Background
Context: open border, undocumented migration to India
Migration and mental health
Methods
Data source, study participants and sampling
Data collection
Characteristics | Frequency (%) | Psychological morbidity | p value | ||
---|---|---|---|---|---|
Total¶ | Non-case-ness | Case-ness | |||
n (%) | n (%) | n (%) | |||
Age | < 25 years | 170 (22.7) | 148 (87.06) | 22 (12.94) | < 0.001 |
25–34 years | 310 (41.39) | 283 (91.29) | 27 (8.71) | ||
35–44 years | 190 (25.37) | 164 (86.32) | 26 (13.68) | ||
45 years and above | 79 (10.55) | 53 (67.09) | 26 (32.91) | ||
Gender | Male | 726 (96.67) | 633 (87.19) | 93 (12.81) | < 0.001 |
Female | 25 (3.33) | 17 (68.0) | 8 (32.0) | ||
Marital status | Unmarried | 123 (16.42) | 104 (84.55) | 19 (15.45) | 0.006 |
Married | 613 (81.84) | 538 (87.77) | 75 (12.23) | ||
Others (widow, divorced) | 13 (1.74) | 6 (46.15) | 7 (53.85) | ||
Education | No Schooling | 102 (13.58) | 75 (73.53) | 27 (26.47) | < 0.001 |
Primary and lower (1–5 grades) | 236 (31.42) | 200 (84.75) | 36 (15.25) | ||
Lower Secondary (6–8 grades) | 231 (30.76) | 211 (91.34) | 20 (8.66) | ||
Secondary (9–10 grades) | 138 (18.38) | 123 (89.13) | 15 (10.87) | ||
SLC and Higher | 44 (5.86) | 41 (93.18) | 3 (6.82) | ||
Ethnicity | Brahmin/Chhetri/Thakuri | 345 (46.25) | 315 (91.3) | 30 (8.7) | < 0.001 |
Dalit and Janajatis Hill | 238 (31.9) | 222 (93.28) | 16 (6.72) | ||
Dalit, Janajatis and others Terai | 144 (19.3) | 99 (68.75) | 45 (31.25) | ||
Religious minorities | 19 (2.55) | 12 (63.16) | 7 (36.84) | ||
Occupation | Hotel worker | 209 (28.32) | 191 (91.39) | 18 (8.61) | < 0.001 |
Factory worker | 208 (28.18) | 172 (82.69) | 36 (17.31) | ||
Watchmen | 197 (26.69) | 165 (83.76) | 32 (16.24) | ||
Others¶¶ | 124 (16.8) | 110 (88.71) | 14 (11.29) | ||
Household income (monthly) (in §Nepali Rupee) | < 10,000 NR | 128 (17.2) | 104 (81.25) | 24 (18.75) | 0.035 |
10,000–19,999 NR | 252 (33.87) | 221 (87.7) | 31 (12.3) | ||
20,000–29,999 NR | 235 (31.59) | 215 (91.49) | 20 (8.51) | ||
30,000 NR and more | 129 (17.34) | 105 (81.4) | 24 (18.6) | ||
Salary (monthly) (in Indian Rupee§§) | < 10,000 IR | 202 (27.08) | 166 (82.18) | 36 (17.82) | 0.03 |
10,000–15,000 IR | 469 (62.87) | 411 (87.63) | 58 (12.37) | ||
15,001 IR and more | 75 (10.05) | 70 (93.33) | 5 (6.67) | ||
Was with family¶¶¶ | Yes | 119 (16.35) | 98 (82.35) | 21 (17.65) | 0.15 |
No | 609 (83.65) | 531 (87.19) | 78 (12.81) |
Data analysis
Results
Demographic of sample
Work and health conditions
Characteristics | Frequency (%) | Psychological morbidity | p value | ||
---|---|---|---|---|---|
Total¶ | Non-case-ness | Case-ness | |||
n (%) | n (%) | n (%) | |||
Working hours/day | 8 h and less | 184 (24.5) | 161 (87.5) | 23 (12.5) | 0.66 |
> 8 h | 567 (75.5) | 489 (86.24) | 78 (13.76) | ||
Day off | Yes | 341 (45.96) | 299 (87.68) | 42 (12.32) | 0.39 |
No | 401 (54.04) | 343 (85.54) | 58 (14.46) | ||
Sick leave | Yes | 466 (64.1) | 423 (90.77) | 43 (9.23) | < 0.001 |
No | 261 (35.9) | 211 (80.84) | 50 (19.16) | ||
Duration of last stay in India | < 12 months | 419 (56.47) | 98 (82.35) | 21 (17.65) | 0.28 |
12–23 months | 241 (32.48) | 531 (87.19) | 78 (12.81) | ||
24–35 months | 50 (6.78) | 44 (88.0) | 6 (12.0) | ||
36 months and later | 32 (4.31) | 25 (78.13) | 6 (21.87) | ||
Reason for return | Holiday | 348 (52.02) | 330 (94.83) | 18 (5.17) | < 0.001 |
Personal problems¶¶ | 305 (45.59) | 248 (81.31) | 57 (18.69) | ||
Others (end of contract, political issues) | 16 (2.39) | 11 (68.75) | 5 (31.25) | ||
Going back¶¶¶ | Yes | 607 (81.59) | 540 (83.59) | 67 (11.04) | < 0.001 |
No | 137 (18.41) | 106 (68.37) | 31 (31.63) | ||
Current smoker | Yes | 415 (55.41) | 359 (86.51) | 56 (13.49) | 0.89 |
No | 334 (44.59) | 290 (86.83) | 44 (13.17) | ||
Current alcohol user | Yes | 429 (57.12) | 387 (90.21) | 42 (9.79) | 0.001 |
No | 322 (42.88) | 263 (81.68) | 59 (18.32) | ||
Smoke marijuana | Yes | 32 (4.27) | 25 (78.13) | 7 (21.88) | 0.15 |
No | 718 (95.73) | 624 (86.91) | 94 (13.09) | ||
Sex in last 6 months | Yes | 502 (67.20) | 452 (90.04) | 50 (9.96) | < 0.001 |
No | 245 (32.80) | 194 (79.18) | 51 (20.82) | ||
Existing health problem§ | Yes | 114 (15.36) | 76 (66.67) | 38 (33.33) | < 0.001 |
No | 628 (84.64) | 566 (90.13) | 62 (9.87) | ||
Accessing healthcare | Difficult to access | 197 (28.84) | 153 (77.66) | 44 (22.34) | < 0.001 |
Easy to access | 486 (71.16) | 446 (91.77) | 40 (8.23) | ||
Health expense coverage | Completely by employer | 54 (11.04) | 46 (85.19) | 8 (14.81) | 0.02 |
Partially by employer | 60 (12.27) | 57 (95.0%) | 3 (5.0%) | ||
Completely by myself | 375 (76.69) | 302 (80.53) | 73 (19.47%) | ||
Healthcare expense | Easy to manage | 313 (42.07) | 288 (92.01) | 25 (7.99) | < 0.001 |
Somehow manageable | 311 (41.8) | 269 (86.5) | 42 (13.5) | ||
Very difficult to manage | 120 (16.13) | 87 (72.5) | 33 (27.5) |
Factors associated with psychological morbidity
Characteristics | Prevalence ratio | ||
---|---|---|---|
uPR (CI) | aPR (CI) | ||
Age | < 25 years | Reference | |
25–34 years | 0.67 (0.38–1.18) | 0.71 (0.29–1.72) | |
35–44 years | 1.06 (0.58–1.87) | 0.82 (0.31–2.19) | |
45 years and above | 2.54 (1.44–4.49)** | 2.74 (1.01–7.41)* | |
Gender | Male | Reference | |
Female | 2.5 (1.21–5.14)*** | 0.77 (0.19–3.12) | |
Marital status | Unmarried | Reference | |
Married | 0.79 (0.49–1.31) | 0.69 (0.28–1.66) | |
Others (widow, divorced) | 3.48 (1.46–8.29)** | 1.16 (0.14–9.9) | |
Education | No Schooling | Reference | |
Primary | 0.58 (0.35–0.95)* | 1.62 (0.72–3.65) | |
Lower Secondary | 0.33 (0.18–0.58)*** | 0.72 (0.26–1.98) | |
Secondary | 0.41 (0.22–0.77)** | 1.2 (0.41–3.55) | |
SLC and Higher | 0.25 ((0.08–0.85)* | 1.0 (0.18–5.76) | |
Ethnicity | Brahmin/Chhetri/Thakuri | Reference | |
Dalit and Janajatis Hill | 0.77 (0.42–1.42) | 0.45 (0.19–1.06) | |
Dalit, Janajatis and others Terai | 3.6 (2.26–5.7)*** | 3.29 (1.6–6.74)** | |
Religious minorities | 4.24 (1.86–9.65)** | 3.64 (1.02–13.14)* | |
Occupation | Hotel worker | Reference | |
Factory worker | 2.0 (1.14–3.54) * | 1.12 (0.46–3.03) | |
Watchmen | 1.89 (1.06–3.36)* | 1.35 (0.54–3.42) | |
Others¶ | 1.31 (0.65–2.64) | 1.65 (0.62–4.42) | |
¶¶Salary/month | < 10,000 INR | Reference | |
10,000–15,000 IR | 0.69 (0.44–1.07) | 0.88 (0.46–1.66) | |
15,001 IR and more | 0.37 (0.14–0.95)* | 0.41 (0.14–1.19) | |
Sick leave | Yes | Reference | |
No | 2.08 (1–38-3.12)*** | 2.4 (1.32–4.34)** | |
Reason for return | Holiday | Reference | |
Personal problems¶¶¶ | 3.61 (2.13–6.14)*** | 1.96 (1.01–3.83)* | |
Others (end of contract, political issues) | 6.04 (2.24–16.27)*** | 4.06 (1.08–15.28)* | |
Going back§ | Yes | Reference | |
No | 2.05 (1–34-3.14)* | 1.23 (0.67–2.25) | |
Existing health problem§§ | Yes | Reference | |
No | 0.3 (0.2–0.44)*** | 0.50 (0.28–0.93)* | |
Current alcohol user | Yes | Reference | |
No | 1.87 (1.26–2.78)*** | 0.99 (0.53–1.84) | |
Sex in last 6 months | Yes | Reference | |
No | 2.08 (1.41–3.08)*** | 1.21 (0.62–2.37) | |
Accessing healthcare | Difficult to access | Reference | |
Easy to access | 0.37 (0.24–0.57)*** | 0.53 (0.3–0.93)* |