1. Introduction

Researchers have highlighted the phenomenon of mental health services among college students, such as accessibility issues, stigma, and lack of awareness about available mental health counseling services [1]. One study delves into the evolving responsibilities and challenges faced by college counselors in providing mental health education and support to students amidst changing societal dynamics and technological advancements [2]. Further, through a longitudinal data analysis from a college counseling center, the researchers seek to provide empirical evidence on the effectiveness of mental health counseling in promoting college student academic success [3].

Moreover, international students usually encounter challenges in mental health well-being. Factors such as being away from home, adjusting to a new culture, language barriers, academic stressors, and feelings of social isolation can impact their well-being [4]. This paper will draw from existing research and examine the important factors for mental health counselors to consider when working with Chinese international college students.

While the academic year of 2022-2023 witnessed a significant surge in international student enrollment in U.S. higher education institutions, totaling 1,057,118 students – an increase of 11.4 percent compared to the previous year [5]. Notably, most of these students, comprising 70.8 percent, came from Asia, with China contributing the largest contingent of 289,526 students, making up 38.7 percent of the total international student population [5]. Despite research efforts investigating the challenges encountered by Chinese international students [6,7], there remains a notable gap in understanding the underlying reasons for their help-seeking behaviors. Thus, this paper aims to synthesize recent research findings pertaining to language barriers, identity struggles, and psychological well-being among Chinese international students. The objective is to provide insights that can guide counseling practices and support tailored to address the unique needs of this population.

2. Literature Review

The purpose of the literature review is to explore the relationship between mental health counseling and help-seeking behaviors among Chinese international students, employing methodology and longitudinal analysis to examine this association. The findings can contribute to the existing literature on counseling effectiveness in higher education settings. They will also have practical implications for enhancing student support services on college campuses. The literature review underscores the importance of mental health resources and integrating counseling services into student support programs to promote the overall well-being of Chinese international students.

2.1. Language Barriers

Language barriers can pose significant challenges in counseling sessions. Chinese international students may struggle to express themselves fully in a second language, leading to misunderstandings or miscommunication. Studies have highlighted the impact of language barriers on counseling outcomes and the need for language-sensitive approaches [8]. Chinese international students demonstrate varying levels of English proficiency, engage in diverse forms of interaction and communication, and undergo different emotional experiences in various contexts. More specifically, a Chinese international student's linguistic skills may either be fully utilized or significantly hindered in some situations, their participation in interactions may range from full engagement to exclusion, and their emotional responses may vary between positive and negative [8].

A separate study about East Asian international students finds that international students generally perceive a counselor who shares similar ethnic and linguistic background as more competent in their interactions. However, this perception is not consistent across all situations. Rather, the perceived attributes of competence are subject to variation based on the specific concerns presented by each student [7].

To further underline the comprehensive nature of this challenge, another research correlates language barriers with depression in Chinese international students, alongside academic performance stressors, with a note on the low help-seeking behavior of this population, which underscores the critical need for effective support strategies in foreign academic environments [9].

Research identifies language barriers as one of the substantial difficulties for Chinese international students; such challenges may extend to social adjustment due to cultural differences, separation from families, and economic concerns alongside language issues such as unfamiliar accents and educational systems [4]. Thus, there is a consistent need for targeted support services to facilitate better academic and social well-being for Chinese international students in U.S. higher education institutions.

2.2. Identity struggles

In addition to language barriers, Chinese international students also face identity struggles and cultural shocks. Indeed, Chinese international students represent demographic challenges in adapting to the American educational framework. These challenges predominantly arise from the different between the educational systems between China and the United States, such as teaching methods, academic expectations, and curriculum settings [10]. Scholars have dedicated attention to examining the concept of social distance and its implications for the learning experiences of Chinese international students within Western educational contexts. Through their investigations, scholars have illuminated how Chinese international students be linked to deeply rooted Confucian cultural traditions and the prevailing collectivist social ethos [10,11]. Furthermore, a challenge noted in Chinese international student adaptation seems to revolve around their desire for autonomy, with their reluctance to seek assistance from others, particularly those they are not acquainted with [11]. Scholars have emphasized the prevalent stress culture in China, where individuals are accustomed to resolving issues independently, fearing the stigma associated with seeking external support, such as counseling services or mental health assistance [11]. As a result of this mindset, Chinese students placed significant value on self-sufficiency.

International students may face identity conflicts, discrimination, homesickness, and feelings of alienation, which can contribute to mental health issues such as anxiety and depression. Counseling interventions should address the stress by providing coping strategies, social support, and cultural adjustment assistance [2]. In the uncertain climate of U.S. visa policies, shifting U.S.-China relations, and the global health crisis due to COVID-19, international students’ aspirations and identity as temporary immigrants are significantly impacted. Chinese international undergraduate students have exhibited a heightened sense of national identity and increased patriotism in the U.S. [12].

Considering the educational and personal encounters of Chinese international students in the United States, the students affirmed undergoing transformations from their previous selves, irrespective of the difficulty of their transition. Among the most cited changes are heightened awareness of cultural variances, increased acceptance of diversity, and a development towards greater maturity and responsibility [10].

2.3. Psychological Well-being

The psychological well-being of Chinese students is a multifaceted issue influenced by cultural and social contexts, as well as personal and environmental factors. For instance, a comparative study between Chinese and Russian students illustrated noteworthy differences in their well-being, linking these disparities to distinct cultural and background differences [13].

During stressful periods like the COVID-19 pandemic, resilience has been identified as a critical factor in promoting psychological well-being of Chinese college students, with environmental stressors exerting a moderate negative influence. This highlights the role of resilience in buffering stress-related impacts on mental health [14]. Similarly, resilience is negatively correlated with stress levels and psychological well-being in Chinese undergraduate nursing students, suggesting its importance in fostering mental health [15].

Yet other factors such as self-efficacy have been positively connected with psychological well-being, indicating the need for emphasizing this trait to enhance mental health outcomes [16]. Moreover, religiosity in Chinese college students in Hong Kong is found to be directly related to psychological well-being and indirectly through traits like gratitude and hope [17].

Outside the academic context, emotion management was deemed crucial for Chinese international students, playing a central role not only in intercultural adjustment but also in preserving psychological well-being [18]. Additionally, social networking site usage was positively associated with social support and subjective well-being among Chinese international students. While examining specific online platforms like WeChat, its intense use is positively correlated with social capital, which in turn influences life satisfaction and loneliness among Chinese international college students in Germany [19].

Various factors such as growth mindsets, language adaptation, adverse childhood experiences, mindfulness practices and social support have also been studied in relation to psychological well-being of Chinese students. Developing growth mindsets, linguistic acculturation, buffering effects of mindfulness on negative childhood experiences, and enhancing social support have all shown connections to improve mental health outcomes in this population [20,21].

In summary, the psychological well-being of Chinese international students is promoted through interventions focused on resilience, positive psychology, social support, and coping mechanisms. Cultural factors, such as religiosity and social networking, also play substantial roles. The evidence suggests that a multifactorial approach is necessary to support the psychological well-being of Chinese international students.

3. Discussion and Conclusion

Issues related to the stigma surrounding mental health and help-seeking attitudes may deter international students from seeking counseling services. Cultural beliefs about mental illness, fear of judgment, and concerns about confidentiality can reduce their help-seeking behavior [6]. Counselors should work to reduce stigma and promote help-seeking behaviors through psychoeducation, outreach efforts, and destigmatizing initiatives. Thus, social support plays a crucial role in the mental well-being of Chinese international students. Establishing connections with peers, faculty, and community members can help mitigate feelings of isolation and loneliness. Counselors can facilitate social support networks by promoting campus engagement, organizing cultural events, and offering group counseling sessions.

To address the challenges faced by Chinese international students, the interventions can be informed by cultural-historical theory and community psychology [8]. Cultural-historical theory emphasizes the influence of culture and history on an individual's development and behavior. By drawing upon this theory, future researchers should recognize the importance of understanding the cultural and historical background of Chinese international students to address their barriers and challenges effectively. This theory helps in identifying the specific cultural factors that may contribute to language barriers and social adjustment difficulties.

On the other hand, community psychology focuses on understanding individuals within the context of their communities and social environments [8]. This approach recognizes the impact of social systems and community support on an individual's well-being. In the context of this paper, community psychology informs the approach to supporting Chinese international students by emphasizing the importance of creating activities and practices that consider the students’ social environment and provide them with the necessary support to overcome the challenges they are facing with.

In conclusion, counseling Chinese international students requires a culturally sensitive and holistic approach that addresses their unique needs and challenges. By understanding the factors influencing their mental health and well-being, counselors can provide effective support and facilitate positive outcomes. Further research and collaboration are needed to enhance counseling practice strategies and promote the importance of mental health among Chinese international students in U.S. higher education settings.