Part 3: Mental Health and

Emotional Well-Being

Challenges of Studying Abroad

Studying abroad can be an exciting experience, but at times the experience

may be overwhelming and anxiety-provoking. Many students are

unprepared for the intense feelings that accompany studying in a different

culture. They may also be unprepared for the impact that this experience

can have on their emotional well‐being, including mood, stress level,

behavior patterns, or identity development. Sometimes the process of

adjusting to a new culture can exacerbate preexisting problems that the

student may have been managing quite well at home.

In this section, we’ll go over some common challenges experienced by first-

time travelers and experienced globetrotters alike, as well as how to deal

with common mental health issues students encounter while abroad.

Challenge #1: Culture Shock

Culture shock is natural – don’t let it get you down!

• Culture shock occurs when one’s values and typical ways of viewing the world

clash with their own values and viewpoints of the new culture. Culture shock is a

normal developmental phase of adjustment to a new cultural environment.

• Culture shock can affect you physically and/or emotionally.

• Culture shock can occur after a few days, a few weeks or even a few months – but

most students begin to feel the effects after about a month into the program

• Effects can range from subtle to severe.

• Relax – culture shock is natural. It can be managed and does not have to ruin

your experience! If you’re experiencing culture shock that negatively impacts your

experience, speak to our on-site staff.

Culture Shock

Culture shock is a tricky thing and not very easy to identify – particularly when you’re suffering from it! Below are some common symptoms and coping mechanisms that you can use to get through culture shock. The most important piece of advice: give yourself a break and don’t let the little things get you down!

Recognize symptoms:

• Sadness

• Homesickness

• Loneliness

• Sleeping too much, too little

• Anger

• Irritability

• Resentment

• Sense of helplessness

• Anxiety/Depression

Coping mechanism and strategies:

• Become familiar with cultural norms

• Keep an open mind

• Talk to someone, a friend or any of the on-site staff

• Get adequate sleep

• Allow time to relax at the end of the day or in between events

• Engage in conversations and activities with others on the program

• Set aside time for yourself.

Challenge #2: Transitions & Relationships

Studying abroad is a major transition, both academically and

personally. Here are some tips on how to deal with relationships:

• Managing transitions: Moving to a new country can include the loss of support

from family, friends, and partners. It can also mean the loss of routine and familiar

environment. Maintain contact with family and friends to ease the transition (e.g.,

send emails, schedule Skype sessions, update Facebook or Twitter posts, text

through WhatsApp, etc.).

• Long-distance relationships: Maintaining healthy long distance relationships can

take a lot of effort and time. Each partner must be open and honest in

communicating their expectations and desires.

• New relationships: Forming new relationships can be an exciting aspect of living

in a new country, particularly for students who have not spent much time away from

home. It is also a time when students can be especially vulnerable, both

emotionally and physically. This can involve taking certain risks (e.g., speaking a

foreign language, encountering people who have preconceived negative views of

the U.S.)

Challenge #3: Societal Expectations and Norms

• Social & sexual norms: A conversation or interaction that Americans might consider just

“friendly” could be considered very flirtatious in the local context. On the other hand, people in

many other places are more culturally conservative than Americans are used to. It’s crucial

that you learn the expectations and customs of the country you’re staying in.

• Abuse of alcohol or other drugs: Many students are drawn to experimentation with alcohol

and other drugs when they are away from home, especially when they are in a foreign country

where, under local law, they have reached to legal drinking age. Excessive use of alcohol and

drugs can lead to abuse and other negative consequences. Additionally, the culture and social

norms surrounding alcohol use may be very different than they are in the U.S., depending on

where you’re studying. Again, behaviors that are common back home may be considered

rude, inappropriate and embarrassing when you’re abroad. So, it is important to be aware of

local norms.

• Remember: The St. John’s University Student Code of Conduct applies to all of

your behavior abroad, including alcohol or other drugs!

One of the difficult experiences of living in a country is learning the

different rules, norms, and laws. Behaviors that may be commonplace

in the United States may be taboo or even illegal in other countries.

Questions to ask yourself

before you go…

Is this the best time for you to be studying abroad?

• If you are currently in treatment, it is important to talk to your physicians and

therapists before you leave. They can give you insight into some of the

potential positive and negative situations you may experience.

• If you are not in treatment but are worried about your mental health, you should

speak with a physician or counselor before you leave.

• For certain illnesses, different stressors can exacerbate or develop symptoms.

For example, time change can affect bipolar disorder or manic episodes.

Are you currently undergoing treatment?

If you are currently in treatment (medical or psychiatric), this is NOT a good

time to stop treatment.

• Discuss your treatment plan with your provider.

• If possible, work with your physician to arrange for a provider in your host

country before you leave. This can be done through CISI insurance.

• It is a good idea to work out a safety plan with your provider and family in case

an emergency arises. Carry emergency numbers and inform friends that you

trust.

Are you currently taking any medications?

If you are taking medication, this is NOT a good time to stop.

• Plan ahead of time and make sure you have enough medication for the

duration of your trip.

• Bring copies of all prescriptions, including eyeglasses/contacts.

• Make sure your prescriptions are in their original container/bottle. Airport

security and/or other legal officials may confiscate unlabeled medications.

• Talk to your prescribing physician if you are thinking about stopping

medication. Do not stop on your own.

Sexual Assault: A High-Risk Group

Study abroad students are at a higher risk for sexual assault.

• Students who study abroad may be more likely to encounter harassment,

including nonconsensual sexual contact and sexual assault.

• Some of the reasons why the risk may be higher for students studying

abroad include:

o minority status within the country

o decreased supervision

o a lack of familiarity with the culture and the language

o first exposure to legalized alcohol

Sexual Assault:

• Students who study abroad are 3-5 times more likely to experience unwanted

sexual experiences (nonconsensual sexual contact, attempted sexual assault,

and completed sexual assault) than when they are on their home campus.

• In the U.S., most college campus sexual assaults involve acquaintances or

people whom they know; however, for study abroad students most perpetrators

were reported to be non-student, local residents.

• Research indicates that American students who are abroad may be perceived

as “vulnerable” to local residents. They may also be targeted either because

they are perceived as “sexually available” or “less likely to go to foreign

authorities if they are sexually assaulted” (Kimble, Flack& Burbridge, 2012).

Dealing With Sexual Assault Abroad:

• If you are sexually assaulted during your time abroad, it may be helpful to seek

support from friends/family. Always know that your program leader, on-site

staff and the Office of Public Safety in New York (+1-718-990-5252) are here to

help. Your health and safety is most important. If you need immediate care or

feel unsafe, you should contact the on-call onsite staff, your program leader, or

the Office of Public Safety in New York.

• St. John’s staff will be able to assist you through the process and inform you of

all of your resources, including medical, counseling, legal and academic

options. The program staff can help you find the best English-speaking doctors,

hospitals, and pharmacies in your area.

• Experiencing a sexual assault can be very overwhelming and confusing. Each

survivor reacts differently. Some common reactions include fear, confusion,

numbness, anxiety, guilt, self-blame, anger, and sadness. Although many

survivors may initially blame themselves for the assault, it is in no way their

fault. Every survivor should know that he/she is not alone and that he/she has

options and resources available.

Dealing with Other Mental Health Crises:

• In a new cultural environment, students often go through culture shock, which

usually occurs for only a few weeks, although it can last longer depending on the

student. If a student has had symptoms for a prolonged period of time (several

weeks or more) AND is unable to function (e.g., not attending class or isolating

themselves), an assessment by a trained mental health professional maybe

helpful and necessary.

• Immediate intervention is necessary if a student shows self-destructive or violent

behaviors or show signs for suicide.

• Warning Signs For Suicide:

- statements indicating suicidal thinking - drug or alcohol use

- reference to indicating desire to die - impulsiveness or recklessness

- depression or other mood changes - anger and anxiety

- withdrawal from family/friends - feeling trapped and hopeless

- giving away possessions - access to destructive means

How to Help a Student Who May Be Suicidal:

• Suicide is the second leading cause of death among college students.

• If you think someone you know may be considering suicide:

- Take all comments about suicide seriously

- Ask directly, “Are you thinking about killing yourself?”

- Do not let the anxiety of a “yes” response prevent you from asking

- Listen to the person and acknowledge his or her pain

- Help the person feel understood and let him or her know you care

- Avoid judging or inducing guilt

- Avoid being pledged to secrecy

- Do not leave an actively suicidal person alone

- Refer the individual for professional help

- If help is refused, consult with a professional

- If you feel the person is at risk, inform your onsite staff/program leader

or the Office of Public Safety in New York

Health & Safety Abroad: Protective Strategies

• Always travel in small groups, and keep an eye on your friends.

• Tell someone you trust where and with whom you’re going out and when you

will return.

• Do not leave beverages unattended or accept drinks from someone you don’t

know; always keep your drinks in sight.

• Be aware of your surroundings.

• Be aware of social and cultural context of your interactions. Social norms may

be different in each country.

• The perpetrator and/or survivor is intoxicated in the majority of sexual offenses

on college campuses. Avoid excessive use of alcohol and other drug use, as

these substances can impair your ability to understand and respond to feelings

and situations and blunt your alertness.

• Be aware of the laws of your host country. Disorderly conduct may not be

acceptable and may lead to negative consequences such as imprisonment.

Informational Websites:

• National Institute on Mental Health (NIMH) - http://www.nimh.nih.gov/health/index.shtml

• American Psychological Association (APA) - http://www.apa.org/topics/index.aspx

• Rape, Abuse, and Incest National Network - http://rainn.org/

• New York City Alliance Against Sexual Assault - http://www.svfreenyc.org/

• The Safe Center LI - http://thesafecenterli.org/

• Legal Information for Families Today (LIFT) - http://www.liftonline.org/

(Free legal advice/support)

• New York State Victim Information & Notification Service - www.vinelink.com (New York

State hotline for crime victims, including victims of domestic violence that gives them the ability

to track the jail custody status of their offenders and register to be notified, via phone or e-

mail, of their pending release.)

Resources

Resources

24-Hour Free & Confidential Hotlines:

• LIFELINE Suicide Prevention Hotline – (800) 273-8255

• RAINN National Sexual Assault Hotline – (800) 656-4673

• SAFE HORIZON Domestic Violence Hotline – (800) 621-4673

• SAFE HORIZON Rape & Sexual Assault Hotline – (212) 227-3000

• The Safe LI Hotline – (516) 542-0404

• NYPD Sec Crimes Report Hotline – (212) 267-7273

• LGBTQ Anti-Violence Project – (212) 714-1141

What would you do?

Here’s a “what would you do” scenario that we’d like you to consider in the unfortunate event something similar happens to you.

It’s about 5 weeks into the program and you notice a pretty drastic change in your

roommate’s behavior. Thus far your roommate has been pretty happy, enthusiastic and

positive. Now he stays in the room all day, says he doesn’t want to do anything and

complains about the country/culture all the time. What would you do? (Our recommendations are on the next slide…)

What would you do?

• Try talking to him and getting him involved in activities. Culture shock is a normal

reaction and is something that everyone will experience differently. He may just need to

vent or may be feeling homesick.

• If he doesn’t want to talk or says something that you find alarming, please notify an on-

site staff member as soon as possible. On site-staff will speak to your roommate to see if

he needs additional support.