International university students’ perspectives on mental health and help-seeking behaviours in China: An exploratory qualitative study

Global mental health concerns are increasing, with international students particularly vulnerable due to cultural adjustment, academic stress, and social isolation. Despite growing awareness, stigma and limited knowledge continue to hinder help-seeking. This study explored international university students' perceptions of mental health and help-seeking behaviours at Nantong University, China. This qualitative study employed purposive sampling to recruit 20 international students from Nantong University. Data were collected between 14th January and 4th February 2025 through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used to identify key patterns in participants' mental health perceptions and help-seeking experiences. Ethical protocols were strictly followed, including informed consent and confidentiality safeguards. Following thematic analysis, five main themes and 16 subthemes emerged, covering mental health literacy, challenges faced, coping strategies, barriers to seeking professional help, and recommendations for improving support. Key findings revealed diverse understandings of mental health, significant stressors like isolation and academic pressure, reliance on peer support, and barriers such as stigma, privacy concerns, and lack of awareness. Recommendations included ensuring confidentiality, enhancing cultural competence, and increasing accessibility to mental health services. International university students face mental health challenges and need accessible, confidential, and culturally sensitive support to reduce stigma and encourage help-seeking.