Prevalence, Associated Factors, and Help-Seeking Behavior of Psychological Distress among International Students at the National University of Malaysia
Depression, anxiety, and stress are associated with decreased role functioning, productivity, and quality of life. International students are more prone to psychological distress as they face many stressors while studying abroad. The objectives of the study were to determine the prevalence and associated factors of depression, anxiety, and stress among international students, their help-seeking behavior, and their awareness of the available on-campus mental support services. A cross-sectional study with a purposive sampling method was performed on 280 international students at Universiti Kebangsaan Malaysia (UKM) between the age of 18 and 35 years. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was used anonymously to assess the mental health of students. Socio-demographic, help-seeking behavior, and awareness data were obtained. Independent sample t-test, one-way ANOVA test, and multiple linear regression were used to explore associated factors. The overall prevalence of depression, anxiety, and stress among international students were 58.9%, 71.8%, and 53.9%, respectively. Age was significantly associated with depression and anxiety. Ethnicity showed a significant association with depression and stress. No other factors were found to be significantly associated with psychological distress. Only 9.6% of the international students had sought help from on-campus mental support services. Students who were aware of the presence of such services were only 21.4% of the participants. In conclusion, this study addressed the gap in the literature on the mental health of international students and provided data that could be used in intervention programs to improve the mental health of the increasing number of international students in Malaysia.Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 235
 X. Lei, L. Xiao, Y. Liu, and Y. Li, “Prevalence of Depression among Chinese University Students: A Meta-Analysis,” pp. 1–14, 2016.
 Í. J. S. Ribeiro, R. Pereira, I. v Freire, B. G. de Oliveira, C. A. Casotti, and E. N. Boery, “Stress and Quality of Life Among University Students: A Systematic Literature Review,” Health Professions Education, vol. 4, no. 2, pp. 70–77, 2018.
 K. Macauley, L. Plummer, C. Bemis, G. Brock, C. Larson, and J. Spangler, “Prevalence and Predictors of Anxiety in Healthcare Professions Students,” Health Professions Education, vol. 4, no. 3, pp. 176–185, 2018.
 S. H. Ridner, “Psychological distress: concept analysis,” 2004.
 A. Drapeau, A. Marchand, and D. Beaulieu-prévost, “Epidemiology of Psychological Distress,” 2007.
 T. A. Rn and B. M. Gp, “Understanding persons with psychological distress in primary health care,” pp. 19–21, 2016.
 K. Shamsuddin et al., “Correlates of depression, anxiety and stress among Malaysian university students,” Asian Journal of Psychiatry, vol. 6, no. 4, pp. 318–323, 2013.
 J. A. Gold, B. Johnson, G. Leydon, R. M. Rohrbaugh, and K. M. Wilkins, “Mental Health Self-Care in Medical Students: A Comprehensive Look at Help-Seeking,” pp. 37–46, 2015.
 J. Goodwin, L. Behan, P. Kelly, K. Mccarthy, and A. Horgan, “Help-seeking behaviors and mental well-being of fi rst year undergraduate university students,” Psychiatry Research, vol. 246, pp. 129–135, 2016.
 D. Sarokhani, A. Delpisheh, Y. Veisani, M. T. Sarokhani, R. E. Manesh, and K. Sayehmiri, “Prevalence of depression among university students: A systematic review and meta-analysis study,” Depression Research and Treatment, vol. 2013, 2013.
 F. Seyfi, K. C. Poudel, J. Yasuoka, K. Otsuka, and M. Jimba, “Intention to seek professional psychological help among college students in Turkey: influence of help-seeking attitudes,” 2013.
 S. Mori, “Addressing the Mental Health Concerns of International Students,” vol. 78, pp. 17–24, 2000.
 L. Bradley, G. Parr, W. Y. Lan, R. Bingi, and L. J. Gould, “Counselling expectations of international students,” International Journal for the Advancement of Counselling, vol. 18, no. 1, pp. 21–31, 1995.
 The International mobility of students in Asia and the Pacific. (2013). Retrieved from https://unesdo
 P. F. Lovibond, “Pergamon The Structure of Negative Emotional States: Scales (DASS) with the Beck Depression and Anxiety inventories” vol. 33, no. 3, pp. 335–343, 1995.
 J. D. Henry and J. R. Crawford, “The short-form version of the Depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample,” British Journal of Clinical Psychology, vol. 44, no. 2, pp. 227–239, 2005.
 N. Bayram, N., Bilgel, “The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students,” pp. 667–672, 2008.
 W. Yousif, A. Wahed, and S. K. Hassan, “Alexandria University Faculty of Medicine Prevalence and associated factors of stress , anxiety and depression among medical Fayoum University students,” Alexandria Journal of Medicine, vol. 53, no. 1, pp. 77–84, 2017.
 C. K. Teh, C. W. Ngo, R. Aniyah, R. Vellasamy, and K. Suresh, “Depression, Anxiety and Stress among Undergraduate Students: A Cross Sectional Study,” no. November, pp. 260–268, 2015.
 L. N. Dyrbye, M. R. Thomas, and T. D. Shanafelt, “Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress among U. S. and Canadian Medical Students,” vol. 81, no. 4, pp. 354–373, 2006.
 L. Dyrbye, A. Eacker, and D. Power, “Race, Ethnicity, and Medical Student Well-being in the United States,” no. April 2014, 2007.
 F. I. Bilican, “Help-Seeking Attitudes and Behaviors Regarding Mental Health Among Turkish College Students Help-Seeking Attitudes and Behaviors Regarding Mental Health Among Turkish College Students,” vol. 7411, 2014.
 S. Quigley, E. Bainbridge, C. Mcdonald, and J. Lally, “Stigma of mental illness and help-seeking intention in university students,” pp. 253–260, 2013.
 N. J. Reavley, S. Cvetkovski, A. F. Jorm, and D. I. Lubman, “Help-seeking for substance use , anxiety and affective disorders among young people : results from the 2007 Australian National Survey of Mental Health and Wellbeing,” 2010.
 J. Lau, T. Garza, and H. Garcia, “International Students in Community Colleges : On-Campus Services Used International Students in Community Colleges : On- Campus Services Used and Its Affect on Sense of Belonging,” Community College Journal of Research and Practice, vol. 00, no. 00, pp. 1–13, 2018.