Depressed and Anxious: The mental cost of being left behind

New research on the mental health of family members of migrant workers ‘left behind’ in Sri Lanka has shown the high prevalence of Common Mental Disorders (CMD) in spouses and non-spouse caregivers, reflecting the flagging mental health among these two categories of people as a direct result of the economic choices made by family members.

High prevalence

The research has highlighted ‘considerable high prevalence’ of Common Mental Disorders (CMD) among adults in the left-behind families. These disorders include depression, somatoform disorder and anxiety.

The data also revealed the overall prevalence of CMD to be 20.7%, some 14.4% among spouses of and 29. 8 % among non-spouse caregivers. The prevalence of depression (25.5%) and somatoform disorder (11.7%) was higher among the non-spouse caregiver group.

Significantly, there is high prevalence of CMD, including depression, among the adult left-behind family members population, when compared with the national prevalence levels which stands at CMD (13.8%) and depression (9.1%)

Also, it brought to light that the non-spouse caregiver group in the left-behind families showed ‘more than double the burden of CMD’ and its constituent disorders than the spouse group.

The research also led to the understanding that CMD among the two surveyed categories differed: Among the spouses, CMD was associated with the non-returning of the International Migrant Worker (IWM) in the family, primary education and low in-bound remittance frequency whereas for the non-spouse caregiver category, the reasons were low/no education, poor general health and increased healthcare visits in the absence of the IWM.

Researchers have drawn the conclusion that despite clear monetary benefits to individuals, their families and the country itself, that there is strong evidence to indicate the numerous unfavourable effects of economic migration, including adverse health outcomes for both IWMs and their left behind families. The research stated: “Although several studies have provided insights into the social, legal and economic impacts of economic migration in Sri Lanka, empirical evidence about the true scale of nationwide health impact of economic migration is scarce….. Although sparse, there is some evidence that migration of adult children for economic reasons can negatively affect both mental and physical health of ageing parents, there is no existing studies exploring health status of left-behind spouses or non-spouse caregivers, who play a role in providing care for children and other members of left-behind families.”

Policy framework

The study also highlighted another important aspect – though less researched: the negative impacts of economic migration among the left-behind families.

Statistically, nearly one in ten Sri Lankans employed overseas is international migrant workers (IMW). Sri Lanka is among the eleven labour-sending countries with over 805 of migrant workers employed in the Middle East.

In this backdrop, the researchers have called for a policy framework that enables health protection while identifying the promotion of migration for development for Sri Lanka being replete with challenges to the nation.

Speaking to the Sunday Observer, Foreign Employment promotion and Welfare Minister, Thalatha Athukorala said that there are multiple aspects to labour migration that had not been addressed due to the “natural preoccupation” with labour and safety concerns. “The government is now looking at some of these concerns which had fallen off the table and understanding these issues scientifically helps the process.”

Meanwhile, Viola Perera of the Action Network for Migrant Workers, said that Sri Lanka’s obsession with a few issues concerning migrant workers have remained a problem. “There is so much that falls through the cracks and a national policy on addressing these multiple concerns is indeed a good idea,’ she said.

Sampling and research
Data for the survey has been gathered through a cross-sectional survey of spouses and non-spouse caregivers from families of economic migrants from six districts – (Colombo, Gampaha, Kurunegala, Kandy, Kalutara and Puttalam) – representing 62% of the outbound international migrant worker population of Sri Lanka.
A total of 410 families have responded to the survey, including spouse and non-spouse caregivers in 55 families, totalling 277 spouses and 188 caregivers.
The study was supported by the International Organization of Migration (IOM Sri Lanka) with input from the Ministry of Health and the Intern Ministerial Task Force on Migration Health, led by Chesmal Siriwardhana of the Faculty of Medicine science, Anglia Ruskin University, UK.
The research – the first of its kind in Sri Lanka and titled ‘Common mental disorders among adult members of ‘left behind’ international migrant worker families in Sri Lanka’ explores the mental health concerns of adult members in families left behind and the mental health implications of economic migration in general.

(Originally published in the Sunday Observer, Sri Lanka.)

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