Examining mental health services during study abroad

In recent years, both students and the administrators have worked to improve accessibility to mental health resources on campus. However, there still exists a significant lack of awareness surrounding mental health challenges that may come up while studying abroad. Due to the positive discourse at the College around studying away, many students who do have negative experiences end up feeling unprepared and isolated. In the first part of a two-part Closer Look on mental health abroad, the Record examines the experiences of students who have faced challenges of this nature and the resources that the College offers.

Oftentimes, students that encounter mental health challenges abroad are taken by surprise due to the largely enthusiastic discourse around study abroad at the College. Abby Rampone ’17, who studied in Granada, Spain during the fall of her junior year, expressed feeling unprepared for the challenges of studying abroad. “I hadn’t really fully understood that going abroad could be a really negative experience because at Williams people only talk about abroad as this life-changing adventure,” she said. “It’s always, always positive and transformative, and I just expected that to automatically happen to me. It was really hard to be abroad and having a hard time because you’re expected to go out and do things and be really enthusiastic and explore and want to travel and just want to all these good experiences, but I just didn’t necessarily have the energy, and I felt a lot of guilt because I felt like I was wasting the time.”

The mental health resources available while abroad vary by individual programs, with certain programs providing and covering the cost of therapy while others do not. Students abroad are not eligible to continue counseling with the College’s Psychological Counseling Services (PCS). “Health resources can be limited in many locations and without a doubt medical structures and country specific health care laws will differ,” Director of International Education and Study Away Tina Breakell said. “The level of care will vary and can be much less than we can offer at Williams.”

There is also a disparity in access to emergency care, which can be covered by the College’s insurance provider if necessary, and consistent therapy, which is not necessarily included in program tuition. “Williams has access to an insurance provider that can offer assistance in situations of imminent risk,” Breakell said. “However, management of non-emergent or chronic conditions is much more variable depending on location.” Director of PCS Wendy Adam concurred. “Treatment resources vary greatly site to site and are often limited to emergency intervention care only,” she said.

Student experiences reflect this variable access to mental health resources abroad. Rampone’s program provided and covered the cost of therapy, although she only had one English-speaking therapist from whom to seek care.

In contrast, Justice Namaste ’17, who studied abroad in the fall of her junior year in Cape Town, South Africa, had no access to therapy. “[The program director] was not particularly helpful or receptive to student needs,” Namaste said. “And so in talking about mental health resources, he was basically like, ‘Hey, unless it’s extremely severe, there’s nothing I can do about it because it’s hard to do something about it.’ And that was a frustrating thing to hear, and also reinforces a lot of ideas about mental health – how bad does it have to be? Because all we wanted was weekly therapy – that was it.”

Often, the lack of resources provided by programs, combined with the fact that the College does not provide therapy for students studying abroad, can leave students in a bind. “I didn’t feel like I had any real support from the program, nor did I feel as though I had any real support from Williams,” Namaste said. “And the frustrating part about that for me was that Williams always tells you, ‘Even when you’re abroad, you’re still a Williams student.’ You don’t have access to any of the resources or anything that you do here when you’re abroad, and while I understand logistically why, because our psych services are already so over-extended, I think it’s frustrating, the kind of rhetoric we use around this type of stuff.”

Following mental health challenges abroad, one of the most isolating parts of the experience can be returning to a College community that expects to hear only positive feedback about studying away. “When you get back everybody wants to say, ‘Oh, how was it?’ and hear about all the positive stuff,” Rampone said. “With friends I could talk about it more, but at the same time, even with friends, I felt like people would get sick of it, and just because most of my friends had very positive experiences, it got a little taxing on me because when we would talk about these things, they would share how wonderful their experiences were.”

Namaste experienced similar stress in bringing back a negative experience studying abroad. “It was really isolating because most of my friends who went abroad were raving about how wonderful their experiences were, and mine was not,” she said. “My big thing was that people would be like, ‘How great was study abroad?’ And I would be like, ‘It wasn’t.’”

Upon returning from studying abroad, students resuming or entering into psychological counseling at the College are encouraged to discuss challenges abroad if they so desire. “PCS therapists have a wide variety of feedback from students regarding their experiences abroad,” Adam said. “When students disclose negative experiences of mental health resources abroad, therapists help students process their experiences [and] identify factors influencing their experiences and whether other outcomes might have been achievable.”

Although individual therapy upon return can be extremely helpful, Namaste believes that she would have also benefitted from a more communal setting with which to discuss her experiences. “[My PCS therapist] was very helpful in … unpacking my experiences with being abroad … on an individual level,” she said. “But in terms of Williams as a small community and feeling very isolated within the community right after you return, knowing other students had had difficult experiences would have been really helpful for me … I think it would be really helpful to have a return group for study-abroad students who either didn’t have a good experience or just want to have a space to talk about their experiences and whatever happened there.”

Namaste and Rampone both expressed a desire for a more open dialogue on campus about the challenges of studying abroad. “I think that the school can provide support and recognition that [studying abroad] might not be exactly what you think it’s going to be,” Namaste said.

“I think that, first of all, we need a culture change, and we need to be more conscious about the way we talk about going abroad and be aware that it’s not for everybody,” Rampone said. “That’s not necessarily something that the College can control, but it’s certainly something they can influence – having more open conversations about it and not discussing it as if you fail if you haven’t had an amazing, life-changing experience.”

According to Adam, PCS is cognizant of these needs and is working to increase awareness of mental health challenges abroad. “PCS is currently working with College administration and the Office of International Travel to develop programming to increase student awareness about wellbeing while abroad, challenging issues that may arise and potential variability in accessing needed mental health care,” she said. 

In the second part of this Closer Look, the Record will examine the mental health resources available at the Williams-Exeter Program at Oxford, the College’s flagship study-away opportunity.

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    I think it’s also important to note that even people who have an awesome time abroad can still struggle with mental health. Sometimes hearing students complain about mental health resources at Williams is so frustrating because I’m currently studying at a university that only offers emergency short-term (1-4 sessions) counseling. When I went for help with a reoccurring eating disorder, they told me they couldn’t really help beyond the session limit and that I should get long-term therapy when I returned to my home university. While there is room for improvement at Williams, I think many students don’t realize how lucky they are that they can get long-term help if needed.