Lonely but Not Asking: Help-Seeking Patterns and Loneliness Among International Students

Background and Purpose: International students face unique acculturation challenges, such as language barriers and social isolation, making them vulnerable to loneliness—especially when access to help-seeking options is limited. Although interest in international students’ mental health has increased, limited research has examined how help-seeking patterns are linked to loneliness. This study investigates that relationship, accounting for relevant background factors.

Methods: This study analyzed data from the 2023–2024 Healthy Minds Study (HMS; N= 104,729), focusing on a subsample of international students (n=5,324). The dependent variable, loneliness, was measured as a summative score of three Likert-type items assessing companionship, social exclusion, and isolation. Total scores ranged from 3 to 9, with higher scores indicating greater loneliness. Due to the ordinal nature of this composite score, an ordered logistic regression was also conducted, and the findings were consistent with the main OLS model. The key independent variable, help-seeking pattern, was constructed by combining past-year informal help experience and current intent to seek formal professional help. The four help-seeking patterns—Non-requesting (no past informal help, no formal help intent), Latent (no past informal help, formal help intent), Informal-dependent (past informal help only), and Open (past informal help and formal help intent)—were constructed by combining past-year informal help-seeking experience and current intention to seek formal support, based on prior conceptualizations of help-seeking across informal and formal domains (Bond et al., 2024). Covariates included age, sex, race/ethnicity, degree program, financial stress, racial trauma, knowledge of campus services, and informal help-seeking intent. An ordinary least squares (OLS) regression was performed with robust standard errors. Additional diagnostic tests confirmed heteroskedasticity, thus justifying the use of robust estimation.

Results: International student participants (N = 5,324) were categorized into four help-seeking patterns based on their informal help-seeking experience and formal help-seeking intent: Non-requesting (reference group; 30.05%), Latent (9.17%), Informal-dependent (40.23%), and Open (20.55%). In the OLS regression model accounting for all covariates, students in the Informal-dependent (B = 0.062, 95% CI = 0.031–0.092, p < .001) and Open (B = 0.074, 95% CI = 0.037–0.111, p < .001) groups reported significantly higher levels of loneliness compared to the Non-requesting group. The Latent group (B = 0.036, 95% CI = -0.010–0.081, p = .123) did not differ significantly in loneliness from the reference group after adjusting for covariates. Additional patterns were consistent with expectations: greater financial stress and racial trauma were associated with higher loneliness, while older age and stronger awareness of campus mental health services were associated with lower loneliness. Male students and postgraduate students reported higher loneliness levels than their female and undergraduate counterparts.

Conclusion: This study found that international students’ levels of loneliness varied by help-seeking patterns, emphasizing that both the presence and type of help-seeking matter. Notably, students who had received informal support but were unwilling to seek formal help reported elevated loneliness, suggesting potential gaps in support access. Addressing loneliness among international students may require a multidimensional strategy that goes beyond counseling services, strengthening social support and improving access to services.