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.
Highlights
3.5 million Nepali are working abroad, primarily in Malaysia, the Gulf Cooperation Council (GCC) and India [1] and most are involved in high-risk unskilled jobs, men mainly on building sites, in factories and women mainly in domestic work
Mental health has attracted much attention globally following a strong statement of the World Health Organization (WHO) in 2005: “There is no health without mental health” [6]
focus group discussions (FGD) and interviews were facilitated by an experienced qualitative researcher
Summary
3.5 million Nepali are working abroad, primarily in Malaysia, the Gulf Cooperation Council (GCC) and India [1] and most are involved in high-risk unskilled jobs, men mainly on building sites, in factories and women mainly in domestic work. International migration is a livelihood strategy for many Nepali workers who send over US$6 billion back home every year, comprising 26.3% of Nepal’s gross domestic product (GDP) [2]. This income is often generated at a great personal cost to the workers. Studies have documented factors that trigger poor mental health among migrants. Migrants in Canada highlighted that racial discrimination is one of the important mental health risk factor for many immigrants [8,9,10,11], whilst immigrants in US experienced stress, sadness and anxiety [12]. Studies among labourers from GCC document evidence that migrant workers are at higher risk of depression, anxiety and suicidal ideation [13,14,15]
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