Mental health first aid For students studying abroad

1. Mental health first aidFor students studying abroad Kate regan, ma, lpc Director of Counseling, health and wellness center

2. Before you go… Preparation will go a long way, below are ideas of how to best prepare as the chaperone and ideas for students to consider preparing on their own. Chaperones: • Develop and know your partnership in your host country/school • Collect and review all health forms • Develop a consistent process and plan across the team for crisis including both physical and mental health

3. Before you go… Students: • Speak with you doctor to plan out medication management while you are abroad • Familiarize yourself with cultural practices in your destination country by reading, or talking to people familiar with the culture • Talk to members of your support system in the U.S. about mutual expectations regarding keeping in touch while you are away, so that you continue to have access to established support systems • Create a coping skills list with your mental health counselor. Many students realize that their coping mechanisms are universal and portable when studying abroad

4. Know your role •  First Responder •  Authority Figure/Adult •  Professional •  Known Commodity •  Institutional Representative •  Decision Maker •  Conduit to Others •  Miracle Worker THIS IS NOT ABOUT PROVIDING THERAPY!

5. self-care tips to share with students • Pay attention to good nutrition • Exercise and move • Journal, reflective writing can serve as a productive “refuge” while abroad, to gather thoughts and feelings in one safe place • Don’t abuse alcohol or other drugs • Expect to feel depressed sometimes. Homesickness is natural, so is culture shock • Expect to feel frustrated and angry at times, communication problems are common, even if they speak English in the host country, communication may be difficult!

6. Medication tips to share with students • Medication should be brought abroad in carry-on luggage. Protecting the supply by not keeping all the medication in one place, so that if part is lost or becomes unusable the student will have some to get through until more can be found. • Encourage student to talk to their doctor about gradually changing medication schedule while in transit, or change to a new schedule after in the new time zone. • Encourage students to continue taking their prescribed medication even if they recognize that they are feeling better. Stopping or changing the dose of a regular medication without the consultation and supervision of a professional can be very dangerous.

7. Culture shock • Culture shock is not a psychological disorder, but in fact, it is a developmental phase that is both common and expected when one adjusts “properly” in a cross-cultural context. Culture shock is PERFECTLY NATURAL. • Culture shock can be described as a clash between one’s personal way of viewing and interacting with the world (which is determined by one’s home culture) and the new cultural environment. When a person struggles through such a challenge, the person grows and they mature. • Culture shock can result from differences related to: Food, Health, Relationships, Finances, Transport, Communication, Worldviews or values, Academic Demands

8. Cycle of culture shock

9. Identifying when a student is in crisis • Be on the lookout for the following symptoms of a student in crisis:

10. Depression and suicidal thoughts • Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. • Watch for students over-engaging in negative talk • Encourage use of coping skills, such as exercise, journaling, medication compliance, talking with friends and family • Encourage students focus on what they can do instead of what they feel they cannot do

11. Anxiety and panic attacks Anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. • Grounding Techniques: Deep breathing exercises, Name the 5 senses, journaling, coloring • Thought stopping: visualize STOP SIGN, reframe thought

12. Substance abuse • Excessive drug or alcohol use • Different cultural norms • Negative coping skill • Impulsivity • Studying abroad can be an escape or indulgence in risky behavior away from home • Initiate a nonjudgmental conversation, share observations, just “I” statements

13. Sexual assault Do Don’t Don't place blame on the student. Sexual assault/abuse is never the victim's fault! (for example, “Why were you out so late?” Don't assume you already know what will help. Don't take away choices or options (for example, “I’ll take care of everything because I know what’s best for you.”). Don't make decisions for them unless you are asked to. Even then, keep them informed of what decisions are made and what is going on. Don't assume you know what the student is feeling. Don't pressure the student to talk. Opening up takes time and feeling safe. Don’t rush in with physical touch to comfort. • Let them know they are not to blame for what happened and there is nothing that justifies sexual assault. Continue telling them, “It was not your fault.” • Let the student one lead you and tell you what they need. • Let the student decide whether to report to the police and participate in an investigation. • Help the student regain a sense of control over their life that was lost during the sexual assault. One way to do this is to let them make decisions and choices without being judged. • Let the student know you care and that it is OK to talk about the assault whenever they are ready.

14. resources • https://ucc.nd.edu/assets/37702/international_educators_handbook_3rd_edition_web.pdf • https://www.miusa.org/resource/tipsheet/mentalhealthsuccess