Background:
International students in the U.S. often face heightened psychological distress due to academic pressure, cultural adjustment, discrimination, and social isolation. Despite this, many students often underutilize traditional mental health services due to stigma or unfamiliarity with Western models of care. Self-Help Plus (SH+), a scalable, low-intensity intervention developed by the World Health Organization, offers a promising model for reaching underserved populations, but it had yet to be adapted for the digitally connected student populations in high-income settings.


Objective:
This formative study aimed to adapt SH+ into an accessible, animated video format tailored for international students at a U.S. university and to assess its feasibility, cultural acceptability, and perceived usefulness.


Methods:
Following the Mental Health Cultural Adaptation and Contextualization for Implementation (mhCACI) framework, we implemented a five-phase adaptation process that included expert consultation, script editing, audio-visual prototyping, and feedback from international students and key stakeholders. Data were collected through 7 focus group discussions (FGDs), 3 key informant interviews (KIIs), and pre/post survey data following a 3-hour pilot screening event (N = 16). Thematic analysis was used for qualitative data, and descriptive statistics were applied to assess acceptability and usability.


Results:
Students found the digital intervention to be engaging and relatable. Themes included: (1) the importance of community-based delivery, (2) relevance of psychoeducation on stress and unhooking, and (3) preferences for shorter video formats. Participants also reported increased awareness of coping tools and greater openness to mental health discussions.


Conclusion:
This study demonstrates the feasibility of culturally and contextually adapting SH+ into an engaging digital format for international students in higher education. The findings support the feasibility of the integration of scalable digital mental health interventions into university well-being ecosystems. They also contribute to global efforts in task-shifting mental health support through technology.