Factors influencing the mental well-being of international college students in the United States during COVID-19: a systematic review

The COVID-19 pandemic created unprecedented disruptions to international higher education and raised significant concerns regarding international students’ mental well-being in the United States. This systematic review synthesizes evidence from 34 peer-reviewed empirical studies published between December 2019 and February 2025 examining factors associated with international students’ mental health during the pandemic. Following PRISMA guidelines, studies were identified through systematic database searches, appraised using the Mixed Methods Appraisal Tool (MMAT), and synthesized through thematic analysis. Four interrelated themes emerged: (1) structural and immigration-related stressors, including visa uncertainty, academic disruption, and financial instability; (2) discrimination, racism, and COVID-19-related stigma; (3) social isolation, disrupted belonging, and limited institutional support; and (4) psychological distress and coping responses. Findings indicate that anxiety, depression, stress, and trauma-related symptoms were common, while coping capacity varied across individuals and contexts. International students’ mental well-being was shaped not only by personal psychological challenges but also by broader structural and sociopolitical conditions. This review underscores the need for culturally responsive mental health services, proactive institutional support, and stable policies to promote international students’ well-being during future crises.