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Article
Publication date: 14 December 2015

Robert Lawrence Quigley, Lisbeth Claus and Ashley Nixon

The increase in prevalence of behavioral health issues among college and university students is burdening the scholastic sector both domestically and internationally. More…

Abstract

Purpose

The increase in prevalence of behavioral health issues among college and university students is burdening the scholastic sector both domestically and internationally. More American students participate in study abroad programs than ever before. These provide educational institutions with additional duty of care challenges and responsibilities especially when it comes to their health status while studying or working abroad. The requests for assistance to an assistance service provider of students from US universities studying abroad were compared to international assignees from US employers in terms of closing diagnoses and case outcome types. The purpose of this paper is to indicate that there are differences in diagnoses and case outcomes between students studying abroad and employees working abroad. Students are more likely than international assignees to be diagnosed with behavioral health issues, to be referred to a health provider (rather than being treated through in-patient care) and to be evacuated or repatriated. It is recommended that US universities change their duty of care practice from the “inform and prepare” to a higher level benchmark, commonly practiced in the US corporate sector, of “assess, assist and protect.”

Design/methodology/approach

US employers and universities often contract with a service provider for international travel assistance for their traveling employees/students. The sample consisted of case records of a large assistance service provider based on request for assistance (RFAs) by international assignees and students from its different US client organizations (US employers and universities) over a 24-month period (January 1, 2010 to December 31, 2011), with all client travel originating in the USA and traveling abroad. A two-year framework was used to include a larger sample of short- and long-term international assignees. The individual requesting assistance (student or international assignee) was the primary unit of analysis. The multiple case records can be viewed as a “case study” of an assistance provider (Yin, 2014). According to Yin’s case study design typology, this research used a single case (embedded) design. It is a single case study of client records from a global assistance provider of medical and security services for international travelers. The case study was embedded because it involved more than one unit of analysis. The case study included 17,071 records from two different subunits: 831 students studying abroad from 82 US universities and 16,240 US international assignees working for 889 US employers requesting assistance for health-related issues from the global service provider. The US client organizations included universities with study abroad programs and employers of different sizes and industries who have global mobility programs.

Findings

The hypotheses related to different diagnoses and outcomes based on RFAs while working or studying internationally were confirmed in spite of the fact the age and gender (important antecedents of morbidity) were controlled. Compared to international assignees, students are more likely to be diagnosed with behavioral health issues, more likely to be referred to a health provider (rather than being treated) and more likely to be evacuated/repatriated. This not only shows the importance of behavioral issues among students while studying abroad but also indicates that the corporate organizational support structures for international assignees are different than those universities provide to students.

Research limitations/implications

This study assessed how RFAs by students studying abroad differed from international assignees working in corporate organizations. With this type of case study, the mode of generalization is “analytic” rather than “statistical.” In analytic generalization, the empirical results of the case study are compared to a previously developed theory (Yin, 2004, p. 38). As a result, the authors are striving to generalize the particular empirical results of students and international assignees to the broader institutional theory.

Practical implications

The research has implications for further research. First, these results can be replicated with other samples of students studying abroad. If replications result in similar findings, indicating that students have increased risk of being diagnosed with behavioral health conditions, this finding can be probed for a better understanding of both process and outcome. For instance, future research can delineate the specific behavioral health diagnoses the students are receiving, which can have important implications for behavioral health care providers, educational duty of care considerations, as well as direct future research in this area. An additional area of critical importance for future research will be elucidating the students’ systemic experience of increased stress associated by studying abroad, the subsequent psychological and physiological responses, as well as how students are impacted by this stress. There are also some systemic stresses that are unique to the study/work abroad context. Many of the administrative requirements (such as required paperwork for travel, visas, travel scholarships, funding, vaccinations, health care, etc.) are taken care of for international assignees by their employers through the global mobility division. They are not necessarily done by universities for their students. Students are largely responsible for these themselves although with some guidance through the study abroad program staff. Researchers can also examine how cultural adjustment models apply to students studying abroad. For instance, how might changes in anticipatory adjustment impact student development of behavioral health conditions, including both individual factors such as pre-travel training, as well as organizational factors such as selection systems designed to identify those that could need additional behavioral health support while they are abroad. Likewise, in-country adjustment can also be evaluated in future research to identify individual, organizational and cultural aspects that could be associated with increased behavioral health diagnoses in students. Such research can shed more light on this understudied population, illuminating the steps that university can take, with regard to duty of care concerns, to ensure students have safe and beneficial experiences abroad.

Social implications

The population of corporate international assignees is emotionally more mature and more experienced in world travel and therefore more likely to be adaptable to the challenges of traveling and living abroad than the study abroad population of students. As more students enroll in study abroad programs, the absence of an infrastructure to support behavioral health issues at the time of enrollment, while on-site and upon return will only result in more exposure for both students and educational institutions. E-learning tools, and even anonymous student self-exams can assist in determining fitness for study abroad. Simultaneously, colleges and universities must educate their local and distant faculty/team leaders, host institutions as well as other students to recognize and react appropriately to a behavioral health crisis. Adherence to such a strategy will certainly help to mitigate the risk of a failed study abroad experience. Although this study is limited to US students traveling overseas, behavioral health is an issue with students globally. American institutions hosting foreign students should, therefore, re-evaluate their existing domestic resources to accommodate the psychological needs of their visiting international students. It is the authors recommendation that, prior to travel, students should develop greater self-awareness, with or without the assistance of a professional. Implementing these recommendations will move university duty of care practice from the “inform and prepare” to a higher level benchmark, commonly practiced in the corporate sector, of “assess, assist and protect.”

Originality/value

With regard to case outcomes, students had lower odds of experiencing severe outcomes, such as in- and out-patient care, than international assignees. Similarly, students had lower odds of being evacuated or repatriated than international assignees.

Details

Journal of Global Mobility, vol. 3 no. 4
Type: Research Article
ISSN: 2049-8799

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Article
Publication date: 14 December 2015

Jan Selmer

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Journal of Global Mobility, vol. 3 no. 4
Type: Research Article
ISSN: 2049-8799

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Article
Publication date: 1 February 1974

Frances Neel Cheney

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here…

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Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

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Reference Services Review, vol. 2 no. 2
Type: Research Article
ISSN: 0090-7324

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Article
Publication date: 1 April 2004

Georgios I. Zekos

Investigates the differences in protocols between arbitral tribunals and courts, with particular emphasis on US, Greek and English law. Gives examples of each country and…

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Investigates the differences in protocols between arbitral tribunals and courts, with particular emphasis on US, Greek and English law. Gives examples of each country and its way of using the law in specific circumstances, and shows the variations therein. Sums up that arbitration is much the better way to gok as it avoids delays and expenses, plus the vexation/frustration of normal litigation. Concludes that the US and Greek constitutions and common law tradition in England appear to allow involved parties to choose their own judge, who can thus be an arbitrator. Discusses e‐commerce and speculates on this for the future.

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Managerial Law, vol. 46 no. 2/3
Type: Research Article
ISSN: 0309-0558

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Publication date: 8 June 2020

Rupert Ward

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Personalised Learning for the Learning Person
Type: Book
ISBN: 978-1-78973-147-7

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Book part
Publication date: 1 November 2016

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Governing for the Future: Designing Democratic Institutions for a Better Tomorrow
Type: Book
ISBN: 978-1-78635-056-5

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Article
Publication date: 1 March 1975

Tom Schultheiss and Linda Mark

The following classified, annotated list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to…

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The following classified, annotated list of titles is intended to provide reference librarians with a current checklist of new reference books, and is designed to supplement the RSR review column, “Recent Reference Books,” by Frances Neel Cheney. “Reference Books in Print” includes all additional books received prior to the inclusion deadline established for this issue. Appearance in this column does not preclude a later review in RSR. Publishers are urged to send a copy of all new reference books directly to RSR as soon as published, for immediate listing in “Reference Books in Print.” Reference books with imprints older than two years will not be included (with the exception of current reprints or older books newly acquired for distribution by another publisher). The column shall also occasionally include library science or other library related publications of other than a reference character.

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Reference Services Review, vol. 3 no. 3
Type: Research Article
ISSN: 0090-7324

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Article
Publication date: 1 February 1984

Joyce Payne and Aurelia Stephen

If you are 30 or older, you are middle‐aged by someone's criteria. When the college students of the 1970s declared “Don't trust anyone over 30,” did you think they would…

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If you are 30 or older, you are middle‐aged by someone's criteria. When the college students of the 1970s declared “Don't trust anyone over 30,” did you think they would be someday talking about you? And what about those who say “Life begins at 40”? Did you ever believe them?

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Collection Building, vol. 6 no. 1
Type: Research Article
ISSN: 0160-4953

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Book part
Publication date: 14 March 2017

Kenneth M. Moffett

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Forming and Centering
Type: Book
ISBN: 978-1-78635-829-5

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Article
Publication date: 1 March 1982

Nancy Hill Allen

The mass media are cultural pipelines through which flow hours of entertainment and information. They represent a part of our culture which critics decry and media…

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The mass media are cultural pipelines through which flow hours of entertainment and information. They represent a part of our culture which critics decry and media specialists praise. They are difficult, if not impossible, to ignore. Television (free, cable, or pay) is the subject of attention of three‐year‐olds and Ph.D. candidates alike. Newspapers are perused daily by all classes and conditions of people and their content, ownership patterns, and circulation statistics are studied in journalism classes, high schools, and by worried editors and publishers. Films entertained children in Nickelodeons, raised the spirits of millions during World War II, and now are the subject of so much analysis that words like ‘pan,’ ‘take,’ and ‘track’ have taken on new meaning in the vocabulary of most ordinary citizens.

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Collection Building, vol. 4 no. 3
Type: Research Article
ISSN: 0160-4953

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