Overcoming borders: A systematic review of mental health issues and challenges faced by international students

International students are central to global higher education, contributing to cultural exchange, institutional revenue, and future labour markets. However, they face persistent challenges that undermine both mental health and academic success. This review aimed to synthesise evidence on the mental health and adaptation of international students, highlight how challenges intersect across psychological, social, linguistic, and academic domains, compare variations across host regions and nationalities, assess strengths and limitations of the evidence base, and generate actionable recommendations for stakeholders. Following PRISMA guidelines, 20 peer-reviewed studies were reviewed, covering mental health, acculturative stress, and adaptation difficulties across diverse global contexts. International students consistently reported stress, anxiety, depression, and social isolation, compounded by stressors such as acculturative stress, library anxiety, and cultural alienation. Vulnerabilities differed across groups: East Asian, South Asian, and Middle Eastern students were disproportionately affected by language stress and stigma, while African and Latin American students showed resilience through community and faith-based networks, though coping often masked unmet needs. Findings confirm international students’ heightened risk of psychological distress while extending prior reviews by demonstrating how vulnerabilities and coping strategies differ by nationality and host context. The evidence base was limited by its concentration in Anglophone contexts, small or convenience samples, lack of subgroup disaggregation, and inconsistent statistical reporting. Research gaps include minority identities, non-Western contexts, and longitudinal or intervention designs. Generic support models are insufficient. Universities should provide integrated academic and language support, foster inclusive peer networks, and address discrimination, while policymakers must embed culturally responsive mental health provision into internationalisation strategies.