In the field of secondary school exchange programs, there has long been a norm that if a student discloses a history of mental health problems or treatment, or experiences the onset of a mental health problem, their participation in the exchange is often deemed infeasible. This cautious approach has been adopted with the intention of protecting both students and host families.

However, as we acknowledge our limited expertise as non-medical professionals, it becomes clear that our views on mental health need to evolve to include a more nuanced perspective. With an increasing number of students entering exchange programs with a history of mental health treatment, it is crucial to recognize that mental health exists on a continuum rather than a binary distinction.

Redefining mental health
Creating a comprehensive understanding of mental health begins with cultivating awareness and adopting a new mindset. Mental health is not a new ‘problem’, but an issue that has been approached differently throughout history. It is also important to recognise that mental health care remains inaccessible to many people around the world.

“Mental health influences how we think and feel about ourselves and others and how we interpret events. It affects our capacity to learn, to communicate and to form, sustain and end relationships. It also influences our ability to cope with change, transition and life events.” (Dr Lynne Friedli, 2004)

Challenges faced on exchange
When a student embarks on an exchange program, they experience a significant transition that temporarily disrupts their mental health continuum. The loss of familiar sources of security such as friends, family, community, school, language and cultural skills is replaced by the unknown. It is not surprising, therefore, that this experience can cause previously thriving students to shift downward on the mental health scale.

Manifestations can include anxiety, depression, irritability, poor sleep and reduced social activity. While many students manage this transition through their inherent resilience, some may require additional support and time to regain a positive state of mental health.

Supporting students in a changing landscape
As young people face crisis after crisis, including the aftermath of pandemics, fears of war and political violence, financial instability and the ubiquity of social media, it is imperative to prioritize working with students to successfully navigate and complete exchange programs. It is no longer possible to ignore these challenges or to continue with the status quo. Adapting programs to meet the evolving needs of these individuals is essential.

Where do we start when it comes to handling such a complex issue?

We are not health care professionals and for most of us it is not an option to employ health care professionals to be part of our teams. But there are still a few things we can do:

As exchange organizations :

• Normalize the fact that a history of mental health care is not a signifier that a person is not suitable or capable. We should rather consider, what kind of tools and skills this person has developed that can help them succeed on an exchange.
• We need to help participants understand that it is normal to experience difficult emotions and struggle with feelings of anxiety, nerves, and stress. These are feelings that we expect them to have at some point in their exchange experience.
• Support them in handling and overcoming these difficult emotions rather than providing “quick fixes” by moving them to a new school or host family.
• Highlight the positives, but not be afraid to show the boring everyday life, the difficult adjustments, and the stress that can come with being an exchange student. We can help everyone by normalizing that not everything is always perfect.

In summary, it is not only the responsibility of the students to adapt; rather, it is our duty as program organizers to adapt to their needs and facilitate their ongoing personal development.