Beyond Performance: Examining Mental Health Outcomes and Support Systems In International Student-Athletes

Background & Purpose: International Student-Athletes (ISAs) represent a critical yet understudied population within U.S. intercollegiate athletics. Despite recent declines in international student enrollment, approximately 25,000 ISAs compete in NCAA Divisions I and II, contributing substantially to the competitive success and global visibility of collegiate sports programs. While prior research has examined student-athlete mental health broadly, limited empirical attention has focused on ISAs, who face unique challenges including acculturation stress, language barriers, legal restrictions, and limited access to financial opportunities. This study aims to examine mental health outcomes among ISAs and identify key psychosocial and structural factors influencing their well-being.

Methods: This primary data study used a cross-sectional design and collected data via an anonymous online survey distributed through NCAA Division I and II athletic departments, yielding 207 responses. Data included demographics, depressive and anxiety symptoms (PHQ-2, GAD-2), and satisfaction with coaches, teammates, medical staff, finances, social life, and sleep habits. It also examined homesickness, discrimination, food insecurity, and mental health services utilization. Chi-square analyses assessed associations between mental health outcomes and explanatory variables.

Results: The sample was predominantly female (87%), with a mean age of 20.4 years (SD = 1.8). Class standing was distributed across undergraduates (freshman 27%, sophomore 21%, junior 20%, senior 18%) and graduate/alumni (14%). Most athletes were of European origin (83%), and 15% identified as non-White. The largest sport represented was volleyball (51%), followed by basketball (14%), other sports (17%), tennis (7%), swimming/ diving (6%), and track (5%).
Overall, 18% reported depressive symptoms, and 25% reported anxiety. Homesickness was reported by 63%, food insecurity by 27%, and discrimination by 20%. While 41% utilized mental health services, only 14% received a formal mental health diagnosis. Satisfaction was relatively high with coaches (57%), teammates (67%), and athletic staff (76%), but lower for finances (38%), diet (28%), sleep (48%), and social life (49%). Chi-square analyses indicated relational factors were the strongest predictors: coach satisfaction predicted depression, χ²(2, N = 206) = 15.58, p < .001, and anxiety, χ²(2, N = 206) = 8.59, p = .014; teammate satisfaction predicted depression, χ²(2, N = 207) = 10.10, p = .006, and anxiety, χ²(2, N = 207) = 8.52, p = .014; the strongest effect was observed for trainers/medical staff, χ²(2, N = 207) = 17.37, p < .001, where over 60% of dissatisfied athletes reported depression. Lifestyle factors, homesickness, discrimination, and female gender were also associated with worsened mental health symptoms.

Conclusions and Implications: With this study being the largest quantitatively of an independent non-NCAA-sponsored group, findings highlight the critical role of relational support in ISAs’ mental health. Athletic departments should foster culturally responsive, supportive interactions between coaches, support staff, and mental health professionals, while also consider the integration of social work into athletic departments. Social workers bring a holistic perspective, addressing acculturative stress, relationships, and overall well-being rather than focusing solely on athletic performance. This broader support can enhance both mental health outcomes and athletes’ success on and off the field.