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

Abstract

Background Poor mental health and illness among the working population have serious socioeconomic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali male returnee-migrants and non-migrant workers, and their perceptions about risk factors for poor health and health service accessibility. Methods This qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions comprising 25 men and a total of 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically. Result Migrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours’ hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers’ poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers’ poor mental health. Conclusion Both migrant and non-migrant workers experienced poor mental and physical health, largely affected by their adverse living and working conditions, unmet familial and financial needs and unhealthy life styles. Greater compliance is needed by employers of work agreements and the promotion of labor rights for worker's health and safety. In addition, policy interventions to raise awareness about occupational health risks and effective safety training for all workers (migrant and non-migrant) are recommended.

Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis

“…Both occupational hazard and poor working environment have increased the vulnerability of migrant workers to poor health outcomes, especially on their mental well-being. Previous research indicated that migrant workers reported experiencing higher mental health problems in comparison to native workers [ 9 – 12 ].…”

Health and social needs of migrant construction workers for big sporting events

“…A meta-analysis found that 47% and 22% of labour migrants globally experienced occupational morbidity and workplace injury or incident, respectively 12. A study of Nepali labour migrants returning from the Gulf and Malaysia concluded that non-compliance with labour agreements, abuse and exploitation by supervisors, lack of privacy, and crowded accommodation made them vulnerable to mental health conditions 13…”

“…Health problems are rooted in the financial, familial, living, and working conditions related to being a temporary labour migrant 1113. Aside from the health of labour migrants themselves, research has shown that the children they leave behind are at risk of depression, suicidal ideation, and anxiety 14…”

“…The International Labour Organization’s labour standards apply to all workers, including labour migrants, with minimum standards on employment, safety, working conditions, social security, and with regards to equality of treatment 1352. Yet international labour standards are guidelines and not obligations unless they are enacted in national law.…”

“…12 A study of Nepali labour migrants returning from the Gulf and Malaysia concluded that non-compliance with labour agreements, abuse and exploitation by supervisors, lack of privacy, and crowded accommodation made them vulnerable to mental health conditions. 13 Health problems are rooted in the financial, familial, living, and working conditions related to being a temporary labour migrant. 11 13 Aside from the health of labour migrants themselves, research has shown that the children they leave behind are at risk of depression, suicidal ideation, and anxiety.…”