Health and support for students

Abstract

This thesis compares the self-reported physical and mental health status, utilisation and satisfaction with Student Health Services, of domestic and international students in Health Sciences First Year and the Health Sciences stream of Foundation Year at the University of Otago.

This was a cross-sectional survey sent out to 590 undergraduate Health Sciences First Year students 6 weeks prior to their final exams, of whom 418 (70.8%) responded. A random sample of domestic students was selected while all international students from the Health Sciences First Year course were eligible. International students from Asian and Middle Eastern countries also included students from the Foundation Studies (Health Sciences stream).

The main outcome measures were the SF12-v2 (measuring self-assessed physical and mental health), satisfaction with Student Health Services, issues facing students and help-seeking patterns.

The study showed no statistically significant differences in the self-reported physical and mental health of these students, nor in their satisfaction with Student Health Services or in issues facing domestic and international students. Fewer international students visited the Student Health Services than domestic students but the mean number of visits was the same across the two groups. Twenty-four percent of the domestic group and 25% of the international group displayed SF12 Mental Component Summary (MCS) scores that indicated moderate mental distress. Eleven percent of domestic students and 12% of international students displayed SF12 MCS scores that showed severe mental distress. Three percent of students in each group utilised the mental health services at Student Health. International students more often said that they would prefer a doctor of the same cultural background. This was statistically significantly different from the domestic students. In the hypothetical situation of seeking help when sad or depressed, proportionately more domestic students than international students said they would seek professional help.

Sub-group analysis according to regions showed that the largest groups were from South East Asia (Malaysia, Thailand, Vietnam, Cambodia and Philippines) and East Asia (China, Korea, Japan and Taiwan), with 44 students each. The smallest group comprised those from Indian Ocean islands (9 students). Students from East Asia were significantly less happy with their accommodation (p=0.01); felt more discriminated against (p<0.001) and had more difficulties with the teaching methods (p=0.04) at university when compared with New Zealand students. Of the 44 students from East Asia, 14 displayed SF12 MCS scores that indicated moderate mental distress and 8 displayed SF12 MCS scores that showed severe mental distress. Sixty-three percent of students from East Asia visited Student Health Services compared with 84% from New Zealand (p=0.02). These East Asian students more often said they would prefer a health provider from a similar cultural background (p<0.001). They also disagreed to a greater extent than domestic students that the doctors at Student Health Services understood their health concerns (p=0.03) and were generally more displeased with the services at Student Health (p=0.02) than students from any other region.

The study concludes that as a whole group, international students were no different from domestic students in terms of self-reported physical or mental health status, utilisation and satisfaction with Student Health Services, and in the issues they faced as students. They were not likely to under-utilise the general health services though they more often preferred a health provider from a similar cultural background and reported greater reluctance in seeking professional help in the hypothetical situation of emotional trouble. Students from East Asia seemed to have more trouble adjusting to life at the University of Otago, being more distressed, and not wanting to seek help as readily for this. Other international students seemed to be doing moderately well at the University of Otago.

Based on these conclusions, the study recommends few finer changes to the already existing support services at the University of Otago concerning Student Health Services, teaching related issues and pastoral care. This study also defines avenues for further in-depth collaborative research concerning mental health, Student Health Service utilisation, socio-cultural and academic adaptation of all students, especially involving international students at the University of Otago.