From isolation to integration: The mental health journey of international students in Türkiye

Abstract

This study explored mental health, coping strategies, perceived social support, and barriers to help-seeking among first-year international students in Turkish language programs in Türkiye. A mixed-methods approach combined survey data from 381 students from 48 countries with interviews from 60 participants. Standardized scales (Warwick-Edinburgh Mental Well-being Scale, Multidimensional Scale of Perceived Social Support, Brief COPE) were used. Results showed 45.93% with optimal mental health, 45.14% with moderate mental health, and 8.92% with low mental health. Family and friend support strongly predicted well-being, while stigma and institutional and cultural barriers restricted access to counseling and help-seeking. Qualitative findings identified additional coping strategies and sources of support. The study emphasizes the need for culturally sensitive counseling and more accessible mental health services to address the unique challenges faced by international students.

Keywords

• Barriers
• International students
• Mental health
• Perceived social support
• Turkish language programs

References

1. Achnak, S., & Vantilborgh, T. (2021). Do individuals combine different coping strategies to manage their stress in the aftermath of psychological contract breach over time? A longitudinal study. Journal of Vocational Behavior, 131(1), 1-15. https://doi.org/10.1016/j.jvb.2021.103651
2. 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. In P. Aloka (Ed.), Student Stress in Higher Education (pp. 201–217). New York: IGI Global. https://doi.org/10.4018/979-8-3693-0708-3.ch012
3. Alsalman, Z., Shafey, M. M., Al-Khofi, A., Alessa, J., Bukhamsin, R., Bokhuwah, M., Aljumaiah, R., Al-makhaitah, N., & Almaslami, M. (2024). Among medical students in Saudi Arabia. Frontiers in Public Health, 12(1), 1-12. https://doi.org/10.3389/fpubh.2024.1371628
4. 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(2), 1-16. https://doi.org/10.1016/j.nedt.2024.106366
5. 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
6. 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
7. 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, 37(8),1-18. https://doi.org/10.1098/rstb.2021.0441
8. Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238

9. 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
10. 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
11. 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
12. 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
13. 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]. (Doctoral dissertation). https://www.proquest.com/dissertations-theses/strain-strength-stressful-realities-coping/docview/3065527684/se-2?accountid=191732 (Accessed: September 23, 2025).
14. Farokhian, M. (2024). Exploring the transitional experiences of international students at community colleges. The University of Houston. (Doctoral dissertation). https://hdl.handle.net/10657.1/4935 (Accessed: September 23, 2025).
15. Fitzgibbon, K., & Murphy, D. (2023). Coping strategies of healthcare professional students for stress incurred during their studies: a literature review. Journal of Mental Health, 32(2), 492–503. https://doi.org/10.1080/09638237.2021.2022616
16. Folkman, S., & Moskowitz, T. (2004). Coping: Pitfalls and promise. Annual Review Of Psychology, 55(1), 745–774.
17. 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
18. 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, 15(1), 5–14. https://doi.org/10.1037/cou0000754
19. 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, 73(4), 658-670.
20. 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), 1-15. https://doi.org/10.3390/ijerph17155538
21. Hugh-Jones, S., Wilding, A., Munford, L., & Sutton, M. (2023). Age-gender differences in the relationships between physical and mental health. Social Science & Medicine, 33(9), 1-16. https://doi.org/10.1016/j.socscimed.2023.116347
22. 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
23. 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]. (Doctoral dissertation). https://www.proquest.com/dissertations-theses/does-acculturative-stress-always-lead-negative/docview/ 3067750693/se-2?accountid=191732 (Accessed: September 23, 2025).
24. 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
25. LaMontagne, A. D., Shann, C., Lolicato, E., Newton, D., Owen, P. J., Tomyn, A. J., & Reavley, N. J. (2023). 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), 151-170. https://doi.org/10.1186/s12889-023-15123-x
26. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Berlin: Springer Publishing Company.
27. 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, 12(2), 1–31. https://doi.org/10.1080/1750984X.2024.2386528
28. Li, H., & Browne, A. (2000). Accessing mental health services: perspectives of Asian Canadians. Canadian Journal of Community Mental Health, 19(1), 143-160.
29. 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]. (Doctoral dissertation). http://hdl.handle.net/1803/19213 (Accessed: September 23, 2025).
30. 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
31. 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), 1-10. https://doi.org/10.1371/journal.pone.0089090
32. 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
33. 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(2), 1-17. https://doi.org/10.1016/j.childyouth.2024.107864
34. 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, 12(9), 18–34.
35. 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
36. Ottenbreit, D., & Dobson, S. (2008). Avoidance. In D. Ottenbreit & S. Dobson (Eds.), Risk Factors in Depression (pp. 447–470). Elsevier. https://doi.org/10.1016/B978-0-08-045078-0.00020-4
37. Oz, Y. (2021). The emergence of Turkey as a regional hub for international students: A macro-level analysis. In A. W. Wiseman (Ed.), Annual Review of Comparative and International Education 2020 (pp. 307–328). Emerald Publishing Limited. https://doi.org/10.1108/S1479-367920210000040017
38. Özenç-Ira, G., Üzar-Özçetin, Y. S., & Çelik, S. (2024). “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, 29(3), 615–630. https://doi.org/10.1080/13548506.2023.2177782
39. Papadaki, A. (2024). The self-stigma of seeking professional psychological help among undergraduate students and associations with attachment style [The American College of Greece]. (Doctoral dissertation). https://sphere.acg.edu/jspui/handle/123456789/2499 (Accessed: September 23, 2025).
40. 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
41. Ranasinghe, R. (2023). Challenges experienced by international students while doing their graduate studies at Memorial University of Newfoundland [Memorial University of Newfoundland] (Doctoral dissertation). http://research.library.mun.ca/id/eprint/16313 (Accessed: September 23, 2025).
42. 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, 106(11), 17-34.
43. 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
44. 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
45. Rudra, K. (2024). The relationship between acculturation levels,help-seeking attitudes, and self-stigma of international students [Capella University]. (Doctoral dissertation). https://www.proquest.com/dissertations-theses/relationship-between-acculturation-levels-help/docview/3069551445/se-2?accountid=191732 (Accessed: September 23, 2025).
46. 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
47. 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), 1-14. https://doi.org/10.3390/ijerph15061147
48. 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
49. 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), 1-16. https://doi.org/10.1080/17482631.2024.2327103
50. 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(2), 361–388. https://doi.org/10.28945/4113
51. 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), 2-10. https://doi.org/10.1186/s12909-024-05167-x
52. Tanhan, A., & Francisco, T. (2019). Muslims and mental health concerns: A social ecological model perspective. Journal of Community Psychology, 47(4), 964–978. https://doi.org/10.1002/jcop.22166
53. Taşdelen, U. (2024). The examination of the relationship between intercultural sensitivity and life satisfaction of foreign students receiving Turkish language education. International Journal of Education & Well-Being, 2(2), 123–135. https://doi.org/10.62416/ijwb-39
54. 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
55. 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), 63-80. https://doi.org/10.1186/1477-7525-5-63
56. 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
57. 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
58. 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
59. 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
60. 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
61. Xu, Y. (2024). Decoding factors influencing mental health help-seeking in Asian international students: A correlational survey study. Graduate Student Journal of Psychology, 22(1), 1-17. https://doi.org/10.52214/gsjp.v22i1.12171
62. Yang, M. S., & Hedeker, D. (2020). A life-span approach to examining older vulnerable population’s subjective well-being: the role of adversity and trauma. Aging & Mental Health, 24(12), 2043–2052. https://doi.org/10.1080/13607863.2019.1652245
63. Yausheva, A. (2024). International students’ perspectives on social-emotional competences in the context of. University of Turku. (Doctoral dissertation). (Accessed: September 23, 2025).
64. Yılmaz, V. (2016). The internationalization experience of Turkish universities from the standpoint of practitioners. SDU Faculty of Arts and Sciences Journal of Social Sciences, 37(2), 91–109.
65. YÖK (2023). Statistics. Higher Education Information Management System. https://istatistik.yok.gov.tr/ (Accessed: September 23, 2025).
66. YÖK. (2024, February 18). TR-YÖS to be Held in 78 centers in 52 Countries. https://www.yok.gov.tr/en/Sayfalar/news/2024/2024-tr-yos-1-to-be-held-in-78-centers-in-52-countries.aspx (Accessed: September 23, 2025).
67. 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
68. 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