Background: In the last couple of years, the number of international students entering the United Kingdom to study has increased. Despite the increase in the number of African students coming to the United Kingdom to further their studies, little is known about the experiences they face and how these challenges could impact their academic performance. Stress and mental health issues are common among numerous migrant populations around the world, especially international students. Although studying in a foreign country has many merits, however, achieving a new degree in a foreign land also comes with its challenges. These students face unique challenges when compared to domestic students. Thus, the study aims to explore the influence of migration on the mental health of international students and its effects on their academic performance.

Method: From the 1st of July to the 31st of July 2023 a quantitative design was employed to collect data of Nigerian international students on a sample of 138 participants. Data was collected utilising a semi-structured questionnaire to obtain responses among the participants using a simple random sampling technique and analysis was done using SPSS. Moreover, ethical guidelines and permission were sought from the University of Wolverhampton Research team.

Results: Of 138 participants, the mean age was 30.05 ± 10.82 years and a greater percentage of the participants (79%) were less than a year in the country as at the time of completing the survey while 21% had lived over a year in the United Kingdom. However, 71.5% of the participants claimed that difficulty in securing accommodation was a major factor for mental health issues and 70% affirmed that the issue of employment challenge was the life experiences that impact their mental well-being.

Conclusions: The study revealed the mental health challenges international students face in the UK which negatively leads to poor academic performance. Thus there is a need for the implementation of regular mental health evaluations to detect severe stress, depression, and anxiety among these students.

Mental Health; International Students; Academic Performance; United Kingdom.

SD: Standard Deviation; SPSS: Statistical Package for Social Science; MH: Mental Health; GP: General Practitioner; FEHW: Faculty of Education, Health, and Wellbeing; XLS: Microsoft Excel Spreadsheet; UK: United Kingdom.

Mental health can be described as the absence of mental disease or a state of being that encompasses biological, psychological, and social variables that contribute to an individual's mental state and ability to function in the environment [1,2]. However, Galderisi, et al. [3] propose that culture influences the definition of mental health and well-being and that one must recognise distinctions in background and values that may impact the concept of mental health in societies. In addition to varied conceptions of mental health, migration constitutes a significant life transition for many individuals, which can affect their mental well-being. In 2017, there were over 5 million international students worldwide, pursuing educational activities in a country other than their home country [4]. This is primarily due to rising student demand for higher education and limited capacity in some nations to accommodate this need. While the desire to pursue an education abroad is only projected to rise in the coming years, numerous initiatives seeking to recruit global talent have given new structure to student flows [5]. While this appears to be beneficial for both students and the schools, international students are faced with many pressures that could have an impact on their emotional well-being.

According to an initial report from the Mental Health International College Student Project, 31% of full-time university students worldwide tested positive for at least one common mental health issue in the previous year [6]. The United States also reported a high prevalence rate of 42.2% among university students [7]. Within the already vulnerable general university population, international students are likely more susceptible to mental health concerns given that they tend to face unique challenges and stressors compared to home students [8-10]. Also, being unfamiliar with the educational system, loss of family support, and trying to settle into the new environment are all sources of additional pressures that could impact the mental well-being of international students [11].

Researchers have been able to show that there is a link between migration and depression, anxiety, and post-traumatic stress disorder [12-14]. It is worth noting that the reasons for which individuals or groups decide to migrate influence the kind of impact of mental stress one tends to face. While motivated by push and pull factors based on perceived opportunities, international migration has been widely established to be a stressful and multi-factorial process that can have negative health outcomes [9-15]. Statistically, the World Health Organization reported that globally, 31% of university students had one mental health disorder [6]. This was also corroborated by a study carried out in Australia where it was reported a 42% prevalence rate of mental health disorders among university students [7]. Similar concerns have been reported in Canada [16], Turkey [17], and Australia (Stallman, 2008). Research in Britain and the USA has also shown some level of mental health stress among university students [18].

Forbes-Mewett and Sawyer, [19] noted that the policies on mental health in the Western world have prioritised the development of early detection, treatment and management programmes specifically for young adults. This is a result of concerns in a broader context of widespread and debated claims that poor mental health has been on the increase in the Western world [20,21]. Research has also shown that compared to home students, the prevalence of mental stress in international students is high [19] which has been closely linked to academic performance. Students experiencing mental health difficulties may struggle with concentration, motivation, and overall academic engagement. This can result in lower grades, increased dropout rates, and a decrease in overall educational performance. The study aims to explore the challenges faced by international students, the impact on their mental health issues and the crucial role educational institutions play in providing support.

Study Area

The study was carried out at the University of Wolverhampton, located in the West Midlands of the UK. The University has more than 2500 international students from over 130 countries and a diverse, vibrant community. The University of Wolverhampton places a major emphasis on international students' mental health and well-being. It provides free and discreet assistance with a variety of challenges, including anxiety, sadness, homesickness, and more. The institution recognises the value of physical, social, and emotional well-being, and strives to help students feel their best.

Research Design

A quantitative cross-sectional design was employed using a semi-structured questionnaire to assess the mental well-being and coping strategies were utilised to manage the emotional stress condition of international students.

Population of the Study

The study comprises all international Nigerian students studying in the UK at the Faculty of Education Health and Wellbeing, University of Wolverhampton.

Eligibility Criteria

All regular Faculty of Education Health and Wellbeing (FEHW) International Nigerian students were included in the study while UK-born participants were excluded, and Nigerian migrants who came in through work visas were also excluded.

Sample Size Determination

The sample size determination is a technique used for selecting the number of observations to be included in the sample. It is key to drawing valid and generalized conclusions [22]. However, the Leslie Kish sample size determination was utilised in this study to get the minimum sampling size. The Leslie Kish formula is a useful tool for estimating sample size in a research project or survey. However, the Leslie Kish formula takes into account the population size, required degree of precision, and confidence level. This aids in the production of dependable and valid outcomes. The Leslie Kish formula aids in determining the sample size required to generate a representative sample, improving the chance of receiving results that properly represent the population. Thus, this shows why it was considered for sampling size determination. Therefore, the formula was used to determine the minimum sample size:

N= p (1- p) z2

                d2

N = sample size

P = prevalence from previous study

D = margin of error (5%)

Z = normal distribution value (1.96)

N= 0.90 (1 – 0.90)1.962

 0.05X 0.05 N = 138 Participants

10% of “n” was added to replace incomplete questionnaires.

Therefore, the total number of the population size was 152 international Nigerian students.

Sampling Techniques

Sampling is the selection of a subset of individuals from within a population to determine the characteristics and features of the entire population. The two primary advantages of sampling are lower cost and faster data collection [23]. In the study, a simple random technique was used which involved all the participants having an equal chance of being selected [24]. The study was conducted to gather information about the mental health issues and general characteristics of Nigerian international students enrolled in undergraduate, graduate, or doctoral programs at a UK university.

The data was collected through a modified semi-structured questionnaire derived from previous studies on the psychosocial and mental health challenges of international students compared to British students in UK universities in England Alsaad, 2017. The survey was conducted live from mid-April to mid-May 2022 predominantly Nigerian international students undergoing study in a UK university from 2022-2023. Moreover, the survey was carried out using Jisc Online Surveys and distributed through the researchers' professional networks, social media groups and university websites. A total of 157 responses were received, with five discarded due to respondents not providing demographic information. The final sample consisted of 152 respondents and at the time of data collection, the majority of the participants (90%) who carried out the survey were living in the UK.

Validity and Reliability of the Survey

To ensure the survey's validity and reliability, the process of questionnaire construction, pilot survey testing, survey delivery, collection of data, and data analysis were diligently designed and implemented this is to ensure the accuracy, consistency, and credibility of test results. They also provide a solid foundation for meaningful interpretation and informed decision-making based on the test outcomes. Sproull [25], emphasises that before employing any measure, its validity and reliability should be evaluated to determine its accuracy and consistency whereas if the researcher has designed the instrument, a validity and reliability estimate should be generated before use.

Data was analysed using Statistical Package for Social Sciences (SPSS) version 29. Linear regression was used to determine the relationship between migration and the mental health of migrants. However, to illustrate the demographic features of the sample at every assessment stage, descriptive statistical analysis was carried out. The completed survey results were saved directly into a computerised file, which could be retrieved anytime during the process of the survey and readily utilised in any data analysis programme. Data collection was considerably fast and less errors in transcribing results from the questionnaire to the computer. The first step was to prepare the data for analysis. After importing the XLS (Microsoft Excel Spreadsheet) format file into SPSS, variables were defined for each of the single-choice questions. It was presented in tables, graphs, pie charts and pictograms to explore the factors that impacted the mental health of migrants in the UK. Linear regression was used to determine the relationship between migration and the mental well-being of participants. To describe the general characteristics of the respondents and the prevalence of mental health problems, descriptive statistics were used.

Demographic Characteristics

The online survey attracted 130 valid responses used for the analysis. (Table 1) shows the information on the general characteristic variables of international students in the United Kingdom in terms of their age, gender, marital status, duration of residence in the country, level of education, number of children if any, and employment status. The gender of the participants was unevenly split with 84% female and 16% male with a higher number of 32% in the age bracket of 26-30 years. This is followed by ages 31- 35 and 36-40 with 26% and 24% respectively. Participants in the age bracket of 40 and above were 11% with the least number of participants (7%) falling in the age bracket of 18-25. Most of the participants (79%) are less than a year in the country at the time of completing the survey while 21% have lived over a year in the country. 64% of the participants are master's students while 32% are undergraduates. Those studying for their doctoral degree and others make up 4%. Interestingly, 72% of the participants were married, 28% were single. None of the participants were either divorced, separated, or widowed. For employment status, 25% of the respondents were fully employed, 59% on percent in part-time jobs and 15% were unemployed.

Table 1: Socio-demographic data of the participants.

Concerning accommodation, barely one-third (35%) of the residents got accommodation one to four weeks after getting into the country. The remaining 65% of respondents stayed 5 weeks or more before securing an apartment. From the survey, it is obvious that a majority (78%) of the respondent had difficulty in securing accommodation for themselves and their families. Furthermore, the result suggested that 31% of the respondents had challenges securing accommodation because landlords and house agents were asking for two or more months of upfront payments of rent while 16% of the participants responded that they were not getting a decent place to live, 6% had other reasons as to why they had difficulty in securing an apartment.

Figure 1: Factors Affecting the Mental Health of International Students.

Figure 2: Impact of Migration on Students.

More than half of the respondents (79%) reported that they were currently employed with the result showing three a quarter of these participants had difficulty in obtaining a job whereas 25% had no difficulty in getting a job. The result showed that 76% of those with a job are currently not satisfied with the kind of jobs they had. The reasons for the dissatisfaction are quite diverse, therefore participants were given multiple choices when asked about reasons for their dissatisfaction. Accordingly, multiple responses were grouped for frequency analysis. There were 126 responses given by 87 respondents. (Table 2 ) gives the frequency and percentage of responses to the reasons why they do not have job satisfaction from their employment. The most common reason (43%) was that the jobs they had were below their qualification, followed by 23% of the respondents feeling that the number of hours allocated to students is small. Meanwhile, 14% believe that their salary is below their monthly upkeep. 12% believe that jobs using their qualification are not available in the areas they reside. Less than 6% believed they were treated differently due to their immigration status and 2% signified they had other reasons as to why they were dissatisfied with their job.

A general view of how satisfied or unsatisfied participants were with their life in the UK was asked and 38% responded they were neither satisfied nor dissatisfied, 32% were somewhat satisfied, 15% were somewhat dissatisfied and less than 8% were very dissatisfied or don’t know. Only 6% claimed that they were very satisfied with their present life in the UK. The pie chart above shows the factors that affect the mental health of the students. 71.5% claimed that they faced difficulty in securing accommodation while 62.3% indicated that their job lower than their qualification is a major factor for mental health issues. Moreso, 53.8% alluded that the inability to enrol their ward and children on school is another inhibiting factor for mental health issues. Moreover, it is important to note that only 52.3% stated difficulty in securing a job as another factor for mental health issues.

The bar chart above shows the life experience that affect mental health of the students. Significant number of the students (71.5%) stated that difficulty in getting accommodation, 70% claimed employment difficulty, 62.3% confirmed lack of satisfaction with the current job hitches while 70% indicated registering with the GP were the most difficult experience they encountered. Thus only 59.2% stated settling in facility impacted their mental health.

Table 2: The comparison of the social demographic data of students with factors to mental health issues.

The Relationship between the Sociodemographic Characteristics of the Students and the Factors That Contribute To Mental Health Issues

This variable indicated in the table above (Section D) appears to affect mental health, but the significance in the first four statements shows that the Factors affecting the mental health of migrants that contribute majorly to the table above indicate that (difficulty in getting accommodation is a contributing factors to mental health of migrant X2 = 0.243) and the (P = 0.527 with a percentage of 71.5%) which shows that a great number of migrant have difficulties in getting accommodation and also the difficulty in getting employment contribute to mental health of migrant (X2 = 3.615) and (p = 0.164 with a percentage level of 53.8). Nonetheless, migrants having difficulty in getting employment contribute largely to their mental health thirdly many migrants who have even gotten employment are not satisfied with the current job they are doing statistically (X2 = 1.800) and (p = 0.404) with (52.3%) the contribution of in satisfaction with their current employment have a great impact on the mental health of migrant. Registration in the health facilities to obtain a GP (General Practitioner) shows a high impact on the mental health of migrants with (X2 = 4.472) and (p = 0.03) with (70%) showing the impact of the registration on the health of migrants.

Accommodation according to the result, was one of the contributing factors that impacted the mental well-being of these internal students. It is generally believed that good housing protects health Shaw, 2004 Thomson and Thomas, 2015. Khawaja and Dempsey 2007 assert that increased costs and dissatisfaction with housing may cause financial and psychological hardship for international students. This was also supported by Duangpracha [26] who reported that international students felt safe and secure with suitable accommodation which helped them focus more on their studies. However, this research showed that the lack of getting an appropriate place to reside had an impact on the mental health of international students with more than two-thirds (71.5%) of the population having difficulty in getting a decent place to live. Calder, et al. [27] also reported a similar finding where more than half of the participants reported personally experiencing challenges with accommodation causing mental stress, leading to instability and hindering students' focus on their studies.

In addition to this, the recent research by Worsley, Harrison and Corcoran [28] carried out in the United Kingdom revealed that housing issues significantly affect the mental health of international students, leading to increased stress, anxiety, and loneliness. Students experiencing overcrowding, lack of privacy, or unsafe environments led to exacerbated mental health issues and hindered their ability to focus on academic and social activities. However, this is contrary to other researchers who averred that the major factor in accommodation was the high average cost of renting a house [27]. In this study, the landlords and house owners were asking for a high cost of rent which was beyond what an average international student could afford. Most International students pay so much for tuition, and the next thing of concern is accommodation. While some students may find it difficult to cater for their accommodation, others would have budgeted for it. However, if students are being made to pay for the high cost of rent, it could lead to anxiety about budgeting and financial stability, thus causing feelings of helplessness and affecting their academic performance in return.

In terms of Job opportunities, the result showed that more than 75% of the participants were dissatisfied with their jobs. However, for multiple reasons, jobs below their qualification stood out. This is similar to studies that have shown that international or foreign qualifications are either undervalued or inadequately recognised by the Western world [29,30] which in most cases often significantly reduces the chances of getting a good job. Moreover, international students face multiple barriers such as less experience in the host country, and limited hours to work which could hinder them from getting good jobs. Creese and Wiebe, [31] further noted that African migrants often results in lowering their skill set on their resume to qualify for employment at a lower level of work force. For such migrants, taking low-wage occupations looked to be the only viable option [31]. Also, some participants noted some level of discrimination at their workplaces. This was also supported by Stewart et al., [29] and Creese and Wiebe, [31] who noted that racial and discriminatory practices influence hiring processes and create additional barriers for migrants. Scholars studying the social determinants of health have long emphasised racism's involvement in the creation of health disparities [32]. Racism and discrimination directly impact socioeconomic inequalities along racial and ethnic lines, and, as such, it is a fundamental cause of disease [33].

Other reasons participants gave for job dissatisfaction included their living expenses being below the salary threshold. This could impact their mental well-being when the necessities of life are not met as a result of being an international student. According to Alsaad, (2017), living expenses constitute a significant component of the total costs of an international student in a Western university. International students' financial issues have been widely recognised as substantial sources of stress and one of the primary reasons for withdrawal from education. This is also supported by Chittoran, [34] who noted that international students who deal with financial challenges while studying abroad might have enjoyed a relatively stable degree of affluence in their home country. However, a change in their financial circumstances and economic status is associated with considerable stress [35].

Furthermore, concerning age and gender, Bhugra, [36] opined that young adults are more adaptable to change when they migrate and are also more likely to be at the risk of developing mental disorders and are more flexible to adjustment. While in contrast, those who are still developing their cultural identities may be profoundly impacted by cultural shock and uncertainty. Surprisingly, the result also showed that a higher percentage of the students were female. This has been supported by the National Centre of Education statistics [37] which noted that the enrolment for female candidates is higher in recent times. According to the study, reasons could include for women to be able to manage the home chores and since the number of hours allocated to students is minimal, their husbands opt out of the school options so they can work for longer hours.

This study showed that the majority (84%) of the students found it easy to be registered at a healthcare facility and be assigned to a GP. However, those who had difficulty in being assigned to a GP attributed it to a lack of permanent address. Also, some of the participants noted that they did not know how to go about it. Orientation programmes can be arranged to enlighten students on how to navigate basic amenities. Studies have shown that the availability and quality of neighbourhood services such as medical care, and schools can influence health, for instance by shaping residents’ opportunity to earn a living. It could be argued that having relatives and family members from one’s own culture may assist international students in coping with a new environment and culture [38].

However, other studies have shown that having limited interaction outside this close social group can have an adverse effect on a person. Research has shown that social support plays a major role in the mental health and adjustment of international students [38,39]. Also, some studies in the US have demonstrated that there is a decrease in academic stress, better adjustment to a new culture, and low levels of anxiety and depression when there is a higher level of social support [40]. While over 50% claimed they had family ties here in the UK, others said they did not have. Nonetheless, Sümer, Poyrazli, and Grahame, [41], suggested that social support from family and friends provides a sort of support to international students to mitigate depression and anxiety. This was further supported by Iwamoto and Iwamoto, [42] who noted that family ties do not only provide support but also some sort of protection, especially at the initial stage of adjustment.

Concerning the impact of migration on mental health, this study showed that international students are faced with some challenges which could impact their mental health. This was supported by other authors, however, contrary to this opinion, de Moissac, et al. [43] reported in their research excellent general health and great mental health as well as greater self-esteem and life satisfaction. From the authors' view, this could be a result of participants being older males who often practice some sort of religion that does have a mitigating effect which could have influenced the result. In addition, the participants were mostly African international students who Zhang and Goodson [10] described as having a different view of mental health. Beyond the obvious result that international students from Nigeria had a high prevalence rate of mental stress, factors leading to this situation can be strategically managed by appropriate authorities. Universities can look for ways to educate and enlighten prospective students about some of the challenges they might face and proffer suitable and various options to manage them.

Implication for Practice, Policy and Health and Social Care

The study will assist Western universities in developing mental health support services for international students, including counselling, peer support groups, and culturally sensitive resources. It will also guide educational institutions in creating comprehensive mental health policies that include provisions for international students, promoting awareness and accessibility. The findings on the impact of migration on the mental health of international students will also help policymakers in allocating funding for mental health initiatives including training, resources, and service expansion. The study will also guide health and social care services to adopt a holistic approach considering the academic, social, and emotional aspects of international students' lives, resulting in improved mental health and academic performance outcomes.

The quality and aim of the study were achieved due to the application of the right methodological approach. However, the study faced some limitations, including only a quantitative method and a small sample size. Future research should focus on a mixed method comprising quantitative and qualitative methods, such as focus group interviews, to better understand international students' experiences and factors contributing to their mental well-being. This method will allow a deeper understanding of individual perspectives, opinions, and attitudes. Additionally, the sample size may not be representative of all international students in the UK, and there may be a tendency for participation bias and a high prevalence of mental stress. Besides, the research only included factors that could help international students settle into a new environment properly, leaving out other factors that could impact their mental health. Future research should explore these areas to gain a more comprehensive understanding of international students' experiences and contribute to a more comprehensive understanding of their mental well-being.

The study revealed the mental health challenges international students face in the UK which negatively leads to poor academic performance. Moreover, difficulty in securing accommodation, language barrier, financial stress, and challenges in securing a job are some factors that affect the mental health of international students. Besides, the study also revealed that there is a significant relationship between the sociodemographic characteristics of the students and the factors that contribute to mental health issues. This suggests that regular mental health evaluations should be implemented to detect severe stress, depression, and anxiety among these students. As the number of international students in the UK increases, proper infrastructure should be established to support their mental health and educational experience. Current services may not fully meet the needs of international students, so support systems for their health and mental well-being should consider these concerns. This can be achieved by involving a significant number of students who share the same values, customs, and beliefs, which can help reduce social isolation and depression among international students.

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