Effects of COVID-19 on Chinese overseas students' mental health: a multi-country cross-sectional analysis (Preprint)

BACKGROUND COVID-19 caused serious mental health burden for international students. However, only several international students obtained related mental health services. The topic of international students' mental health has the bigger jump among social and educational concerns during the pandemic. OBJECTIVE This study surveyed the effects of COVID-19 on the mental health of Chinese overseas students to provide essential reference for identifying mental health problems of Chinese overseas students, so that they can be targeted for timely crisis-oriented and tailoring mental health interventions during periods of public health emergencies. METHODS Descriptive statistics such as percentages, 95% CIs, means and standard deviations were calculated to reflect the demographic characteristics of the survey population. The Kolmogorov-Smirnov test was used to test the normality of continuous variables. The chi-square test was used to determine the statistical significance of the differences in participants' mental health status. Binary logistic regression was used to analyze the factors influencing on Chinese overseas students' mental health. The data were analyzed through quantitative and qualitative methods. RESULTS Chinese overseas students had several poor mental health status during the COVID-19 pandemic. Furthermore, the degree of mental health burden might differ between countries, but there were not notable differences in gender (p = 0.75) and in ant-pandemic duration. Some main factors caused an unhealthy psychological status, including epidemic severity in residence（67.94%, 95% CI：67.06% — 68.82%）, fear of being infected（64.54%, 95% CI：63.72% — 65.36%）, worries of academic performance（62. 43%, 95% C%I：60.64% — 64.22）, infection control policies of the host government（58. 09%, 95% CI：57. 16% — 59. 01%）, epidemic preventive measures of locals（56. 03%, 95% CI：55. 10% — 56. 96%）, obstruction of return trips（54.85%, 95% CI：53.91% — 55. 79%）, mutation of the epidemic virus（53. 75%, 95% CI：52. 71% — 54. 79%）. CONCLUSIONS The main conclusion of this research is that Chinese overseas students experience mental health burdens during the COVID-19 pandemic and they need timely psychological services, positive support, and tailoring guidance to better manage mental health in this unusual situation.