Nepali Migrant Workers and the Need for Pre-departure Training on Mental Health: A Qualitative Study

Abstract

Every year around 1000 Nepali migrant workers die abroad. Every one in three females and one in ten males commit suicide, reflecting a high mental health risk among Nepali migrant workers. This study aims to identify triggers of mental ill-health among Nepali migrant workers and their perceptions on the need of mental health components in the pre-departure orientation programme. We conducted five focus group discussions (FGD) and seven in-depth interviews with Nepali migrant workers and eight semi-structured interviews with stakeholders working for migrants. Participants were invited at Kathmandu's international airport on return from abroad, at hotels or bus stations near the airport, through organisations working for migrants, and participants' network. All FGD and interviews were conducted in Kathmandu and audio recorded, transcribed and translated into English. Data were analyzed thematically. High expectations from families back home, an unfair treatment at work, poor arrangements of accommodation, loneliness and poor social life abroad were frequently reported factors for poor mental health. Access to mental health services abroad by Nepali migrant was also poor. We found little on mental health in the pre-departure orientation. We need to improve our knowledge of mental health risks to provide better, more focused and more up-to-date pre-departure training to new migrant workers leaving Nepal.

Perceived mental health, wellbeing and associated factors among Nepali migrant and non-migrant workers: A qualitative study

“…Consistent with the findings from previous studies [24,25], this study also found that mental health problems among migrant workers persist as a result of poor living and work environments. On many occasions, migrants’ experienced their psychosocial health threatened due to communication barriers, abuse and exploitation by supervisors.…”

Health and well-being issues of Nepalese migrant workers in the Gulf Cooperation Council countries and Malaysia: a systematic review

“… 21 One study analysed Nepalese government’s report and looked at 1354 deaths in Nepalese migrant workers, of which 8.5% were due to suicide. 35 The fifth quality qualitative study reported various mental health problems among the workers including loneliness, social isolation, tensions, anxiety, attempt to suicide 38 ( table 1 ).…”

“… 7 The fourth study reported that only insurance 68% of the workers had health insurance abroad and only 20% underwent regular health check-up. 37 In the qualitative study, participants reported poor access to mental health services related, mainly related to communication problems, and stigma to mental health 38 ( table 1 ).…”

“…Adhikary et al 33 reported that almost a quarter of labour migrants to Malaysia, Qatar and Saudi Arabia had experienced mental health issues, with a strong positive correlation between perceived health risk in the work environment and mental health status. The qualitative study by Regmi et al 38 highlighted various mental health problems among the workers including loneliness, anxiety and attempt to suicide. Similar findings were reported in a cross-sectional study of 5000 migrant workers in Shanghai, where 21% reported mental disorders such as obsessive-compulsive disorder, anxiety, and hostility.…”

Perceived Risk Factors for Suicide among Nepalese Migrant Workers in South Korea

“…Understanding the suicide risk among migrants is complex, as suicidal ideation and/or suicide attempts are influenced by a myriad of socio-cultural and economic factors in both the country of origin and destination, including demographic factors such as age and gender and mental health problems including depression, anxiety, and hopelessness [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Migrant workers as a vulnerable group also experience social exclusion and mental health issues in host countries, which further lead to higher risk for suicide ideation and attempt [ 12 , 15 ].…”