Abstract Background With the increasingly prominent mental health issues worldwide, the demand for mental health nursing professionals is rapidly increasing, driving the globalization of mental health nursing education. Existing research mostly focuses on introducing the experiences of a single country, lacking analysis of the systematic interaction and contradictions between the two. The research aims to systematically explore the adaptation of global education frameworks in different cultural contexts, analyze core challenges, and propose integration paths to construct an education model that combines international standards and cultural responsiveness. Methods The study adopts a sequential mixed research method. Firstly, conduct a systematic literature review to analyze Chinese and English literature from the past decade and extract the core trends of globalization. Then conduct a comparative study of multiple cases, selecting typical educational projects in China, the United States, and Japan, and comparing their curriculum documents and implementation reports through text analysis. Simultaneously organize two rounds of Delphi expert consultations and invite 15 international experts to rate the challenges and strategies, with a consensus threshold set at 75%. Finally, a questionnaire survey was conducted to evaluate the relevance of curriculum culture and skill application among 220 students from 8 universities in China. The questionnaire reliability Cronbach's alpha was 0.87, and descriptive statistics and analysis of variance were performed on the data. Results Literature analysis shows four major globalization trends: curriculum standardization (92.3%), ability oriented teaching (89.7%), cross-cultural competence centralization (85.9%), and digital resource integration (81.0%). Case comparison shows that the integration rate of American projects in various trends exceeds 90%, while Japanese projects are highly compatible in standardization (88%) and teaching methods (85%) but localized in form. Chinese projects follow up well in standardization (82%) and teaching methods (78%), but there is a certain gap in cross-cultural competence localization (45%) and resource adaptability (50%). Delphi experts have identified five major challenges: cultural belief conflicts (92%), ethical and legal differences (87%), lack of local resources (82%), inadequate teacher capacity (79%), and standard demand conflicts (88%). According to the survey data, only 34.5% of students believe that the curriculum fully integrates local psychological characteristics (M = 2.91), while 67.3% of students find it difficult to directly apply international communication skills (M = 3.68), and there are significant differences in students' perception among different practice durations (F = 4.32, p.05). Discussion Research has found that the globalization of mental health care education must undergo deep localization transformation. Data analysis shows that simply transplanting international standards can lead to insufficient cultural relevance and difficulties in practical application. The "Trend Challenge Strategy" framework of research provides a systematic tool for educational evaluation and reform. It is recommended to prioritize the development of localized teaching cases, strengthen the training of teachers' cultural transformation abilities, and establish a diversified negotiation curriculum mechanism. Future research should track the long-term effects of localization reforms and validate the applicability of this framework in more cultural contexts, promoting the establishment of an education system that truly integrates global standards and local care.
Zhang et al. (Sun,) studied this question.