Australia is an inspired destination for thousands of Indian sojourners. An Australian study was conducted to investigate the factors contributing the psychological distresses in international students in Australia. The study assessed the manner of manifestation of the psychological distress among these students. The study included 86 students who were to fill a nine self-reported questionnaire. Results revealed that worry manifested by obsessive–compulsiveness, reflection and perfectionist tendencies were the most common manifestations of psychological distress. Inability to cope was the only major factor contributing the distress. The implications of the study underscored the need for assessment of students’ mental health issues and the need for designing of suitable intervention programs.¹

Over the decades, researchers have identified myriad of issues faced by expatriates during their adjustment processes abroad. The earliest study on sojourner adjustment was conducted in the year 1951 by Forstat. The researcher investigated the various adjustment problems pertaining to 182 international students enrolled in an American university. The results concluded that dating, financial issue, the English language, the academic system, housing, and food were the most common adjustment issues among the international students .²

Another earlier study was conducted by Sharma which analyzed adjustment problems among sojourners in universities in North Carolina^. The problems were categorized as academic, personal, and social which were perceived by international students. The major academic problems included perceiving lectures, involvement in class modules, or working on oral and written reports. The personal problems included housing, nostalgia, financial independence, groceries. Social problems included adjusting the American customs, making contacts, and acceptance by social groups. ³

During the year 2010, the Australian authorities raised the minimum English language score (IELTS score) to 7 from 6.5. This caused havoc to many sojourners especially the nurses. The nurses, estimated to number of 400, were from India, China, Thailand and Philippines respectively and were faced with deportation from Australia because of the lack of English proficiency. These nurses, individually, had paid AUD 25,000/- to be a registered nurse in Australia but were now faced with no registration and no job.⁴

In a recent research conducted by Expat Forum on behalf of Barclays International Banking regarding challenges faced by sojourners in Australia. The census findings highlightedloneliness (22.41%), cost of living (18.97%), cultural differences (8.62%), relationship problems (6.90%), healthcare (3.45%) and other issues (39.66%) as the major challenges faced by sojourners in Australia. It was found out that Younger generation expatriates had minor problems in learning the local language, but had a harder time making friends and settling in. On the contrary, it was also found that aged expatriates had a harder time learning the local language and had lesser difficulties in arranging for an accomodation.⁵

Proficiency of the English language is a gateway to cultural adjustment. In 2013, the Deccan Herald newspaper reported an incident at Sydney Adventist Hospital in Australia. The Indian male nurse was found guilty of giving dishwashing powder to an elderly patient. The nurse was alleged of giving medication from a bottle that was labeled as heart pills. Later it was found out by the Australian authorities that the bottle contained detergent powder and not heart pills. The nurse’s registration was cancelled by the Australian registration board. The board said the nurse could have confused about the bottle contents due to his poor English proficiency.⁶

A project was initiated by the Prince of Wales hospital to help the overseas nurses during their initial phase of work in Australia. The intention of the project was to help nurses with orientation information. The project included literature review, survey, focus groups interviews, committee-meeting with senior staff, and development of a launch strategy for the new overseas nurses in their hospital. During their survey and committee meetings, it was found out that all overseas nurses faced career and lifestyle difficulties, loneliness and homesickness as a major problem. ⁷

A study investigated the psychological distress among 280 Muslims migrants living in Brisbane, Australia. The Muslim participants were asked to fill questionnaires in English or Arabic language. The study results indicated that participants’ psychological distress was affected by their marital and visa statuses. it was also found that psychological distress was assumed by the perceived difficulties in English language, lack of community support, and inclination to use emotional and avoidance coping.⁸

A study was conducted to find out the similarity and dissimilarities in the cross-cultural adjustment among expatriates. The Q method and interviews were used for the study to assess factors that helped and hindered expatriates during their first year in the country. Q factor analysis identified three types of adjustment patterns among participants. The first type of international students identified their social and communication skills as the most helpful factors, and was more likely to report homesickness. The second group of participants preferred to seek help from their own countrymen when experiencing difficulty, and considered insufficient English skills their biggest barrier. International students in the third type thought that their commitment to study and their immediate family played the most helpful roles, and they reported more financial difficulties. Besides these differences, the three types of international students also encountered similar barriers such as cultural differences, financial difficulty, discrimination, and impractical expectations.⁹

A systematic review of literature was conducted in 2011 to assess the adjustment issues of international students enrolled in American colleges and universities. The review was conducted in three online databases—PsycINFO, ProQuest Education Journals, and ProQuest Psychology Journals. The Search was limited to date range (1991-2010), full text documents, and peer-reviewed journals. The findings of the study indicated that English fluency, social support, length of stay in the U.S., perceived discrimination or prejudice, establishing relationships with Americans, and homesickness were the most significant variables related to the adjustment of international students.¹⁰

The Australian health care follows most of its health care policies and regimens from the UK health care policies. Moreover, over the years the UK trained Indian nurses have been found to be immigrating to Australia due to monetary benefits. A qualitative research was done to understand the experience of overseas nurses during their registration process at UK. A total 20 overseas nurses was interviewed for the study. All participants were from India. All the nurses were registered nurses in India and had clinical experience of 2-14 years in various areas of specialties. From the verbatim of the nurses, theoretical constructs were identified. It also contained the difficulties the overseas nurses experienced inorder to get their registration in the UK. The constructs identified in the study were communication issues, cross-cultural difference, role definition, feelings of self-worth.¹¹

Registered Nurses and Midwives from around the world are facing great difficulty to find job sponsorship in Australia. Nadeine Myer, journalist working for expatriate nurses in Australia, reported an incident of an Indian Registered Nurse who came to Australia to work as an RN with the view to find job sponsorship as soon as she completed her registration. Unfortunately, she soon found out that selected hospitals in Australia were not interested in sponsoring foreign nurses with general clinical experience. After receiving her registration in Queensland, she had only days to find a sponsor before her visa expired. She did acquire any job and had to return to her country, crushed that her dream was now over. ¹²