Psychiatric morbidity among housemaids in Kuwait: the precipitating factors

National study comparing psychiatric presentations among migrants and citizens in Qatar

Arab countries host 10 % of the global migrant population, yet research on the mental health of migrant workers within this region is notably lacking. Addressing this gap, our study marks the inaugural nationwide investigation into psychiatric conditions among migrant workers compared to native Qatari citizens in an inpatient setting. Employing a retrospective cohort methodology, we scrutinized psychiatric presentations among two cohorts: migrant workers (cohort 1) and Qatari nationals (cohort 2) admitted to psychiatric inpatient facilities in Qatar. Our sample comprised 150 migrant workers and 138 Qatari inpatients, with a predominance of males in both cohorts and mean ages around 34-35 years. The median length of hospitalization was 13 days for migrant workers and 14 days for Qatari patients. Qatari inpatients exhibited a higher prevalence of prior psychiatric history and comorbid physical conditions. The primary diagnosis upon discharge for approximately one-third of patients in both groups was schizophrenia spectrum and other psychotic disorders, with bipolar disorder representing roughly one-quarter of cases in each cohort. Notably, migrant workers demonstrated a higher incidence of depressive disorders, trauma, and stress-related conditions, while Qatari patients were more frequently diagnosed with substance use disorder and displayed aggressive behaviors.

Psychiatric disorders in inpatient Ethiopian migrant workers in the United Arab Emirates

Migrant workers have higher rates of mental health problems than non-migrant workers, with Ethiopian migrant workers in the United Arab Emirates appearing to be overrepresented in the psychiatric inpatient population compared with their numbers in the general population. We sought to investigate the pattern of psychiatric inpatient admissions in Ethiopian migrant workers over a 10-year period (2011-2020) in order to highlight demographic and clinical characteristics, and to investigate factors predicting the length of hospital stay. We reported the mean and frequency of demographic and clinical data of Ethiopian psychiatric inpatients at one of the largest governmental hospitals in eastern Abu Dhabi between 2011 and 2020, and investigated factors predicting length of stay in hospital using linear regression. Our results show that Ethiopian expatriates made up 7.9% of all admissions over a 10-year period, had a mean length of hospital stay of almost 20 days, with 98.1% of them being female, 92.8% being domestic workers, 90.1% having a language barrier, 57.4% being single and 55.5.% having one or more recent stressors prior to admission. The most common diagnoses were acute stress reaction (31.6%), psychosis (29.3%), bipolar disorder (14.8%) and adjustment disorder (11.0%). Work-related stress, termination of employment and several clinical factors significantly predicted length of stay in hospital.

The mental health needs of immigrant workers in Gulf countries

The oil-rich member states of the Gulf Cooperation Council (GCC) attract large numbers of migrant workers. The reported rates of psychiatric morbidity among these migrant workers are higher than among nationals, while the mental health services in the GCC countries remain inadequate in terms of both staff and service delivery. The multi-ethnic origin of migrants poses considerable challenges in this respect. The development of mental illness in migrants, especially when many of them remain untreated or inadequately treated, results in their premature repatriation, and the mentally ill migrant ends up facing the same economic hardships which led to migration in the first place. The availability of trained interpreters and transcultural psychiatrists, psychologists and social workers should make psychiatric diagnoses more accurate. Suitable rehabilitation services are also needed.

Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa

BACKGROUND

Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa.

METHOD

A cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression.

RESULTS

The prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long term mental illnesses.

CONCLUSIONS

CMD symptoms were found to be prevalent among Ethiopian migrant returnees. As pre-migration factors are associated with CMD symptoms, pre-departure training could be useful to mitigate the risk factors. Creating and routinely arranging mental health interventions and rehabilitation services are advisable for returnees who are screened for, or diagnosed with, mental health problems.

Workplace and security stressors and mental health among migrant workers on the Thailand-Myanmar border

BACKGROUND

Migrant workers in low-resource settings may experience multiple types of workplace and security-related stressors. This study explores the relationship between these stressors and adverse mental health outcomes, through a study of migrant workers from Myanmar, working in agriculture, factory, and sex industries in and around Mae Sot, Thailand.

METHODS

Respondent-driven sampling was used to recruit a total sample of 589 male and female migrants. Trained data collectors administered a survey, which included measures of workplace and security-related stressors, and depression and anxiety symptoms. Multivariate regression models were conducted separately for depression and anxiety symptoms.

RESULTS

For male agricultural workers, security stressors (β = 1.9, p = .001) are associated with an increase in depression symptoms and coercive working conditions are associated with an increase in anxiety symptoms (β = .8, p = .000). For female agricultural workers, daily hassles and stressors were associated with both depression (β = 1.5, p = .000) and anxiety (β = .5, p = .027), and barriers to exit (β = 3.0, p = .005) and security stressors (β = .9, p = .010) were significantly associated with increased depression symptoms. In the factory subsample, sexual assault and abuse (depression: β = 2.7, p = .009; anxiety: β = 2.8, p = .002) and daily hassles and stressors (depression: β = .7, p = .007; anxiety: β = .7, p = .001) were both significantly associated with increased depression and anxiety symptoms for males. Other categories of stressors similarly showed different associations with mental health outcomes between occupational groups, and between male and female migrant workers.

CONCLUSION

The differing influences of stressors on mental health between the three occupational groups, and between males and females, indicate the need for targeted and tailored approaches to reduce specific stressors and improve services to address mental health needs. Prevention and response need to recognize the differences in working conditions, vulnerabilities, and needs between occupational groups, and between male and female migrant workers.

Mental health issues among migrant workers in Gulf Cooperation Council countries: literature review and case illustrations

More than 15 million non-nationals are currently living and working in Gulf Cooperation Council (GCC) states. The majority are blue-collar or domestic workers coming from the Indian Subcontinent or South East Asia. They often work under very harsh conditions. There are reports of a high rate of psychosis and suicide among these people but no reliable data are available. To address this issue we conducted a literature search both in English and in Arabic to review the available articles on the psychological well-being of this population. Very few articles were found. We hereby review the available literature and contribute by presenting several brief vignettes to illustrate the various clinical aspects of this at risk population. We also discuss possible reasons for underreporting and underscore the need for more research in this area.

Migration and mental health: a study of low-income Ethiopian women working in Middle Eastern countries

BACKGROUND

Few studies have explored influences on mental health of migrants moving between non-Western countries.

METHODS

Focus group discussions were used to explore the experiences of Ethiopian female domestic migrants to Middle Eastern countries, comparing those who developed severe mental illness with those remaining mentally well.

DISCUSSION

Prominent self-identified threats to mental health included exploitative treatment, enforced cultural isolation, undermining of cultural identity and disappointment in not achieving expectations. Participants countered these risks by affirming their cultural identity and establishing socio-cultural supports.

CONCLUSIONS

Mental health of migrant domestic workers may be jeopardized by stressors, leading to experience of social defeat.