Nepali Migrant Workers and the Need for Pre-departure Training on Mental Health: A Qualitative Study

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ORIGINAL PAPER

Nepali Migrant Workers and the Need for Pre‑departure Training on Mental Health: A Qualitative Study Pramod R. Regmi1   · Nirmal Aryal1 · Edwin van Teijlingen1 · Padam Simkhada2 · Pratik Adhikary3

© The Author(s) 2019

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. Keywords  Labour migrant · Mental health · Pre-departure · South Asia · Screening

Introduction Approximately 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. Currently, 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]. However, this income is often generated at a great personal cost to the workers. The literature highlights several health issues of migrants in GCC and Malaysia, such as accidents and * Pramod R. Regmi [email protected] 1



Faculty of Health and Social Sciences, Bournemouth University, Bournemouth House (B220), Bournemouth BH1 3LH, UK

2



School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK

3

Research Unit, Green Tara Trust, Kathmandu, Nepal



injuries due to poor health and safety at work [3–5]. The Foreign Employment Board (FEB) of Nepal reports around 1000 deaths of Nepali migrant workers in the GCC and Malaysia every year and of these around 1 in 10 deaths in males and 1 in 3 deaths in females are due to suicide [1]. Mental health has attracted much attention globally following a strong s