“You feel hopeless when you can't access healthcare”: International students' experiences of mental health help-seeking through primary healthcare services in Scotland

Abstract

Purpose: International university students (ISs) experience elevated rates of psychological distress due to the unique challenges of living and studying in a new country. Nonetheless, their utilisation of mental health services tends to be low. This study aimed to explore ISs' experiences of help-seeking via the Scottish primary healthcare services. Methods: A qualitative design using semi-structured interviews and interpretative phenomenological analysis (IPA) was employed. The sample included nine female ISs from a range of cultural backgrounds, who sought mental health support from the Scottish primary healthcare services within the previous year. Results: Participants' help-seeking experiences, contextualised within the challenging, liminal reality of living and studying in Scotland as an IS, were hindered by challenges with navigating two healthcare systems simultaneously and culturally-mediated attitudes towards mental health. Positive and negative experiences of patient-GP interactions had a considerable impact on participants' subsequent help-seeking endeavours. Conclusions: Transnational and relational lenses are key for understanding ISs' help-seeking. Beyond individual factors, help-seeking trajectories hinge on perceived quality of patient-doctor relationships and the accessibility of both local and home-country systems. These findings highlight the need for universities to implement targeted mental wellbeing interventions for ISs, and primary care to improve the quality patient–GP interactions.