International students who take their own lives are far more likely to do so without warning than their domestic peers, an Australian study has found.
Nevertheless, most give signs that they were at risk, suggesting that dozens of tragedies could be averted if friends and family were more alert to the danger.
The study was conducted by the Coroners Court of Victoria as part of an inquest into the death of Chinese student Zhikai Liu, who threw himself off a Melbourne balcony in March 2016. The 24-year-old had arrived in Australia just four months earlier to study at the University of Melbourne.
Mr Liu had apparently been depressed over study and language difficulties. He had played down his problems to his sister, who lived with him, but confessed to his mother that he was experiencing suicidal thoughts.
Coroner Audrey Jamieson instructed the court’s analytical arm to tally data on similar cases, after failing to find any Australian or overseas research into suicides by foreign students.
The findings suggested that as many as six international students were taking their own lives each year in Victoria alone, on average, with 27 confirmed student suicides – and another 16 possible cases – tallied over a seven-year period.
The study found that the foreigners most at risk were male, Asian, aged below 25 and studying at universities rather than vocational colleges or schools.
It also uncovered marked differences between overseas-born and locally-born victims, with Australians more likely to have been experiencing legal, gender, sexuality or abuse issues, while foreigners had been more prone to educational or financial pressures.
Australian-born students who took their own lives were between two and four times as likely to have diagnosed or suspected mental illnesses, recent contact with mental health services and known histories of self-harm. But most foreign as well as local victims had given some indication that they were considering suicide.
Student mental health advocate Benjamin Veness said that the “red flags” among the two groups were different, and that students’ housemates and relatives – who were often best placed to intervene – needed to be alert to the signals.
He said that there was a need for educational material about mental health to be made available to family members of international students, as well as the students themselves. “That’s not to say that it will prevent all deaths but it’s a really obvious principle that hasn’t been implemented by a lot of institutions,” he said.
Dr Veness said that, while international students may avoid mental health services for financial or cultural reasons, many also lacked an understanding about how such services worked. “There’s often an assumption that family members would be contacted,” he said.
The research found that many overseas students who had committed suicide had been failing their courses and were worried about parents finding out. Mr Liu had attracted his father’s disapproval after saying he wanted to pay more attention to language studies than his degree.
The coroner recommended that the Australian Department of Education and Training should consult on ways to help international students requiring mental health support, and oblige education providers to inform coroners of international students’ deaths and share the critical incident reports with each other.
Not to do so was a “major missed opportunity from a prevention perspective”, she said. “A central public health principle is that problems must be defined and understood before interventions are developed.”
The department said that it was “considering” her recommendations.