Migration and Mental Health in Low- and Middle-Income Countries: A Systematic Review

Abstract

Objective: Rural-to-urban migration within low- and middle-income countries (LMICs), and migration from one LMIC to another, are prevalent forms of international migration. Migration may be associated with adverse mental health outcomes. The aim of the current study is to systematically review the literature on migration and mental health between and within LMICs. Methods: This systematic review of PubMed, PsycINFO, Embase, Web of Science, and PILOTS, identified 2,818 total records published between 1991 and 2016, with 139 of these assessed for eligibility. Two authors reviewed full text to assess if they met inclusion criteria, extracted data, and applied a quality assessment to all included studies. Results: The search identified 37 articles that met the inclusion criteria, based on 28 separate studies. All studies apart from one were cross-sectional studies, and studies utilized a range of sampling methods. In all, 19 of these studies were conducted in China. Studies addressed a range of mental health outcomes, and variation in prevalence was reported. Research questions addressed determinants of mental health outcomes, including analysis of risk and protective factors, such as social, cultural, and economic determinants; migration-related risk factors; and substance use. Conclusions: Limitations in study design and methodological rigor of studies indicate a limited evidence base concerning migration and mental health in LMICs. Expansion of research to different regions, utilization of adapted and validated measurement instruments, and longitudinal research could significantly strengthen the evidence base.