Common mental disorders among adult members of ‘left-behind’ international migrant worker families in Sri Lanka

Abstract

BackgroundNearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka.MethodsA cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered.ResultsA total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group.ConclusionsTo our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is highlighted by the considerably high prevalence of CMD among adults in left-behind families. A policy framework that enables health protection whilst promoting migration for development remains a key challenge for labour-sending nations.

The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study

“…Our result on prevalence of mental ill-health risk and depression in migrants' female spouses is in sharp contrast with the preponderance of existing evidence. Other studies usually reported higher mental ill-health risk in female spouses of migrants than ours [9,10]. For example, a Sri Lankan study among 277 spouses of international migrant workers reported prevalence of common mental disorders in 14.4% and depression in 12.3% [9].…”

“…An Indian study concluded that the migration of husbands does not improve the health of the left-behind wives, but instead puts them at a greater risk of reproductive morbidities [8]. In relation to the mental ill-health risk among left-behind female spouses, evidence is stronger towards an increased risk [9,10]. Female spouses of migrant workers may be vulnerable to mental ill-health risk because of the pain of spousal separation and lack of companionship; due to the increased household responsibilities, i.e., undertaking the work, which is mostly done by the husband in a male dominant society; and an increase in daily stressors or being worried about the health and well-being of the migrating husband.…”

The impact of parental labour migration on left‐behind children's educational and psychosocial outcomes: Evidence from Romania

“…Second, within our sample, there was a rather small number of children living in migrant households who reported who is caring for them. Furthermore, no information was available on the well‐being or mental health of the principal caregiver, as well as on the quality and forms of caregiving, variables that were shown to influence left‐behind children's outcomes (Graham et al., ; Lahaie et al., ; Lu et al., ; Siriwardhana et al., ). It was thus not possible to include these information in our analysis.…”

International Migration and Health in the Countries of Origin. The Effect on Households with Migrants and/or Recipients of Remittances, and on Returned Migrants. A Systematic Review

“…Some studies found positive effects; others, negative ones. With regard to child mortality, all the articles found positive effects (3,47,48,49). The opposite occurred with risk factors, the migration of a family member increases the probability that children and/or adolescents smoke (13), consume more alcohol (50).…”