While supporting students as part of my role in an international school in Asia, I am often struck by the different approaches and understandings of mental health and how to support students and their families – and the tension this can cause.
Of course, having been born and educated in the UK, I naturally see mental health problems and treatment through a western lens.
This bias is something that I am very much conscious of, and seek to be sensitive about, when working with international students on issues of wellbeing and mental health.
We all have different experiences and understandings in this area. Bringing these together into a coherent framework for international schools would make for a much richer discussion that would, in turn, better help all students – whenever they are in the world.
The scale of the problem
The need is clearly there.
Poor or challenging mental health problems are a global phenomenon and the increasing (and reported) rates of mental health problems among young people have received a growing amount of attention since the 2000s.
Latest World Health Organization data estimates that between 10 to 20 per cent of children and adolescents experience mental health problems. Furthermore, approximately half of these identifiable disorders begin before the age of 14, and 75 per cent of them by the mid-twenties.
Without adequate treatment and support, these problems can severely influence child development, educational achievement, and the potential to lead fulfilling and productive lives.
The value of school
To counter this, there is a growing belief that, because of the amount of time that students spend there, schools are well-positioned to offer opportunities that educate students on social and emotional wellbeing, signpost students to outside services and provide mental health support.
In the UK, this is now a mandated requirement, with the health elements of PSHE provision in schools set to be compulsory in the UK from September 2021. However, the PSHE Association has recommended a phased-in approach, which prioritises a focus on mental health and wellbeing content during the 2020-21 academic year.
It is unclear how the implementation of sessions related to the health education element of the PSHE curriculum in UK schools will translate to the classroom, but it is a positive move.
Perhaps international schools should do something similar – creating a standardised framework that would allow them to adopt a more globalised understanding of mental health, which also considers the local and national context of the school community.
After all, with children moving between schools regularly, teachers arriving from all over the world and cultures ranging massively in their views on mental health, creating a uniform approach that could be adopted worldwide, and adapted to fit local cultures and custom, could have a huge impact.
A siloed existence helps no one
Yet currently little, if anything, exists like this.
An interesting article to highlight here is Carlson’s (2019) article entitled ‘Considerations Regarding School-based Mental Health Promotion and Provision at International Schools in Japan’. It was the only paper that I was able to locate that highlighted the need for a more culturally-considered approach to mental health provision in international schools.
The author explains that being part of a multicultural school comes with many advantages, but also faces unique challenges when it comes to mental health provision and education.
An earlier paper by Inman et al (2009) examined the critical issues and challenges facing international school counsellors. It argued there may be some different counselling-based needs within the international school communities compared to UK- and US-based schools.
The authors explained: "Due to the multinational nature of the student body, international schools are increasingly challenged by a transient and mobile family lifestyle, competing cultural practices, political upheavals, and limited personnel and professional resources."
Resources that adapt and react
In my current place of work, there are some external sources of support available to students, including Thai counsellors who most commonly offer sessions in Thai, and international counsellors (mostly British and American) who offer sessions in English.
Additionally, there are a number of psychiatric departments in private hospitals.
However, as young students require parental consent and support to access these services, and given the fact we have a diverse student body (the largest groups of students are Thai, Thai-British, Thai-American, Korean and Chinese), it’s clear to see the narrow options available for students. Financial constraints, differing views on mental health issues and treatment, and language and cultural factors can all present challenges, too.
Lastly, as a white, British female, I cannot fully comprehend the nuances of dealing with, for example, body-related problems as an international student with parents who do not speak English, living in a country that is not their own and with ideas and portrayals of the "perfect body".
So where can I, or international school counsellors in Peru, Kenya, or Dubai, turn for help?
The international school counsellor networks that exist within different countries and globally – such as the International School Counselor Association (ISCA) – often prove to be a great source of advice, support and connection with appropriate services.
But without a specific, internationalised PSHE curriculum that takes into account cultural nuances, perhaps these school counsellor networks should join forces with PSHE coordinators in international schools to create resources that offer more targeted approaches, as well as an enhanced network of different types of counselling services conducted in different languages.
After all, we have seen how the delivery of lessons online can work.
Developing something similar around mental health that best suits the needs of our students and families – available from anywhere in the world and of use to mental health counsellors everywhere – would be a smart step to take.
Sadie Hollins is head of sixth form at a British-curriculum school in Thailand and has been teaching internationally for two years