Mental health and well-being in higher education: A review of international students living abroad

International students comprise a growing and diverse population in higher education worldwide, and their mental health and wellbeing have become issues of global concern. This narrative literature review builds on an influential 2016 review and provides a comprehensive, global analysis of international student mental health. We synthesize theoretical perspectives, empirical research, and policy insights across key themes: acculturative stress and adjustment challenges, social support and belonging, resilience and coping mechanisms, stigma and help-seeking, and institutional responses (including the impact of COVID-19). International students often face unique stressors related to cultural transition, academic pressure, language barriers, financial precarity, and discrimination, which can heighten risks of anxiety and depression. Protective factors such as peer support and personal resilience are identified as critical buffers that promote adaptation and psychological wellbeing. However, cultural stigma and unfamiliarity with mental health services frequently impede help-seeking. In response, higher education institutions have implemented a range of targeted interventions spanning orientation reforms, peer mentoring, and counseling innovations aimed at both prevention and early intervention. The COVID-19 pandemic magnified existing challenges, yet also spurred novel support strategies (such as virtual and group-based interventions) and underscored the urgency of comprehensive mental health support for international students. Overall, this review highlights the complex and context-dependent nature of international students’ mental health and wellbeing, and underscores the importance of sustained, culturally responsive, and institutionally embedded support systems. By offering an updated global synthesis that integrates theoretical, empirical, and applied insights the review provides a robust evidence base to inform future research, higher education policy, and institutional practice.