Counseling in a Second Language: How Language Shapes International Students’ Path to Mental-Health Support in Bern

Context

International students in the Bern region study in a multilingual world — German for institutional and everyday life, English as an academic bridge, and their own first language for emotional life. Mental-health pressure in this group is real: the latest Swiss national survey on higher education found that 29% of students report moderate-to-severe depressive symptoms (BFS, 2025). In the Bern region, there are many counseling options available to students through the regular swiss health system. Free, confidential counseling exists for all four Bernese higher-education institutions through the Beratungsstelle der Berner Hochschulen. Yet for students whose first language is not German, the existence of a service does not guarantee they will find it, trust it, or use it. This thesis investigates that gap — not whether counseling is available, but whether it is accessible.

Goal & Tasks

The thesis asks one central question: How do non-German L1 international students in the Bern region experience counseling services and language-related barriers when they face psychological difficulties? Five sub-questions trace the full help-seeking journey — how students recognize a need for support, how they become aware of services, how language influences both the decision to seek counseling and the experience inside it, what coping strategies they use instead, and how counselors interpret these language-related challenges from professional practice.

Methods

The study used a qualitative design built on eight semi-structured interviews: five non-German L1 international students (first languages including Italian, Spanish, English, and an Eastern European language) and three counseling professionals from institutional and private practice. Crucially, the student group included both people who had used counseling and people who had not — covering the whole pathway, including those who never reach the door. Interviews were transcribed and analyzed through hybrid coding (deductive codes drawn from the theoretical framework combined with inductive codes emerging from the data) using the qualitative-analysis tool Taguette. The analysis was anchored in Andersen’s Behavioral Model of Health Services Use, Berry’s acculturation theory, and multilingual counseling research.

Results

Five findings emerged. First, perceived need built up gradually — students normalized strain for long periods before recognizing they needed help; as one put it, “asking for help was not one decision. It was many small decisions.” Second, services were often invisible, and a warm or cold first contact could decide everything. Third, language acted as a gatekeeper before contact: a service assumed to be German-only was excluded before anyone reached out. Fourth, inside the counseling room language had a dual effect — a first language carried emotional resonance and humor, while a second language created distance that was sometimes limiting and sometimes genuinely helpful for setting boundaries and discussing difficult topics. Fifth, students coped informally in their first language, and counselors emphasized that the therapeutic alliance and cultural attunement matter as much as language once contact is made.

The core conclusion: available counseling is not automatically accessible counseling — language conditions every stage of the path, from finding a service to speaking meaningfully within it.