Behavioral health morbidity for those studying or working internationally

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 st