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eCoping Strategies\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eHigh\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003e45.93\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eHigh\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e79.43\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e38.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e77.14\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e61.71\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMedium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e17.71\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e55.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e18.29\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e78.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e29.14\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e57.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLow\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.86\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e4.57\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e9.14\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eMedium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003e45.14\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eHigh\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e51.74\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e34.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e51.74\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e44.19\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e31.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMedium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e37.21\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e54.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e36.05\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e40.7\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e65.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLow\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e11.05\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e12.21\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e15.12\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eLow\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003e8.92\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eHigh\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e17.65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e23.53\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e29.41\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMedium\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e26.47\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e32.35\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e50\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e85.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLow\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFamily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e55.88\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eProblem Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eFriends\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e44.12\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEmotion Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e41.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eOthers\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e20.59\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eAvoid Focused\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe descriptive data analysis indicated that among first-year Turkish language learning international students, 45.93% exhibit optimal mental health, 45.14% are experiencing medium levels of mental health, and 8.92% have low mental health. Further analysis revealed significant relationships between mental health well-being, perceived social support, and coping strategies. Individuals with high mental well-being received the strongest support from family (79.43%), friends (77.14%), and others (61.71%). In terms of coping strategies, this group showed a moderate reliance on problem-focused coping (38.29%), a lower engagement with emotion-focused coping (16%), and a notable use of avoidance-focused coping (40.57%), suggesting that they may manage stress by selectively avoiding it when needed.\u003c/p\u003e \u003cp\u003eFor individuals with medium mental well-being, family and friends offered moderate support, with 17.71% and 18.29%, respectively, perceiving high levels of support. Support from others was slightly higher at 29.14%. This group showed a substantial increase in the use of problem-focused coping (55.43%) and a sharp rise in emotion-focused coping, with 78.86% of individuals using this strategy. Avoidance-focused coping remained moderately high at 57.14%, indicating that avoidance was still a common way of handling stress.\u003c/p\u003e \u003cp\u003eIn contrast, individuals with low mental well-being reported the lowest levels of perceived social support, with only 2.86% receiving strong family support, 4.57% supported by friends, and 9.14% receiving support from others. These individuals engaged the least in problem-focused coping (6.29%) and emotion-focused coping (5.14%), and had minimal reliance on avoidance-focused coping (2.29%), suggesting significant difficulties in managing stress through any of the coping strategies.\u003c/p\u003e \u003cp\u003eOverall, individuals with medium well-being exhibited the highest engagement with both problem-solving and emotional regulation, while those with high well-being balanced their strategies by incorporating avoidance. In contrast, individuals with low well-being struggled the most with all forms of coping and received the least social support.\u003c/p\u003e \u003cp\u003eA multiple regression analysis was conducted to examine the influence of gender, perceived social support, and coping strategies on mental health well-being (see \u003cem\u003eTable\u0026nbsp;4\u003c/em\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRegression Analysis Predicting Mental Health Well-being\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental Well-being\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eCoef.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSt.Err.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e[95% Conf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eInterval]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSig\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Perceived Support\u003c/p\u003e \u003cp\u003e\u003cem\u003e(base) Low PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Medium PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.506\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e3.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily High PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.764\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e5.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends Perceived Support\u003c/p\u003e \u003cp\u003e\u003cem\u003e(base)\u003c/em\u003e Low PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends Medium PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.555\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends High PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.759\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Perceived Support \u003cem\u003e(base)\u003c/em\u003e Other Low PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Medium PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e-0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.805\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther High PSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProblem Focused Coping\u003c/p\u003e \u003cp\u003e\u003cem\u003e(base)\u003c/em\u003e A Little\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium Amount\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e-0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA Lot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e-1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion Focused Coping\u003c/p\u003e \u003cp\u003e\u003cem\u003e(base)\u003c/em\u003e A Little\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium Amount\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA Lot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAvoidant Focused Coping \u003cem\u003e(base)\u003c/em\u003e A Little\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium Amount\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.443\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA Lot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.803\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e-2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender : Base Male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e.367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e4.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e.217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3.208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.464\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e6.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e2.296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean dependent variable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e3.511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eSD dependent variable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eR-squared\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e0.313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eNumber of obs.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003e381\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eF-test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e10.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAkaike crit. (AIC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e789.521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eBayesian crit. (BIC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003e856.548\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"11\" nameend=\"c11\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e*** p\u0026thinsp;\u0026lt;\u0026thinsp;.01, ** p\u0026thinsp;\u0026lt;\u0026thinsp;.05, * p\u0026thinsp;\u0026lt;\u0026thinsp;.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe multiple regression analysis in the table 4 revealed that most significant predictors of mental health wellbeing are high family (.764) and friends (.486) perceived social support, as well as medium family (.506) and friends (.284) perceived social support. On the coping side, emotion focused coping strategy at medium level (.369) significantly effects the mental wellbeing. All of these effects are positive, indicating that with increase in these variables the mental health wellbeing increases. Additionally age (- .056) negatively effects the mental health wellbeing at 1% significance level indicating that with the increase in age the mental health wellbeing decreases.\u003c/p\u003e \u003cp\u003eOn the gender side, females are having higher mental health wellbeing as compared to males at 1% significance level.\u003c/p\u003e \u003cp\u003eTo get the most parsimonious model, the general to specific methodology was used (detailed output in \u0026lt;link rid=\"Sec43\"\u0026gt;\u003cspan refid=\"Sec44\" class=\"InternalRef\"\u003eappendix\u003c/span\u003e\u0026lt;/link\u0026gt;) and the final results are shown in table 5.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eshows the parsimonious model for mental health wellbeing Linear regression\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eMental Wellbeing\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCoef.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSt.Err.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e[95% Conf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eInterval]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSig\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003ebase Family Low PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFamily Medium PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.492\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.131\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.75\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e0\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e.234\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.75\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFamily High PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.756\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.133\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e5.67\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e0\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e.494\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e1.018\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003ebase Friends Low PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFriends Medium PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.236\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.132\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e1.79\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e.074\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e\u0026minus;\u0026thinsp;.023\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.496\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFriends High PSS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.494\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.134\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.70\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e0\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e.231\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.757\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003ebase A Little\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMedium Amount\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.346\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.125\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.78\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e.006\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e.101\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.591\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eHigh\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.231\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.15\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e1.54\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e.124\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e\u0026minus;\u0026thinsp;.063\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.526\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAge\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e\u0026minus;\u0026thinsp;.054\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.02\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e-2.75\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e.006\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e\u0026minus;\u0026thinsp;.093\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e\u0026minus;\u0026thinsp;.015\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eGender: base Male\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFemale\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e.345\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.074\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e4.68\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e0\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e.2\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e.489\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eConstant\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e3.152\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e.4\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003e7.87\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e0\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e2.364\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003e3.939\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003e***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMean dependent var\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e3.511\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSD dependent var\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.788\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eR-squared\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e0.304\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003eNumber of observations\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e\u003cem\u003e381\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eF-test\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e16.151\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003eProb\u0026thinsp;\u0026gt;\u0026thinsp;F\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.000\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAkaike crit. (AIC)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e782.361\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003eBayesian crit. (BIC)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003e\u003cem\u003e825.732\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e*** p\u0026thinsp;\u0026lt;\u0026thinsp;.01, ** p\u0026thinsp;\u0026lt;\u0026thinsp;.05, * p\u0026thinsp;\u0026lt;\u0026thinsp;.1\u003c/h2\u003e \u003cp\u003eFrom table 5 it can be observed that family perceived social support, friends perceived social support and emotion focused coping strategy along with age and gender are significant determinants of mental health wellbeing.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eQualitative Data Analysis\u003c/h2\u003e \u003cdiv id=\"Sec21\" class=\"Section3\"\u003e \u003ch2\u003eThematic Analysis\u003c/h2\u003e \u003cp\u003eThe qualitative data were analysed using thematic analysis, following the six-phase approach outlined by Braun \u0026amp; Clarke, (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). The process involved familiarizing with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. This analysis was facilitated by NVivo software, which was used to organize and code the data.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eFindings of qualitative data\u003c/h2\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eThe qualitative data revealed three major themes\u003c/h2\u003e \u003cp\u003eThe qualitative data was analysed under three major categories: barriers in mental health help-seeking behaviors, perceived social support from sources other than family and friends back home (Others), and the coping strategies employed by international students.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eI. Barriers in mental health help-seeking behaviours\u003c/h2\u003e \u003cp\u003eThe qualitative data revealed two primary sub-themes under the category of mental health help-seeking behaviors, which can be classified into: (1) Institutional barriers and (2) Personal barriers.\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eInstitutional Barriers\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003ea. Lack of Counseling Facility\u003c/h2\u003e \u003cp\u003eOne of the key issues highlighted by participants was the lack of counseling facilities and counselors in Turkish hospitals. Many students shared their experiences, noting that their attempts to seek counseling through government hospitals often led them to appointments with psychiatrists instead of counselors. This distinction is important, as psychiatrists primarily focus on medication management, while many students were seeking talk therapy or other counseling services. One student expressed this frustration:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI ended up meeting with a psychiatrist in the hospital who prescribed me medication, but what I actually needed was to speak with a counselor and receive therapy\u003c/em\u003e.\" (Student 23)\u003c/p\u003e \u003cp\u003eThis statement reflects a systemic gap in Turkey\u0026rsquo;s healthcare system, where counseling services are often unavailable in government hospitals. As a result, students are funnelled toward psychiatric care, even when their needs might be better addressed through counseling and therapeutic support.\u003c/p\u003e \u003cp\u003eAnother student described their experience with a Turkish online healthcare app, noting the absence of counseling services:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI kept searching the Turkish online app (e-nabız) for a counseling appointment, but I couldn\u0026rsquo;t find any counseling services, and it left me feeling even more frustrated\u003c/em\u003e.\" (Student 12)\u003c/p\u003e \u003cp\u003eThis lack of easily accessible counseling services, both in hospitals and online, has become a significant barrier for students seeking mental health support. Many international students, in particular, who may already be struggling with the challenges of living in a foreign country, found themselves in desperate need of mental health care but unable to access appropriate resources. The absence of counseling services exacerbates their feelings of isolation and helplessness, as they are left with few options to address their mental health concerns.\u003c/p\u003e \u003cp\u003eThis shortage of counseling services is a major setback for international students who are actively seeking mental health support. Without access to these services, they are often left exploring alternative options or feeling forced to navigate the system without receiving the kind of help they truly need.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eb. Financial burden\u003c/h2\u003e \u003cp\u003eParticipants highlighted the significant financial challenges associated with seeking counseling services in Turkey. Many students reported that when help was not readily available in government hospitals, they sought private counseling services. However, the cost of private therapy was so high that it became unaffordable for many. One student shared their experience:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eWhen I calculated the cost per session at private counseling centers, I couldn\u0026rsquo;t believe it\u0026mdash;it was nearly my entire monthly scholarship\u003c/em\u003e.\" (Student 23)\u003c/p\u003e \u003cp\u003eFor undergraduate students, in particular, the financial burden of private counseling is even more overwhelming. The high cost of therapy sessions often exceeded their limited financial resources. As one undergraduate participant explained:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eMy scholarship isn\u0026rsquo;t even enough to cover half of the sessions\u003c/em\u003e.\" (Student 40)\u003c/p\u003e \u003cp\u003eThis reflects a common struggle among students, where the cost of mental health support creates a barrier to accessing necessary care. The financial strain is compounded by the fact that many students are living on tight budgets, relying on scholarships or family support, making private counseling unaffordable.\u003c/p\u003e \u003cp\u003eMoreover, a lack of insurance coverage for mental health services was a recurring concern among the participants. Many students discovered that their health insurance policies did not cover mental health treatments, forcing them to bear the full cost of seeking therapy. This financial burden left students in a difficult position, where they had to choose between their mental health and their financial stability. One student shared their frustration:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI realized that my insurance doesn\u0026rsquo;t cover therapy sessions, so I had to pay out of pocket, which is really expensive\u003c/em\u003e.\" (Student 30)\u003c/p\u003e \u003cp\u003eThis statement underscores a broader issue in Turkey\u0026rsquo;s healthcare system, where mental health services are often excluded from insurance coverage. As a result, students face significant financial barriers, making it difficult for them to access the help they need. The lack of affordable and accessible mental health care exacerbates the mental health crisis for students, who are already dealing with academic and personal pressures.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003ec. Lack of Multicultural Counseling Perspectives\u003c/h2\u003e \u003cp\u003e Participants expressed concerns about the absence of a multicultural perspective in their counseling experiences. Many felt that their cultural backgrounds were not fully understood or acknowledged by their counselors, which affected the quality of the sessions. One student, for example, shared their frustration:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"It's challenging to connect with a counselor who doesn't grasp my cultural background. At times, I feel like she doesn\u0026rsquo;t fully understand me, and the blank expression on her face leaves me feeling disconnected and uncertain.\"\u003c/em\u003e (Student 12)\u003c/p\u003e \u003cp\u003eThis statement highlights the emotional distance created when counselors are unable to engage with the cultural context of their clients. A lack of cultural sensitivity in counseling can lead to feelings of isolation, making the therapeutic process less effective for students from diverse backgrounds. Furthermore, some participants pointed out that language barriers compounded this issue, as counselors often lacked proficiency in the English languages. This limitation hindered meaningful communication and made the students feel as though their cultural experiences were being dismissed. One participant shared:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"While I was explaining to my counselor how much I miss my family, my relatives, and the open fields and greenery of our home, the counselor gave me a blank look, as if I wasn't supposed to feel that way. It felt like he wasn\u0026rsquo;t listening and quickly changed the subject.\"\u003c/em\u003e (Student 19)\u003c/p\u003e \u003cp\u003eThis student's experience illustrates how cultural disconnect and inadequate communication can prevent counselors from understanding the emotional significance of certain cultural references, leaving the client feeling unheard and misunderstood.\u003c/p\u003e \u003cp\u003eIn addition to these concerns, some students reported feeling stereotyped or judged based on their appearance. As one participant described:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI felt that because of the way I dress, the counselor was judging me. I didn\u0026rsquo;t feel comfortable at all. The way the counselor looked at me made me feel even more uneasy\u003c/em\u003e.\" (Student 27)\u003c/p\u003e \u003cp\u003eThis comment sheds light on the importance of addressing biases within the counseling environment. When counselors unintentionally project judgments based on appearance or cultural differences, it undermines trust and creates barriers to effective therapy. Participants emphasized the need for counselors to be aware of and sensitive to diverse cultural backgrounds to foster an inclusive and supportive atmosphere.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003ed. Counseling Centres\u003c/h2\u003e \u003cp\u003e Many participants reported facing significant challenges in accessing counseling services, whether through university counseling centers or private providers. One of the most common issues students encountered was finding a counselor or therapist who could communicate effectively in English. Since many new commers international students rely on English as a primary language, they often experienced frustration when counselors lacked fluency. As one participant explained:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eIt\u0026rsquo;s hard to communicate with a counselor who doesn\u0026rsquo;t understand English well, which makes it difficult to explain my problems\u003c/em\u003e.\" (Student 15)\u003c/p\u003e \u003cp\u003eThis language barrier poses a serious obstacle to effective communication in therapy sessions, where understanding nuances and emotions is crucial for progress. Students who are unable to fully express themselves may feel their concerns are misunderstood or not addressed adequately, leaving them without the support they need.\u003c/p\u003e \u003cp\u003e Another challenge frequently mentioned by participants was the difficulty in securing timely appointments. University counseling centers, which are often overcrowded, tend to have long waiting times. One student shared their experience of needing urgent support but being unable to receive it in a timely manner:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI was struggling and needed help, but they gave me an appointment two months later. By then, I didn\u0026rsquo;t even feel like going anymore\u003c/em\u003e.\" (Student 27)\u003c/p\u003e \u003cp\u003eThis delay in receiving help can have a profound impact on students' mental health, as many feel discouraged or demotivated by the long waiting periods. Timely access to counseling is critical, especially for students dealing with immediate emotional or psychological distress.\u003c/p\u003e \u003cp\u003eThe shortage of staff at counseling centers was also a major concern. With too few counselors to meet the growing demand, students found it difficult to schedule appointments. One student remarked:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eThere aren\u0026rsquo;t enough counselors, so getting an appointment is really tough\u003c/em\u003e.\" (Student 19)\u003c/p\u003e \u003cp\u003eThis scarcity of available professionals exacerbates the problem, as students are left feeling that there simply isn\u0026rsquo;t enough support to address their mental health needs.\u003c/p\u003e \u003cp\u003eAdditionally, for first-year students who are still in language learning programs, the logistical challenges of accessing counseling centers further complicate the situation. Some centers are located far from the main campus, making them difficult to reach. One student shared:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eThe counseling center is too far from my dormitory, and when I checked on Google Maps, it showed a two-hour travel time each way. I just gave up\u003c/em\u003e.\" (Student 55)\u003c/p\u003e \u003cp\u003eThis comment illustrates the additional burden that distance and accessibility place on students. For those who are new to the country and still adapting to their surroundings, the lack of nearby mental health resources becomes a significant deterrent. The physical distance, combined with other barriers such as language and long waiting times, creates a situation where students may feel forced to forgo seeking help altogether.\u003c/p\u003e \u003cp\u003e \u003cb\u003e2. Personal Barriers\u003c/b\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003ea. Language barrier\u003c/h2\u003e \u003cp\u003e A significant barrier identified in the participants' willingness to seek mental health assistance was the challenge posed by language barriers. Participants shared that the internal conflicts encountered due to difficulties in effectively communicating emotions in the Turkish language, which contributed to reluctance to express mental health concerns:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eYou feel very shy; although you may understand Turkish somehow, you may not know how to articulate your emotions and feelings... so it can be very embarrassing. I don\u0026rsquo;t know how to express my emotions in Turkish, and I am always worried about making mistakes\u003c/em\u003e\" (Student 10).\u003c/p\u003e \u003cp\u003e These language barriers were reported to impact participants on multiple levels, ranging from difficulties in self-expression to adverse effects on their self-confidence and self-identity. A. Student highlighted this struggle:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI feel strange... I am not who I used to be because of this language. It becomes difficult to convey what I truly feel. I don\u0026rsquo;t feel like myself when I switch to Turkish\u003c/em\u003e\" (Student 44).\u003c/p\u003e \u003cp\u003eFor many participants, these barriers led to a sense of social isolation. They perceived themselves as struggling to establish meaningful social connections, feeling unable to \"\u003cem\u003efit in\u003c/em\u003e\" (Student 23) and form \"\u003cem\u003econnections\u003c/em\u003e\" (Student 29). Despite efforts to build new interpersonal relationships during their language program, communication with peers was further constrained by underlying cultural differences. As Student explained:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI don\u0026rsquo;t know, I just can\u0026rsquo;t engage... after all, I am an African student... and I don\u0026rsquo;t know the culture... I just listen, and at that moment, I feel very lonely because I cannot participate in the conversation\u003c/em\u003e\" (Student 38).\u003c/p\u003e \u003cp\u003e As a consequence, participants found it challenging to be open and authentic with their peers. This inner conflict often led them to avoid burdening their friends with their issues, as they perceived seeking help or support for their mental health as \"\u003cem\u003ebeing a burden\u003c/em\u003e\" (Student 22). Consequently, they frequently withheld their problems and expressed a reluctance to initiate social contact or seek help. Student 36 described how this reluctance led to social withdrawal:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI tried to solve the problems on my own, but I failed... I tried my best to avoid sharing with other people and tried to avoid socialization... I became very lonely and depressed\u003c/em\u003e\" (Student 36).\u003c/p\u003e \u003cp\u003eMany participants expressed a profound sense of \"\u003cem\u003eloneliness\u003c/em\u003e\" (Student 3), \"\u003cem\u003efeeling alone\u003c/em\u003e\" (Student 27), and \"\u003cem\u003ebeing different from others\u003c/em\u003e\" (Student 11), which further intensified their feelings of isolation and disconnection from their host country and its culture.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eb. Navigating Support Services\u003c/h3\u003e\n\u003cp\u003eThe majority of participants expressed uncertainty about where to seek mental health support, highlighting a significant lack of information regarding available services. This gap in knowledge was particularly pronounced among students from African and Asian countries. For instance, Student 55 questioned: \"\u003cem\u003eAre there any such services in our campus?\u003c/em\u003e\" (Student 55).\u003c/p\u003e \u003cp\u003eSimilarly, another student expressed confusion about accessing services:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eHow do I make an appointment with a counsellor? Are these services free, and are they included in our health insurance\u003c/em\u003e?\" (Student 61).\u003c/p\u003e \u003cp\u003eThe process of accessing information online was reported to be highly complicated, with several participants acknowledging that they had attempted to do so but found it too \"\u003cem\u003ecomplex\u003c/em\u003e\" (Student 9). There was also confusion about the distinctions between a therapist and a counsellor, further complicating their efforts to seek help. These challenges were exacerbated for those from distant regions of Africa and Asia, making it even more difficult to be aware of mental health resources and how to access them. Participants also admitted that their universities did not provide them with the necessary information to navigate these services effectively.\u003c/p\u003e \u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003ec. Mental Health Perceptions\u003c/h2\u003e \u003cp\u003eParticipants consistently highlighted the negative connotations and perceptions associated with mental health issues. Mental health was predominantly linked to adverse beliefs such as \"\u003cem\u003eweakness\u003c/em\u003e\" (Student 5), \"\u003cem\u003efailure\u003c/em\u003e\" (Student 9), \"\u003cem\u003ebeing mad\u003c/em\u003e\" (Student 17), \"\u003cem\u003ea taboo\u003c/em\u003e\" (Student 31), or representing \"\u003cem\u003ebad emotions\u003c/em\u003e\" (Student 36). The notion that mental health concerns were \"\u003cem\u003eshameful\u003c/em\u003e\" (Student 42) and \"\u003cem\u003efrowned upon and shoved under the rug\u003c/em\u003e\" (Student 7) was widely recognized and often internalized.\u003c/p\u003e \u003cp\u003eThe majority of participants reported that studying abroad posed challenges to their mental health; however, they were reluctant to disclose these difficulties due to the fear of being \"\u003cem\u003enegatively judged\u003c/em\u003e\" (Student 28) by their peers in the host country (Turkey) and by their social circles back home through \"\u003cem\u003eloss of face\u003c/em\u003e\" (Student 21). Student articulated his personal thoughts and fears about acknowledging and addressing his mental health concerns:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI didn\u0026rsquo;t perceive that was problematic at all. In fact, I think I was scared to seek help, that I was scared to be aware of the problem... I worried how others would react\u003c/em\u003e\" (Student 22).\u003c/p\u003e \u003cp\u003eSimilarly, Student 8 recounted being told that \"\u003cem\u003ethe way I\u0026rsquo;m thinking is wrong\u003c/em\u003e\" when he disclosed his mental health challenges to a family member. Student expressed \"\u003cem\u003efear\u003c/em\u003e\" that she would be sent to a psychiatric hospital if she voiced her mental health concerns or sought help within her university. There was also concern among participants that disclosing personal struggles with mental health could adversely \"\u003cem\u003eimpact on [their] education\u003c/em\u003e\" and lead to the possibility of being \"\u003cem\u003esent home\u003c/em\u003e\" (Student 16).\u003c/p\u003e \u003cp\u003eThese negative perceptions surrounding mental health issues led participants to believe that students from similar cultural backgrounds often lacked awareness and possessed limited knowledge about mental health. This sentiment is reflected in Students observation:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eIn our culture, discussing mental health openly isn't encouraged, as we tend to view it as a very private matter\u003c/em\u003e\" (Student 21).\u003c/p\u003e \u003cp\u003e As a result, participants emphasized their apprehension about sharing their mental health concerns with others, fearing judgment, potential consequences, and bringing shame upon themselves or their families. Participants also reported dealing with constant feelings of \"\u003cem\u003ebeing very low\u003c/em\u003e\" (Student 45) and navigating the \"\u003cem\u003ereally stressful\u003c/em\u003e\" (Student 60) environment of socio-cultural and lifestyle differences in Turkey, such as differences in food, living in dormitories, weather, and understanding various Turkish dialects and accents. They described a tendency to downplay the severity of their mental health issues to avoid \"\u003cem\u003ebothering\u003c/em\u003e\" (Student 11) their peers or \"\u003cem\u003ebringing shame to [their] family\u003c/em\u003e\" (Student 19). Another student expressed concern that discussing her mental health issues might amplify them:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI feel like if I seek help for my mental health, I'm turning a small issue into a much bigger problem. Why should I do that when everyone else here is dealing with similar challenges?\u003c/em\u003e\" (Student 7).\u003c/p\u003e \u003cp\u003eParticipants viewed seeking mental health support as being at odds with their desire to \"succeed academically\" (Student 18). They feared that disclosing mental health issues would bring \"\u003cem\u003eshame to family\u003c/em\u003e\" (Student 13) and negatively impact their self-identity as being \"\u003cem\u003eself-sufficient\u003c/em\u003e\" (Student 23), \"intelligent\" (Student 33), and \"\u003cem\u003eacademic\u003c/em\u003e\" (Student 41).\u003c/p\u003e \u003cp\u003eMoreover, some participants believed that accessing mental health support was reserved exclusively for individuals with \"serious\" (Student 28) mental illnesses. This belief, coupled with the notion that stress and anxiety are issues to be managed independently or with the assistance of family and friends, further discouraged seeking professional intervention. Student 54 commented:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eMental health is a synonym for mad or insanity in our culture, and stress and anxiety are life things, something small that goes away with time or talking to family or friends\u003c/em\u003e.\" (Student 54).\u003c/p\u003e \u003cp\u003eSuch attitudes may contribute to the underutilization of mental health services, as individuals may feel reluctant to seek help unless they perceive their condition as severe enough to warrant it. This mindset can exacerbate the stigma associated with mental health, reinforcing the idea that professional help is only necessary in extreme cases, thereby discouraging early intervention and preventive care.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec32\" class=\"Section2\"\u003e \u003ch2\u003eII. Perceived social support from sources other than family and friends (Others)\u003c/h2\u003e \u003cp\u003eThe quantitative data indicated that international students predominantly seek support from their family and friends back home. The data revealed that 24.41% of students sought support from their families, while 23.24% relied on friends back home. Notably, 16.67% received support from fellow international students, 14.32% from language learning teachers, 14.08% from senior international students from their home country, and only 6.57% sought help from their scholarship agency. In line with it, qualitative phase of the study aimed to further explore the effectiveness of this support and investigate the reasons behind the limited utilization of social support services within the host country. This exploration focused on sources such as language learning institutes, scholarship agencies, and university counseling services.\u003c/p\u003e \u003cp\u003eThe thematic analysis highlighted that students perceived social support within the host country as insufficient, particularly due to the unavailability of professional mental health services. One key finding was the absence of professional counselors in language learning centers, a gap that significantly impacted students' ability to seek proper mental health support. This lack of formal resources often left students relying on informal networks. For example, one student shared:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eWhen I was not able to understand anything in my language class, I felt so depressed and was looking for help. I called my mother back home, but she couldn\u0026rsquo;t understand my problems because she had no context. So I looked for help at the language learning institute and spoke with one of my teachers. Although she\u0026rsquo;s not a counselor, sharing my issues with her made me feel relaxed.\u003c/em\u003e\" (Student 51)\u003c/p\u003e \u003cp\u003eAnother student expressed the challenges of seeking professional help due to language barriers:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I kept crying on the phone while talking to my friend about my problems, and my friend suggested I seek professional help. But I don't have enough Turkish language skills to explain my emotions and feelings.\"\u003c/em\u003e (Student 2)\u003c/p\u003e \u003cp\u003eThe analysis further revealed that many students began to feel uncomfortable sharing all their problems with their family, as the geographical distance made it difficult for family members to provide tangible support. Some students feared burdening their loved ones with their struggles, leading them to internalize their issues or seek alternative coping strategies. One student explained:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"I started feeling guilty when my mother became stressed after hearing that I was struggling here. Over time, I stopped sharing my problems with her because I didn\u0026rsquo;t want to make her worry. I started trying to figure things out on my own, which helped me for the moment.\"\u003c/em\u003e (Student 34)\u003c/p\u003e \u003cp\u003eIn summary, the qualitative data underscores the limited availability of social support from institutional sources within the host country, compelling many students to rely on personal networks. However, the reliance on informal support from family and friends back home often proves inadequate, especially given the lack of professional mental health services and language barriers. This leaves students feeling isolated and unsupported, potentially contributing to their use of both adaptive and maladaptive coping strategies to manage their emotional well-being.\u003c/p\u003e \u003cdiv id=\"Sec33\" class=\"Section3\"\u003e \u003ch2\u003eIII. Coping Practices\u003c/h2\u003e \u003cp\u003eParticipants reported employing various strategies to cope with stress, yet they often lacked awareness or knowledge of effective coping mechanisms that could genuinely mitigate their stress. The qualitative data further highlighted the diverse strategies these international students typically adopted, without recognizing the long-term efficacy of such approaches. For instance, one participant shared that when feeling stressed, they tend to \"\u003cem\u003esleep\u003c/em\u003e\" or \"\u003cem\u003ekeep surfing the internet\u003c/em\u003e,\" (Student 8) which helps them temporarily forget their problems. Another student mentioned:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI keep watching movies to divert my attention\u003c/em\u003e\" (Student 17).\u003c/p\u003e \u003cp\u003eHowever, this participant also acknowledged the negative impact of these habits:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eI keep watching movies, surfing the internet, or watching never-ending series and consume a lot of junk food, which makes me gain weight and increases my stress\u003c/em\u003e\" (Student 17).\u003c/p\u003e \u003cp\u003eIn addition to these behaviors, participants pointed out that in their families and cultures, prayer is often a common response to stress. As student noted:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eWhen we struggle with problems, we often pray\u003c/em\u003e\" (Student 22).\u003c/p\u003e \u003cp\u003eAnother student admitted:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eTo be honest, I don\u0026rsquo;t know what to do in such situations, so I pray\u003c/em\u003e\" (Student 60).\u003c/p\u003e \u003cp\u003eAnother student further expressed a tendency to withdraw completely when stressed:\u003c/p\u003e \u003cp\u003e\"\u003cem\u003eWhenever I feel stressed, I feel no energy and choose to sleep all day, avoiding talking to anyone... I feel somewhat better when I wake up, but the cycle continues\u003c/em\u003e\" (Student 8).\u003c/p\u003e \u003cp\u003eThis lack of awareness regarding maladaptive coping strategies can prolong their struggles with mental health, potentially exacerbating the issues rather than addressing them effectively.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec35\" class=\"Section2\"\u003e \u003ch2\u003eDiscussion of Quantitative Data Results:\u003c/h2\u003e \u003cp\u003eThe results indicate that nearly half of the first-year Turkish language learning international students maintain normal mental health, while a similar proportion experience moderate mental health challenges. A smaller percentage faces low mental health, highlighting the need for targeted support, particularly for those struggling with adjustment and coping strategies. This distribution suggests varying levels of mental well-being among students, potentially influenced by social support, coping skills, and the barriers they face in accessing mental health services. The study revealed that high level of perceived social support (family and friends) plays a crucial role in mental health wellbeing higher outcomes. International students with high mental health wellbeing had the highest perceived support from family (79.43%) and friends (77.14%), accompanied by moderate problem-focused coping (38.29%) and avoidance-focused coping (40.57%). This suggests that while students rely on active problem-solving coping strategies, they also selectively disengage from stressors through avoidance when necessary. In contrast, individuals with medium well-being reported moderate levels of social support from family (17.71%) and friends (18.29%), but they exhibited a significant increase in both problem-focused (55.43%) and emotion-focused (78.86%) coping. This suggests a stronger reliance on emotional regulation and problem-solving, possibly indicating a heightened need for coping mechanisms to maintain mental health at this level. The low well-being group received the least social support, with only 2.86% perceiving high family support, and they engaged minimally with all coping strategies, including problem-focused coping (6.29%), emotion-focused coping (5.14%), and avoidance-focused coping (2.29%). This implies a severe deficit in both external resources (social support) and internal strategies for managing stress, contributing to poorer mental health outcomes.\u003c/p\u003e \u003cp\u003eThe finding that social support is a critical determinant of mental well-being is consistent with the buffering hypothesis of social support, which posits that support from family and friends can alleviate the negative effects of stress, improving overall well-being (Lubarsky, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Negi \u0026amp; Sattler, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). The current data reinforces this theory, showing that individuals with high and medium levels of perceived social support have correspondingly better mental health. Moreover, the significant role of problem-focused coping aligns with previous research suggesting that active problem-solving strategies are associated with better mental health outcomes (Lazarus \u0026amp; Folkman, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1984\u003c/span\u003e). However, the data also indicate that avoidance-focused coping, while generally considered maladaptive, plays a notable role in the high well-being group, suggesting that selective disengagement from stressors may also be an adaptive strategy in certain contexts (Leis et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral studies support these findings. For example, Thoits, (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) emphasizes that social support not only buffers against stress but also provides emotional and instrumental resources that enhance coping capabilities. The elevated use of emotion-focused coping in the medium well-being group is also supported by (Folkman \u0026amp; Moskowitz, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2004\u003c/span\u003e), who suggest that emotional regulation becomes crucial when individuals are dealing with situations that cannot be immediately changed, thereby reducing emotional distress. However, the reliance on avoidance-focused coping in the high well-being group presents an interesting contradiction. While avoidance coping is often linked to poorer mental health outcomes (Holahan et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2005\u003c/span\u003e), the data here suggest that it might serve a protective role when balanced with other coping strategies. This finding could reflect a nuanced view of avoidance, where temporary disengagement from stressors can prevent emotional overload, thus contributing to better mental health (Montero-Marin et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Reh et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe regression analysis underscores the importance of family and friends' perceived social support as significant predictors of mental well-being. High perceived support from family (Coef. = 0.764) and friends (Coef. = 0.486) emerged as the strongest positive predictors, indicating that the presence of close relational networks significantly improves mental health outcomes. These findings align with Ramos et al., (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), who highlight the protective effects of familiar support on psychological resilience. Furthermore, the positive impact of emotion-focused coping at a medium level (Coef. = 0.369) suggests that emotional regulation, rather than mere avoidance or problem-solving, plays a key role in maintaining mental health. This aligns with the transactional model of stress, which posits that individuals can modulate their emotional responses to stress, thereby mitigating its negative effects (Lazarus \u0026amp; Folkman, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1984\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe contrast in coping strategies between high and low well-being individuals highlights the nuanced role of avoidance-focused coping. Interestingly, those with high mental health well-being had a moderate use of avoidance-focused strategies, indicating that strategic avoidance can be a functional method of managing stress in certain contexts. This is consistent with studies showing that avoidance, while generally maladaptive, can sometimes provide temporary relief in high-stress situations​ (Aloka et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Kadir, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, individuals with lower well-being had the lowest levels of all coping strategies. This may suggest that they are either unaware of effective coping mechanisms or are disengaged from attempting to manage their stress. This finding echoes studies that emphasize the importance of awareness and education about mental health management among international students, particularly those from cultures where mental health is stigmatized (Cogan et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Subu et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Such students may face internalized stigma that hinders them from seeking help or developing effective coping mechanisms.\u003c/p\u003e \u003cp\u003eOn the other hand, age was found to have a negative effect on mental health (Coef. = -0.056), which is consistent with research indicating that older individuals may face cumulative stressors, including health-related concerns, that negatively affect their well-being (Whitehead \u0026amp; Blaxton, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Yang \u0026amp; Hedeker, 2020). Lastly, the gender effect (Coef. = 0.367 for females) reveals that women, in this sample, reported better mental health outcomes than men, which could be attributed to stronger social networks and greater emotional expressiveness (Bedrov \u0026amp; Gable, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Hugh-Jones et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDiscussion of Qualitative Data Results:\u003c/h3\u003e\n\u003cdiv id=\"Sec37\" class=\"Section2\"\u003e \u003ch2\u003eInstitutional Barriers\u003c/h2\u003e \u003cp\u003eThematic analysis of qualitative interviews revealed significant institutional barriers that prevent international students from seeking mental health care. The lack of culturally competent counselors and language barriers were the most frequently cited issues. This mirrors findings from studies conducted in other countries, where international students reported similar challenges in accessing mental health services. For example, research on international students in Iran and the United Kingdom has emphasized that students often feel alienated when they cannot find counselors who understand their cultural background, leading to ineffective counseling experiences (Farokhian, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Tajvar et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents in qualitative study were not only struggling with linguistic barriers but also felt culturally misunderstood. This sentiment aligns with findings from Tajvar et al., (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), who highlighted that international students at Iranian universities also reported feeling disconnected due to the lack of cultural sensitivity in counseling services​. Similarly, Cruter, (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) found that suppressive coping, which involves denying or avoiding problems, was a common response among students facing such barriers. Without culturally competent support, students may continue to rely on these ineffective coping strategies, further worsening their mental health outcomes.\u003c/p\u003e \u003cdiv id=\"Sec38\" class=\"Section3\"\u003e \u003ch2\u003ePersonal Barriers and Cultural Perceptions\u003c/h2\u003e \u003cp\u003eThe qualitative data also shed light on the personal and cultural barriers preventing students from seeking help. Many participants cited the stigma associated with mental health issues in their home countries, where mental health problems are often viewed as a sign of weakness or failure. This finding resonates with existing literature, such as studies on Asian and African international students, which suggest that mental health stigma and fear of judgment can severely limit help-seeking behaviors (Rudra, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Xu, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). One significant insight from the qualitative data was the frequent mention of social isolation, which was compounded by language difficulties and cultural differences. These findings are consistent with research on international students\u0026rsquo; well-being in countries like the UK and Canada, where feelings of isolation are prevalent due to communication challenges and cultural misunderstandings (Astley, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Bai \u0026amp; Wang, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Oliso, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Tavares, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) also emphasized that cultural group plays a significant role in how students cope with these challenges. For example, Asian students in their study were more likely to use suppressive coping styles, potentially due to cultural norms around emotional self-control​ (Robinson, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Yausheva, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec39\" class=\"Section2\"\u003e \u003ch2\u003eCounseling Practices and Institutional Gaps\u003c/h2\u003e \u003cp\u003eAnother recurring theme was the lack of easily accessible information on mental health resources, as well as the financial burdens associated with seeking care. Several students mentioned that their insurance did not cover mental health services, echoing findings from other studies where financial constraints posed a significant barrier to accessing mental health care​ (Alsalman et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Kuzhabekova \u0026amp; Amankulova, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Universities, therefore, need to provide clearer guidance and financial support for international students to navigate these services, a point made by multiple researchers studying international student populations (Bai \u0026amp; Wang, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Zhao \u0026amp; Schartner, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec40\" class=\"Section3\"\u003e \u003ch2\u003eIntegration of Quantitative and Qualitative Data\u003c/h2\u003e \u003cp\u003eThe integration of quantitative and qualitative data provides a more nuanced understanding of the complex relationships between social support, coping strategies, and mental health well-being among international students. The quantitative findings showed that individuals with high mental health well-being benefited from strong social support networks, particularly from family and friends, and effectively used problem-focused coping strategies. However, the qualitative data revealed that institutional barriers\u0026mdash;such as the lack of counseling services and financial constraints\u0026mdash;prevented many students from accessing the mental health support they needed. Even for those who sought help, the lack of multicultural competence in counseling services often left students feeling misunderstood and disconnected from their therapists, further hindering their ability to cope with stress. For students with medium mental health well-being, the quantitative analysis indicated higher use of emotion-focused coping, suggesting that these individuals may rely more on emotional regulation strategies in response to stress. However, the qualitative findings revealed that many participants were unaware of effective coping mechanisms, often resorting to maladaptive behaviors such as avoidance or distraction. This reliance on less effective coping strategies may contribute to the moderate mental health outcomes observed in this group. Participants with low mental health well-being reported the lowest levels of perceived social support and struggled the most with all forms of coping. The qualitative data supported these findings, with many participants describing feelings of isolation, language barriers, and a lack of awareness about available mental health resources. This combination of institutional and personal barriers left these individuals particularly vulnerable to psychological distress, as they lacked both the social support and coping mechanisms necessary to effectively manage their mental health.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eImplications\u003c/h3\u003e\n\u003cp\u003eThis study has implications for policy makes, scholarship agencies, language learning institutions and concerned universities in Turkey. Arguably, the scholarship agencies and Turkish language learning institutions could be more supporting by providing perceived social support and access to mental health services. For example, Turkish language learning institutions must provide counsellors in their institutions and easy access to them while keeping multicultural environment in consideration. To reduce the language barriers the institution must provide a multi lingual counselors to the students during their initial months. Culturally sensitive, mental health awareness and mental health help seeking workshops, seminars must be provided to the incoming international students.\u003c/p\u003e \u003cp\u003eTurkish higher education institutions, including universities and language learning centers, must recognize the critical mental health challenges faced by international students. Immediate action is required to reduce institutional barriers and address personal challenges related to mental well-being. Raising awareness is essential not only among students but also among faculty and staff who interact with international students, to ensure comprehensive support and understanding.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of our study align with a broader body of research highlighting the critical role of social support and adaptive coping strategies in maintaining mental health among international students. Those with higher well-being benefit from stronger family and friend support and employ more balanced coping strategies, while those with lower well-being struggle with both social support and effective coping mechanisms.\u003c/p\u003e \u003cp\u003eThe qualitative data further emphasizes the institutional and cultural barriers that exacerbate mental health challenges. Universities need to prioritize providing culturally competent counseling services and more accessible mental health resources. Addressing the stigma around mental health in the international student population is also vital for encouraging early intervention and fostering an environment where students feel comfortable seeking help.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval for the study was obtained from the Ethics Committee of Ibn Haldun University (Approval No: E-71395021-050.06.04-30552), and all procedures were conducted in accordance with the ethical standards set by the university. Consent to participate was obtained from all participants prior to their involvement in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available on request from the corresponding author, [XX]. The data are not publicly available due to restrictions e.g. their containing information that could compromise the privacy of research participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest regarding the publication of this article. Author have no financial, personal, or professional relationships that could be perceived as influencing the content or conclusions of this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author was solely responsible for all aspects of this research. This includes the conceptualization and design of the study, data collection, analysis, and interpretation. The author also conducted the literature review, developed the research methodology, and wrote the entire manuscript. All revisions and final approvals were completed by the author, ensuring the integrity and accuracy of the research presented.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Ibn Haldun University Bilimsel Araştirma Projesi (BAP) under project number 2217. The author would like to express gratitude to Ibn Haldun University for their valuable support in making this study possible.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAloka, P. J. O., Ooko, M., Onyango, T. K. O., \u0026amp; Orao, R. (2024). \u003cem\u003eMaladaptive Coping Mechanisms to Stress Among University Students From an Integrative Review\u003c/em\u003e (pp. 201\u0026ndash;217). IGI Global. https://doi.org/10.4018/979-8-3693-0708-3.ch012\u003c/li\u003e\n\u003cli\u003eAlsalman, Z., Shafey, M. M., Al-Khofi, A., Alessa, J., Bukhamsin, R., Bokhuwah, M., Aljumaiah, R., Al-makhaitah, N., \u0026amp; Almaslami, M. (2024). Barriers to mental health service utilisation among medical students in Saudi Arabia. \u003cem\u003eFrontiers in Public Health\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e. https://doi.org/10.3389/fpubh.2024.1371628\u003c/li\u003e\n\u003cli\u003eAltıntaş, S., \u0026Ccedil;elik, S., Karahan, E., U\u0026ccedil;ar, \u0026Ouml;., \u0026amp; Y\u0026uuml;cel, M. (2024). Investigation of the relationship between the self-efficacy levels in clinical practice and coping behaviors with stress among international nursing students. \u003cem\u003eNurse Education Today\u003c/em\u003e, \u003cem\u003e143\u003c/em\u003e, 106366. https://doi.org/10.1016/j.nedt.2024.106366\u003c/li\u003e\n\u003cli\u003eAstley, M. (2024). Cross-cultural challenges faced by international students. \u003cem\u003eJournal of International Students\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 971\u0026ndash;988. https://doi.org/10.32674/jis.v14i4.6765\u003c/li\u003e\n\u003cli\u003eBai, L., \u0026amp; Wang, Y. X. (2024). Combating language and academic culture shocks\u0026mdash;International students\u0026rsquo; agency in mobilizing their cultural capital. \u003cem\u003eJournal of Diversity in Higher Education\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(2), 215\u0026ndash;228. https://doi.org/10.1037/dhe0000409\u003c/li\u003e\n\u003cli\u003eBedrov, A., \u0026amp; Gable, S. L. (2023). Thriving together: the benefits of women\u0026rsquo;s social ties for physical, psychological and relationship health. \u003cem\u003ePhilosophical Transactions of the Royal Society B: Biological Sciences\u003c/em\u003e, \u003cem\u003e378\u003c/em\u003e(1868). https://doi.org/10.1098/rstb.2021.0441\u003c/li\u003e\n\u003cli\u003eBraun, V., \u0026amp; Clarke, V. (2012). Thematic analysis. In \u003cem\u003eAPA handbook of research methods in psychology, Vol 2: Research designs: Quantitative, qualitative, neuropsychological, and biological.\u003c/em\u003e (pp. 57\u0026ndash;71). American Psychological Association. https://doi.org/10.1037/13620-004\u003c/li\u003e\n\u003cli\u003eCarver, C. S. (1997). You want to measure coping but your protocol\u0026rsquo; too long: Consider the brief cope. \u003cem\u003eInternational Journal of Behavioral Medicine\u003c/em\u003e, \u003cem\u003e4\u003c/em\u003e(1), 92\u0026ndash;100. https://doi.org/10.1207/s15327558ijbm0401_6\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;ebi, E., \u0026amp; Demir, A. (2020). Help-Seeking Attitudes of University Students in Turkey. \u003cem\u003eInternational Journal for the Advancement of Counselling\u003c/em\u003e, \u003cem\u003e42\u003c/em\u003e(1), 37\u0026ndash;47. https://doi.org/10.1007/s10447-019-09385-7\u003c/li\u003e\n\u003cli\u003eCetinkaya-Yildiz, E., Cakir, S. G., \u0026amp; Kondakci, Y. (2011). Psychological distress among international students in Turkey. \u003cem\u003eInternational Journal of Intercultural Relations\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(5), 534\u0026ndash;539. https://doi.org/10.1016/j.ijintrel.2011.04.001\u003c/li\u003e\n\u003cli\u003eCogan, N. A., Liu, X., Chin-Van Chau, Y., Kelly, S. W., Anderson, T., Flynn, C., Scott, L., Zaglis, A., \u0026amp; Corrigan, P. (2024). The taboo of mental health problems, stigma and fear of disclosure among Asian international students: implications for help-seeking, guidance and support. \u003cem\u003eBritish Journal of Guidance \u0026amp; Counselling\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(4), 697\u0026ndash;715. https://doi.org/10.1080/03069885.2023.2214307\u003c/li\u003e\n\u003cli\u003eCruter, S. (2024). \u003cem\u003eFrom Strain to Strength: The Stressful Realities and Coping Mechanisms of Black Student Affairs Professionals in Predominantly White Institutions.\u003c/em\u003e [University of Georgia]. https://www.proquest.com/dissertations-theses/strain-strength-stressful-realities-coping/docview/3065527684/se-2?accountid=191732\u003c/li\u003e\n\u003cli\u003eEducation, C. of H. (2023). \u003cem\u003eStatistics. Higher Education Information Management System\u003c/em\u003e. https://istatistik.yok.gov.tr/\u003c/li\u003e\n\u003cli\u003eFarokhian, M. (2024). \u003cem\u003eExploring the Transitional Experiences of International Students at Community Colleges\u003c/em\u003e. The University of Houston.\u003c/li\u003e\n\u003cli\u003eFolkman, S., \u0026amp; Moskowitz, T. (2004). Coping: Pitfalls and promise. \u003cem\u003eAnnual Rev. Psychology\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e(55), 745\u0026ndash;774.\u003c/li\u003e\n\u003cli\u003eGoodman, L. (2017). Mental Health on University Campuses and the Needs of Students They Seek to Serve. \u003cem\u003eBuilding Healthy Academic Communities Journal\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e(2), 31\u0026ndash;44. https://doi.org/10.18061/bhac.v1i2.6056\u003c/li\u003e\n\u003cli\u003eHammer, J. H., Vogel, D. L., Grzanka, P. R., Kim, N., Keum, B. T., Adams, C., \u0026amp; Wilson, S. A. (2024). The integrated behavioral model of mental health help seeking (IBM-HS): A health services utilization theory of planned behavior for accessing care. \u003cem\u003eJournal of Counseling Psychology\u003c/em\u003e. https://doi.org/10.1037/cou0000754\u003c/li\u003e\n\u003cli\u003eHolahan, J., Moos, R., Holahan, K., Brennan, L., \u0026amp; Schutte, K. (2005). Stress generation, avoidance coping, and depressive symptoms: a 10-year model. \u003cem\u003eJournal of Consulting and Clinical Psychology,\u003c/em\u003e \u003cem\u003e4\u003c/em\u003e(73), 658.\u003c/li\u003e\n\u003cli\u003eHuang, L., Kern, M. L., \u0026amp; Oades, L. G. (2020). Strengthening University Student Wellbeing: Language and Perceptions of Chinese International Students. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(15), 5538. https://doi.org/10.3390/ijerph17155538\u003c/li\u003e\n\u003cli\u003eHugh-Jones, S., Wilding, A., Munford, L., \u0026amp; Sutton, M. (2023). Age-gender differences in the relationships between physical and mental health. \u003cem\u003eSocial Science \u0026amp; Medicine\u003c/em\u003e, \u003cem\u003e339\u003c/em\u003e, 116347. https://doi.org/10.1016/j.socscimed.2023.116347\u003c/li\u003e\n\u003cli\u003eHyun, J., Quinn, B., Madon, T., \u0026amp; Lustig, S. (2007). Mental Health Need, Awareness, and Use of Counseling Services Among International Graduate Students. \u003cem\u003eJournal of American College Health\u003c/em\u003e, \u003cem\u003e56\u003c/em\u003e(2), 109\u0026ndash;118. https://doi.org/10.3200/JACH.56.2.109-118\u003c/li\u003e\n\u003cli\u003eKadir, M. (2024). \u003cem\u003eDoes Acculturative Stress Always Lead to Negative Outcomes? Understanding the Role Acculturative Stress Plays in Fostering Social Behaviors and Improved Well-Being Among International Students\u003c/em\u003e [Pace University]. https://www.proquest.com/dissertations-theses/does-acculturative-stress-always-lead-negative/docview/3067750693/se-2?accountid=191732\u003c/li\u003e\n\u003cli\u003eKuzhabekova, A., \u0026amp; Amankulova, Z. (2024). International Student Agency in Emergency. \u003cem\u003eJournal of International Students\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(3), 131\u0026ndash;148. https://doi.org/10.32674/jis.v14i3.6107\u003c/li\u003e\n\u003cli\u003eLaMontagne, A. D., Shann, C., Lolicato, E., Newton, D., Owen, P. J., Tomyn, A. J., \u0026amp; Reavley, N. J. (2023a). Mental health-related knowledge, attitudes and behaviours in a cross-sectional sample of australian university students: a comparison of domestic and international students. \u003cem\u003eBMC Public Health\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 170. https://doi.org/10.1186/s12889-023-15123-x\u003c/li\u003e\n\u003cli\u003eLaMontagne, A. D., Shann, C., Lolicato, E., Newton, D., Owen, P. J., Tomyn, A. J., \u0026amp; Reavley, N. J. (2023b). Mental health-related knowledge, attitudes and behaviours in a cross-sectional sample of australian university students: a comparison of domestic and international students. \u003cem\u003eBMC Public Health\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 170. https://doi.org/10.1186/s12889-023-15123-x\u003c/li\u003e\n\u003cli\u003eLazarus, R. S., \u0026amp; Folkman, S. (1984). \u003cem\u003eStress, appraisal, and coping\u003c/em\u003e. Springer publishing company.\u003c/li\u003e\n\u003cli\u003eLeis, O., Sharpe, B. T., Pelikan, V., Fritsch, J., Nicholls, A. R., \u0026amp; Poulus, D. (2024). Stressors and coping strategies in esports: a systematic review. \u003cem\u003eInternational Review of Sport and Exercise Psychology\u003c/em\u003e, 1\u0026ndash;31. https://doi.org/10.1080/1750984X.2024.2386528\u003c/li\u003e\n\u003cli\u003eLubarsky, S. (2024). \u003cem\u003eSocial Support in the Digital Age: A Re-examination of the Buffering and Main Effect Models of Social Support\u003c/em\u003e [The Vanderbilt University]. http://hdl.handle.net/1803/19213\u003c/li\u003e\n\u003cli\u003eMbous, Y. P. V., Mohamed, R., \u0026amp; Rudisill, T. M. (2024). International students challenges during the COVID-19 pandemic in a university in the United States: A focus group study. \u003cem\u003eCurrent Psychology\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(9), 8325\u0026ndash;8337. https://doi.org/10.1007/s12144-022-02776-x\u003c/li\u003e\n\u003cli\u003eMontero-Marin, J., Prado-Abril, J., Piva Demarzo, M. M., Gascon, S., \u0026amp; Garc\u0026iacute;a-Campayo, J. (2014). Coping with Stress and Types of Burnout: Explanatory Power of Different Coping Strategies. \u003cem\u003ePLoS ONE\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), e89090. https://doi.org/10.1371/journal.pone.0089090\u003c/li\u003e\n\u003cli\u003eNahidi, S., Blignault, I., Hayen, A., \u0026amp; Razee, H. (2018). Psychological Distress in Iranian International Students at an Australian University. \u003cem\u003eJournal of Immigrant and Minority Health\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(3), 651\u0026ndash;657. https://doi.org/10.1007/s10903-017-0590-8\u003c/li\u003e\n\u003cli\u003eNegi, S., \u0026amp; Sattler, K. M. P. (2024). Protective effect of social support: A longitudinal application of Family Stress Model. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e164\u003c/em\u003e, 107864. https://doi.org/10.1016/j.childyouth.2024.107864\u003c/li\u003e\n\u003cli\u003eNewton, C., Tomyn, A., \u0026amp; LaMontagne, D. (2021). Exploring the challenges and opportunities for improving the health and wellbeing of international students: Perspectives of international students. \u003cem\u003eJournal of the Australian and New Zealand Student Services Association,\u003c/em\u003e \u003cem\u003e1\u003c/em\u003e(29), 18\u0026ndash;34.\u003c/li\u003e\n\u003cli\u003eOliso, Z. (2024). International Students\u0026rsquo; Intercultural Interaction with Canadian Domestic Students: Observations from Literature Review. \u003cem\u003eSDU International Journal of Educational Studies\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(1), 19\u0026ndash;33. https://doi.org/10.33710/sduijes.1399266\u003c/li\u003e\n\u003cli\u003eOz, Y. (2021). The Emergence of Turkey as a Regional Hub for International Students: A Macro-Level Analysis. In \u003cem\u003eAnnual Review of Comparative and International Education 2020\u003c/em\u003e (pp. 307\u0026ndash;328). Emerald Publishing Limited. https://doi.org/10.1108/S1479-367920210000040017\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;zen\u0026ccedil;-Ira, G., \u0026Uuml;zar-\u0026Ouml;z\u0026ccedil;etin, Y. S., \u0026amp; \u0026Ccedil;elik, S. (2023). \u0026ldquo;What doesn\u0026rsquo;t defeat me makes me stronger\u0026rdquo; A Qualitative Study drawing on the Perspectives of Syrian Refugee University Students in Turkey. \u003cem\u003ePsychology, Health \\\u0026amp; Medicine\u003c/em\u003e, 1\u0026ndash;16.\u003c/li\u003e\n\u003cli\u003ePapadaki, A. (n.d.). \u003cem\u003eThe self-stigma of seeking professional psychological help among undergraduate students and associations with attachment style\u003c/em\u003e. Retrieved September 21, 2024, from https://sphere.acg.edu/jspui/handle/123456789/2499\u003c/li\u003e\n\u003cli\u003eRamos, G., Ponting, C., Bocanegra, E., Chodzen, G., Delgadillo, D., Rapp, A., Escovar, E., \u0026amp; Chavira, D. (2022). Discrimination and Internalizing Symptoms in Rural Latinx Adolescents: The Protective Role of Family Resilience. \u003cem\u003eJournal of Clinical Child \u0026amp; Adolescent Psychology\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(6), 997\u0026ndash;1010. https://doi.org/10.1080/15374416.2021.1923018\u003c/li\u003e\n\u003cli\u003eRanasinghe, R. (2023). \u003cem\u003eChallenges experienced by international students while doing their graduate studies at Memorial University of Newfoundland\u003c/em\u003e [Memorial University of Newfoundland]. http://research.library.mun.ca/id/eprint/16313\u003c/li\u003e\n\u003cli\u003eReh, S., Wieck, C., \u0026amp; Scheibe, S. (2021). Experience, vulnerability, or overload? Emotional job demands as moderator in trajectories of emotional well-being and job satisfaction across the working lifespan. \u003cem\u003eJournal of Applied Psychology\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(106), 1734.\u003c/li\u003e\n\u003cli\u003eRobinson, H. (2024). Cross-Cultural Differences in Emotional Regulation Strategies in United States. \u003cem\u003eInternational Journal of Psychology\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(3), 1\u0026ndash;14. https://doi.org/10.47604/ijp.2622\u003c/li\u003e\n\u003cli\u003eRosenthal, D. A., Russell, J., \u0026amp; Thomson, G. (2008). The health and wellbeing of international students at an Australian university. \u003cem\u003eHigher Education\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(1), 51\u0026ndash;67. https://doi.org/10.1007/s10734-006-9037-1\u003c/li\u003e\n\u003cli\u003eRudra, K. (2024). \u003cem\u003eThe Relationship Between Acculturation Levels, Help-Seeking Attitudes, and Self-Stigma of International Students\u003c/em\u003e [Capella University]. https://www.proquest.com/dissertations-theses/relationship-between-acculturation-levels-help/docview/3069551445/se-2?accountid=191732\u003c/li\u003e\n\u003cli\u003eSerras, A., Saules, K. K., Cranford, J. A., \u0026amp; Eisenberg, D. (2010). Self-injury, substance use, and associated risk factors in a multi-campus probability sample of college students. \u003cem\u003ePsychology of Addictive Behaviors\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(1), 119\u0026ndash;128. https://doi.org/10.1037/a0017210\u003c/li\u003e\n\u003cli\u003eSkromanis, S., Cooling, N., Rodgers, B., Purton, T., Fan, F., Bridgman, H., Harris, K., Presser, J., \u0026amp; Mond, J. (2018). Health and Well-Being of International University Students, and Comparison with Domestic Students, in Tasmania, Australia. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(6), 1147. https://doi.org/10.3390/ijerph15061147\u003c/li\u003e\n\u003cli\u003eSmith, R. A., \u0026amp; Khawaja, N. G. (2011). A review of the acculturation experiences of international students. \u003cem\u003eInternational Journal of Intercultural Relations\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(6), 699\u0026ndash;713. https://doi.org/10.1016/j.ijintrel.2011.08.004\u003c/li\u003e\n\u003cli\u003eSubu, M. A., Dias, J. M., Mottershead, R., Ahmed, F. R., Narulita, S., Maryuni, M., Zakiyah, Z., Nurbaeti, I., Mohamed Al Marzouqi, A., \u0026amp; Al-Yateem, N. (2024). Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. \u003cem\u003eInternational Journal of Qualitative Studies on Health and Well-Being\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(1). https://doi.org/10.1080/17482631.2024.2327103\u003c/li\u003e\n\u003cli\u003eSverdlik, A., C. Hall, N., McAlpine, L., \u0026amp; Hubbard, K. (2018). The PhD Experience: A Review of the Factors Influencing Doctoral Students\u0026rsquo; Completion, Achievement, and Well-Being. \u003cem\u003eInternational Journal of Doctoral Studies\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e, 361\u0026ndash;388. https://doi.org/10.28945/4113\u003c/li\u003e\n\u003cli\u003eTajvar, M., Ahmadizadeh, E., Sajadi, H. S., \u0026amp; Shaqura, I. I. (2024). Challenges facing international students at Iranian universities: a cross-sectional survey. \u003cem\u003eBMC Medical Education\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(1), 210. https://doi.org/10.1186/s12909-024-05167-x\u003c/li\u003e\n\u003cli\u003eTavares, V. (2024). Feeling excluded: international students experience equity, diversity and inclusion. \u003cem\u003eInternational Journal of Inclusive Education\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(8), 1551\u0026ndash;1568. https://doi.org/10.1080/13603116.2021.2008536\u003c/li\u003e\n\u003cli\u003eTennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., \u0026amp; Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. \u003cem\u003eHealth and Quality of Life Outcomes\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(1), 63. https://doi.org/10.1186/1477-7525-5-63\u003c/li\u003e\n\u003cli\u003eThoits, P. A. (2011). Mechanisms Linking Social Ties and Support to Physical and Mental Health. \u003cem\u003eJournal of Health and Social Behavior\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(2), 145\u0026ndash;161. https://doi.org/10.1177/0022146510395592\u003c/li\u003e\n\u003cli\u003eTikhonova, E. V., Kosycheva, M. A., \u0026amp; Efremova, G. I. (2021). Primary Professionalization of Foreign Students: Barriers, Stigmatization, Adaptation. \u003cem\u003eIntegration of Education\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(4), 608\u0026ndash;628. https://doi.org/10.15507/1991-9468.105.025.202104.608-628\u003c/li\u003e\n\u003cli\u003eWhitehead, B. R., \u0026amp; Blaxton, J. M. (2021). Daily associations among aging perceptions, perceived health, and perceived stress in older adults. \u003cem\u003eAging \u0026amp; Mental Health\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(12), 2255\u0026ndash;2264. https://doi.org/10.1080/13607863.2020.1855625\u003c/li\u003e\n\u003cli\u003eW\u0026ouml;rfel, F., Gusy, B., Lohmann, K., T\u0026ouml;pritz, K., \u0026amp; Kleiber, D. (2016). Mental health problems among university students and the impact of structural conditions. \u003cem\u003eJournal of Public Health\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(2), 125\u0026ndash;133. https://doi.org/10.1007/s10389-015-0703-6\u003c/li\u003e\n\u003cli\u003eXiong, W., Radunz, M., Ali, K., King, D., Kyrios, M., Zhao, Y., \u0026amp; Fassnacht, D. (2024). Comparing the mental health and wellbeing of domestic and international tertiary students. \u003cem\u003eJournal of International Students\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 702\u0026ndash;740. https://doi.org/10.32674/jis.v14i4.6647\u003c/li\u003e\n\u003cli\u003eXu, Y. (2024). Decoding Factors Influencing Mental Health Help-Seeking in Asian International Students: A Correlational Survey Study. \u003cem\u003eGraduate Student Journal of Psychology\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e. https://doi.org/10.52214/gsjp.v22i1.12171\u003c/li\u003e\n\u003cli\u003eYausheva, A. (2024). \u003cem\u003eInternational students\u0026rsquo; perspectives on social-emotional competences in the context of.\u003c/em\u003e University of Turku.\u003c/li\u003e\n\u003cli\u003eZhao, X., \u0026amp; Schartner, A. (2024). Revisiting the \u0026lsquo;U-curve\u0026rsquo; hypothesis: international students\u0026rsquo; academic, sociocultural, and psychological adjustment trajectories at a British university. \u003cem\u003eEuropean Journal of Higher Education\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(2), 343\u0026ndash;366. https://doi.org/10.1080/21568235.2023.2193702\u003c/li\u003e\n\u003cli\u003eZimet, G. D., Dahlem, N. W., Zimet, S. G., \u0026amp; Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. \u003cem\u003eJournal of Personality Assessment\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(1), 30\u0026ndash;41. https://doi.org/10.1207/s15327752jpa5201_2\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Barriers, International students, Mental Health, Perceived Social Support","lastPublishedDoi":"10.21203/rs.3.rs-5349000/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5349000/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aimed to examine the mental health status, coping strategies, perceived social support and barriers in mental health help seeking behaviour among first-year international students enrolled in Turkish language learning programs in Turkey.\u003c/p\u003e\u003ch2\u003eParticipants:\u003c/h2\u003e \u003cp\u003eThe study included undergraduate, graduate, and Ph.D. international students studying at Turkish language institutions.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA mixed-methods approach was utilized. Quantitative data were collected through surveys administered during the winter and spring terms of 2024, comprising the Warwick-Edinburgh Mental Wellbeing Scale, the Multidimensional Scale of Perceived Social Support, the Brief COPE Inventory, and a demographic questionnaire. Qualitative data were gathered through one-on-one and group interviews with 60 participants.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the 381 participants from 48 countries, 45.93% reported optimal mental health, 45.14% exhibited moderate mental health, and 8.92% experienced low mental health. High levels of perceived social support from family and friends were significant predictors of mental well-being. Thematic analysis of the qualitative data identified three main themes: barriers to mental health help-seeking, perceived social support from sources beyond family and friends, and coping strategies used by students. Institutional and cultural barriers, including limited access to counseling and cultural stigma, were highlighted as critical challenges impacting mental health.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe findings reveal that while perceived social support significantly enhances mental well-being, institutional and cultural barriers severely hinder help-seeking behaviors among international students. These results underscore the urgent need for culturally competent counseling services and more accessible mental health resources in universities to support the unique needs of this student population.\u003c/p\u003e","manuscriptTitle":"From Isolation to Integration: The Mental Health Journey of International Students in Turkey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-29 06:35:52","doi":"10.21203/rs.3.rs-5349000/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ee875e2c-6708-4e0e-a071-2e676a6cdb86","owner":[],"postedDate":"November 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-28T12:38:09+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-29 06:35:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5349000","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5349000","identity":"rs-5349000","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}