The rising incidence of suicide-related thoughts and behaviors among international students presents a significant public health challenge and growing concern among college campuses. Current intervention strategies often rely on Western-centric and colonized approaches developed and tested with primarily Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. Exclusion and historical underrepresentation of ethnoracially minoritized groups in suicide prevention treatment trials create gaps in advancing our science because they often miss the cultural contextualization crucial for effective prevention and intervention in diverse groups from different countries of origin. To address the limitations of these Western-centric strategies, we explored existing prevention recommendations and approaches through the lens of an expanded version of the newly developed Protective Factors Framework, tailored for non-Western cultural perspectives. We propose significant opportunities for enhancing current practices and point to promising future directions. The primary areas for development include: (1) bolstering community empowerment and ownership, (2) refining mechanisms of change to encompass multicultural viewpoints, and (3) focusing on effective implementation and thorough evaluation for ongoing refinement. This methodology not only shows promise for enhancing international student suicide prevention but also offers insights for broader application in suicide prevention among other culturally diverse populations.

1 Introduction

Suicidal thoughts and behaviors among international college students in key destination countries such as Australia and the US represents a significant public health challenge (Veresova et al., 2024). Existing evidence suggests current prevention and intervention strategies are, at best, only partially effective (Jamieson, 2019, 2021; McKay et al., 2023). In such countries, prevention strategies primarily employ Western mental health paradigms focusing on individual-level interventions. Indeed, a comprehensive review of suicide prevention strategies for international students revealed that current approaches primarily seek to enhance mental health literacy, facilitate access to local services, and heavily rely on symptom reduction (McKay et al., 2023). The foundational evidence for such approaches largely stems from studies involving participants from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies (Maria Guzmán et al., 2024), which are not representative of the majority of international students (UNESCO, 2024). Research with diverse cultural groups has demonstrated that such strategies overlook cultural and other contextual considerations crucial to effective prevention and intervention (Wexler and Gone, 2012; Alvarez et al., 2022; Look et al., 2023).

In this article, we propose that integrating culturally contextualized prevention models, which blend evidence-based Western mental health best practices with the unique cultural perspectives of the international student population, can enrich existing efforts and unveil innovative opportunities for prevention and intervention. We begin the article by overviewing existing evidence on international college student suicidality before turning to the literature on culturally responsive suicide prevention. Building on this research, we examine the existing recommendations for prevention and intervention among international students. Our analysis leverages recent theoretical developments from the Protective Factors Framework (Allen et al., 2022), while also drawing upon established models including the public health model of suicide prevention (World Health Organization, 2021a, 2022; Pirkis et al., 2023). This approach allows us to identify critical areas along the suicide care continuum where culturally responsive approaches have significant potential to enhance the effectiveness of suicide prevention efforts for international students.