Psychiatric symptoms among migrants to Malaysia from the southernmost provinces of Thailand

Abstract

Aim:

The objective of this paper is to examine the level of psychiatric symptoms and associated factors among Thai migrants from the southernmost Thai provinces of Pattani, Yala, and Narithiwat who are working in Malaysia. Comparisons will be made with the sending population in the southernmost provinces of Thailand.

Methods:

Data are drawn from survey and in-depth interviews with Thai migrants who are working in Malaysia. Comparisons are made with a probability sample of working age adults in Thailand. The twenty item Self Reporting Questionnaire (SRQ) was the measure of mental health.

Results:

The study found that the migrants, on average, have normal levels of psychiatric symptoms. However, although about 24% of migrants reported more eight or more symptoms that may indicate a need for evaluation. There are many stressors in their lives including distance from families, reduced social support, legal matters surrounding immigration, and discrimination/exploitation of migrant groups.

Conclusion:

The study highlights the need for policy makers and non-governmental organizations to give attention to migrants’ mental health, well-being and sustainable livelihoods.

Keywords

Migrant southeast Asia anxiety depression conflict

Introduction

Migration for work from the southernmost provinces of Thailand (Pattani, Yala, and Narithiwat) to Malaysia has been ongoing for many years. A continuing civil conflict (Chalk, 2008) has accelerated migration from these provinces to Malaysia (Jampaklay et al., 2020). The objective of this paper is to examine measures of mental health as well as factors related to mental health of Thai migrants working in Malaysia. Comparisons will be made with the sending population in the southernmost provinces of Thailand.

Previous research on migration and mental health of migrants has produced both negative and positive results. On the negative side, some studies have reported an increased incidence of common mental disorders including anxiety and depression (Bhugra, 2004; Lu, 2010). A longitudinal study of migrants in Indonesia found that migration imposes considerable costs on migrants (Lu, 2010). Female migrants in this Indonesian study internalized their stress and become depressed while males increased their smoking. Furthermore, Thai migrants in Australia reported feelings of sadness and a lack of social support due to limited connections with family and friends (Jirojwong and Manderson, 2001).

On the other hand, studies have also reported positive mental health outcomes after migration. Li et al. (2007) reported that rural-urban migrants in China were not especially vulnerable to poor mental health. They suggested that the improved mental health of these migrant may be due to improved economic well-being. A rural to urban study of migration in Thailand also found that for migrants who stay at least 2 years, mental health was better after migration, compared to before migration (Nauman et al., 2015). Factors that may increase the resilience of migrants include premigration preparation, social support, comfort in the new culture, and religion, including religious rituals Bhugra, 2004).

Study setting—Civil conflict in Thailand’s southernmost provinces

The southernmost provinces of Pattani, Narathiwat and Yala became part of Thailand in the 19th century (Chalk, 2008; Croissant, 2005). Since this time, there has been tension between the provinces and the Thai government over authority, assimilation to the Thai Buddhist culture, and other issues (UNICEF East Asia and Pacific Regional Office, 2014). In the years since 2004, the area experienced more than 7,000 deaths due to the conflict (Parameswaran, 2020). Most of the deaths were to civilians (Maximillian, 2018). Consequently, residents from the southernmost provinces may migrate to Malaysia for increased income, but also to get away from the insurgency. This insurgency has accelerated migration to Malaysia (Jampaklay et al., 2020).

Migrants from the southernmost provinces to Malaysia may experience mental health issues due to their experience with the conflict. Exposure to violent events has been found to increase traumatic stress disorder (PTSD) as well as depression and other mental health disorders (Ford et al., 2019; Jewkes et al., 2017; Miller and Rasmussen, 2010). Previous research has found an increased reporting of psychiatric symptoms associated with the unrest among working age Muslim adults in the southern provinces (Ford et al., 2017, 2019). This study examines the presence of psychiatric symptoms among the migrants from this area to Malaysia. Comparisons will be made between the migrant and the resident working age adults in the southern provinces. Like the residents, the migrants have experienced a period of unrest that may have increased their psychiatric symptoms. However, the migrants may receive benefits that could improve their mental health including earning higher wages and being away from the violence. Muslim residents of the southern provinces share the Muslim religion and a similar language with a large part of the Malaysian population. This shared religion and language with Malaysians may support their mental health compared to the stresses of migration to other areas. In contrast, they may experience reduced social support, concern about family members in Thailand, discrimination due to being a Thai in Malaysia, and issues related to their legal status. The adverse effect on mental health may also be due to pressure to move from the unrest and the belief that moving to Malaysia is their only option.

Methods

Data

The data on migrants were drawn for survey and in-depth interviews with migrants and a household survey in the southernmost Thai provinces. All protocols were reviewed and approved by a human subjects committee of Mahidol University.

Migrant survey and in-depth interviews

Migrant sample

The migrant sample for the survey interviews was constructed in two phases. First, Muslim households in the southernmost provinces who were interviewed in the 2016 round of the longitudinal study described below were contacted and asked to provide a way to contact migrants to Malaysia. This method resulted in about 25 interviews. These migrants were interviewed by phone or on visits to their Thai homes in the southernmost provinces. Some migrants were not able to participate because of unreachable phone numbers or because they were no longer working in Malaysia. Some also worked in distant or remote areas. Consequently, the interviewers then traveled to a Malay enclave in central Kuala Lumpur, Kampung Baru, and a nearby market area, Chow Kit. Migrants working in Thai restaurants and the Chow Kit market were interviewed. The interviewers introduced themselves to the restaurant and market owners and workers, sometimes ordering food. They also asked migrants who participated for referrals to their friends. Respondents for the in-depth interviews were selected from the same areas. The demographics of the survey respondents are shown in Table 2. The demographic characteristics of the respondents who participated in in-depth interviews are shown in Table 1.

Table 1.

Participants in in-depth interviews.

Number	Age	Gender	Occupation
1	32	male	Restaurant owner
2	31	male	Store owner frozen food
3	49	female	Restaurant owner
4	45	female	Butcher stall owner in market
5	48	male	Restaurant owner
6	39	male	Owner clothing store and restaurant
7	56	male	Restaurant cook
8	26	male	Order taker at restaurant
9	57	male	Restaurant cook
10	29	male	Marker seller, employee
11	52	female	Restaurant cook

Table 2.

Demographic characteristics of Thai Malaysian migrants and residents of the southern provinces.

	Resident sample (2016)	Migrant sample (2018–2019)
Age mean (SD)	42.3 (11.5)	Mean 28.2 (8.5)
15–24	8.1%	38.8%
25–34	23.9%	43.7%
35 or more	67.9%	17.5%
Gender
Male	49%	57%
Female	51%	43%
Marital status
Single	8.9%	39%
Married (spouse present)	79.7%	39%
Married (spouse absent)	4.1%	10%
Separated, Widowed, Divorced	7.3%	13%
Level of secular education completed
0 None	27.65%	4%
1 Primary	29.13%	19%
2 Lower secondary	14.41%	73%
3 Upper secondary	15.53%	3%
4 University	13.16%	1%
Strictness of religious practice
Very strictly	21.0%	16%
Fairly strictly	72.7%	74%
Not very strictly	6.0%	10%
I don’t care	0.2%	0%

Southernmost provinces survey

Data for the southern provinces are from the second round of a two round probability sample of Muslim households in the southernmost Thai provinces of Pattani, Narathiwat and Yala (Ford et al., 2019). In each household, the head was interviewed and a woman and a man age 18 to 59 were selected randomly for individual interviews. In 2016, 85% of the households were re-interviewed including 1,746 men and women of working age.

Measurement of variables

Self-Reporting Questionnaire (SRQ)

A first measure of mental health, the SRQ, was developed by the World Health Association (WHO) to screen for psychiatric disturbances. Data on evaluation of the measure can be found in the WHO guide (World Health Organization [WHO], 1994). This 20-item measure has been used in many international studies, including Thailand (Ford et al., 2017; Jampaklay et al., 2012). The questionnaire measures the domains of anxiety and depression as well as somatic symptoms. Item responses were binary (1 = yes, 0 = no) and cover a 30-day recall period. The items were summed to create a total score (theoretical range 0–20). The alpha coefficient of the SRQ for the migrant sample was 0.79. The SRQ was included in the migrant survey as well as the 2016 survey of adult residents in the three southernmost provinces.

Exposure variables

Migrant demographics, religious practices and other experiences

Age was measured in single years.

Education was measured in five groups: none (0), primary (1), lower secondary (2), upper secondary (3), and (4) university.

Gender was coded as male or female.

Number of children was coded as the total number of children.

Time in Malaysia was coded in months.

Strictness of religious practice was measured by the question ‘How strictly do you practice Islam in your daily life?’ with responses (1) I don’t care, (2) not very strictly, (3) fairly strictly, and (4) very strictly.

Celebrate Eidul Fitri was coded as (1) celebrate and (0) do not celebrate. Eidul Fitri is a religious holiday that brates the end of the month-long Ramadan fasting period.

Job harms health. The migrants were asked if their job harms their health. Responses were (1) no, not at all, (2) yes

cele, a little bit, (3) yes, some, (4) yes, much, and (5) yes, very much.

Discrimination or exploitation was measured by a series of questions about whether the migrant (1) witnessed or experienced physical, verbal, sexual or other abuse of migrant workers, witnessed or experienced discrimination related to employment, group segregation, or public discrimination (refused services), or (3) exploitation due to receiving reduced or delayed payment for work, or rights and freedom at work (documents kept by employer, being forced to work, threats to report the migrant to authorities).

Fair treatment of workers

The migrants were asked ‘Do you think that you are treated fairly at work?’ Responses were (1) not at all, (2) a little, (3) somewhat, (4) much, and (5) very much. The migrants were also asked ‘Do you think that migrants from other countries are treated fairly at work?’ Responses were (1) not at all, (2) a little, (3) somewhat, (4) much, and (5) very much.

Migrant concerns

The respondents were asked about concerns that they have about living in Malaysia with regards to a number of factors. Responses were coded as (1) not at all, (2) a little, (3) somewhat, (4) much, and (5) very much. The respondents were also asked which item they were most concerned about.

Statistical methods

Chi-square was used to test the difference between groups when using proportions. Analysis of variance was used to test the differences between groups when using continuous variables. Tests for significance between the migrants’ survey and the 2016 southern provinces survey include difference of proportions and difference of means. Regression and multiple regression were used to assess relationships between the SRQ score and the exposure variables. The multivariate models adjusted for age, gender, and education.

Results

Demographic factors

Table 2 shows demographic variables for the migrant and the southern provinces samples. Respondents in the migrant sample (mean age 28.2 years) were quite a bit younger on average than those in the southern provinces (mean age 42.3 years). Males outnumbered females in the migrant sample. Migrants were less likely to be married that residents. Most migrants had obtained a lower secondary education, while residents included many persons with lower and higher education. Most persons in both samples reported strict or very strict religious practice.

Self-reporting questionnaire (SRQ)

The mean SRQ score for the migrant sample was 4.9 (Table 3). In some studies, a cut off score of 8 or more ‘Yes’ answers to the 20 questions has been used to identify persons in need of evaluation. Among the Malaysian migrants, about 24% reported eight or more symptoms. Gender differences were not significant.

Table 3.

SRQ (Self reporting questionnaire) scores for migrants and residents of southern provinces.

Sum SRQ	Total	Female	Male
Thai migrants in Malaysia
SRQ mean	4.9 (3.6)	5.4 (3.9)	4.5 (3.4)
N	103	44	59
% 8 or more symptoms	24.30	29.50	20.30
Age group
17–24 mean SRQ	5.1 (3.2)	6.9 (2.9)	4.1 (3.0)
N	40	14	26
25–34 mean SRQ	4.5 (3.4)	4.6 (3.9)	4.5 (3.0)
N	45	23	22
35 or more	5.5 (4.9)	5.1 (5.2)	5.7 (4.9)
N	18	7	11
Adults in southernmost provinces 2016
SRQ mean	3.1 (3.0)	2.6 (2.8)	3.6 (3.4)
N	1,526	769	757
% 8 or more symptoms	8.90	11.50	6.40
Age group
18–24 mean SRQ	2.4 (3.3)	2.3 (3.4)	2.4 (3.1)
N	75	39	36
25–34 mean SRQ	3.0 (3.0)	2.4 (140)	3.3 (3.2)
N	326	140	186
35 or more	3.2 (3.1)	2.7 (2.8)	3.7 (3.4)
N	1,125	590	535

The SRQ was also included in our recent 2016 survey of adult resident in the three southernmost provinces. The mean score (3.1) and the percent reporting 8 or more symptoms (9%) were lower in the resident population of the southern provinces compared to the migrants (p < .01). The migrant population is younger than the resident population, though the scores for age groups also show higher scores for the migrants compared to the residents.

Table 4 shows the association of the SRQ score of the migrant sample with a number of exposure variables and migrant concerns. The exposure variables were selected to include demographic variables as well as other common experiences of migrants. Age, gender and education were not significantly associated with the SRQ score. The number of children that the migrant reported was related to an increase in the SRQ score (p < .01). While the number of months in Malaysia and strictness of religious practice were not significant factors, the celebration of Eidul Fitri was negatively related to the SRQ score (p < .05). If the migrant reported having witnessed or experienced abuse of, exploitation of, or discrimination against migrants, the SRQ score increased substantially (p < .01). The migrants were also asked if the Thai and other migrants are treated fairly at work. Most migrants reported that the Thai migrants were treated fairly, though they viewed other migrants as being treated less fairly. This variable was associated with greater reporting of psychiatric symptoms scores. Thai migrants who viewed other migrants as being treated fairly had lower SRQ scores. (p < .01).

Table 4.

Association of study variables with total SRQ score among migrants in Malaysia.

	Mean (SD)	Binary regression coefficient (SE)	Multivariate regression coefficient (SE)^a
Age (years)	31.50 (1.12)	0.07 (0.04)	–
Gender			–
Female	42.72%
Male	57.28%	0.72 (1.2)
Education (Range 0–4)	1.71 (0.08)	–0.45 (0.59)	–
Number of children	1.78 (0.20)	1.04 (0.29)**	1.24 (0.49)**
Time in Malaysia (months)	47.74 (5.59)	0.00 (0.01)	–0.00 (0.01)
Strictness of religious practice (Range 1–4)	3.07 (0.05)	0.96 (0.70)	0.87 (0.71)
Celebrate Eidul Fitri	23.30%	–1.84 (0.83)*	–2.18 (0.84)**
Experienced discrimination or exploitation	22.33%	2.85 (0.82)**	2.74 (0.84)**
Job harms your health (Range 1–5)	1.92 (0.10)	0.58 (0.35)	0.50 (0.36)
You are treated fairly at work (Range 1–5)	4.05 (0.11)	–0.49 (0.34)	–0.55 (0.34)
Migrants from other countries are treated fairly at work (Range 1–5)	2.77 (0.06)	–0.79 (0.33)*	–0.84 (0.34)**
N	103

Adjusted for age, gender and education.

p < .05. **p < .01.

The migrants were asked about a number of areas that they might be concerned about (Table 5). A low score indicates that the area was not a concern. Several areas of concern have means of three or more. These included the family in Thailand (3.9), being homesick (3.6), and the economy in Thailand (3.4). Areas of concern with means between 2.0 and 2.9 included future life (2.9), the unrest in Thailand (2.5), being unemployed (2.5), health (2.3), lack of free time (2.2), and child education (2.1), and the family in Malaysia (2). Areas with relative low average levels of concern were adapting to Malay culture (1.8), place of living (1.6), difficulty in Malay language (1.6), relation to people in the community (1.6), relationship with coworkers (1.5), and food (1.3). Gender differences were not significant. When asked about the most important factors of concern, the top three factors were the unrest in Thailand (mentioned by 32 migrants), child education (mentioned by 25 migrants), and the economy in Thailand (also mentioned by 25 migrants). Areas of concern related to a significantly higher SRQ score were child education, the economy in Thailand, the migrant’s health, the family left behind in Thailand, homesickness, being unemployed, and relationships with coworkers. The significance of the bivariate and multivariate coefficients was consistent except for food.

Table 5.

Association of migrant concerns with SRQ score.

Migrant concerns	Mean (SD)	Binary regression coefficient (SE)	Multivariate regression coefficient (SE)^a
Child education	2.11 (0.16)	0.73 (0.21)**	0.74 (0.27)**
Unrest in Thailand	2.48 (0.12)	0.53 (0.30)	0.54 (0.32)
Economy in Thailand	3.37 (0.13)	0.58 (0.28)*	0.56 (0.29)*
Health of yourself	2.31 (0.12)	0.90 (0.29)**	0.83 (0.30)**
Family in Thailand	1.94 (0.12)	0.69 (0.29)*	0.76 (0.30)*
Difficulty with Malaysian Language	4.01 (0.11)	0.60 (0.39)	0.71 (0.40)
Future life	3.01 (0.14)	0.13 (0.26)	0.18 (0.26)
Homesick	3.64 (0.14)	0.85 (0.25)**	0.83 (0.25)**
Lack of free time	2.24 (0.11)	0.47 (0.32)	0.59 (0.32)
Being unemployed	2.51 (0.14)	0.69 (0.25)**	0.69 (0.25)**
Place of living	1.65 (0.11)	0.59 (0.32)	0.59 (0.32)
Difficulty in adapting to Malay customs	1.81 (0.09)	0.33 (0.39)	0.53 (0.40)
Food	1.29 (0.07)	0.99 (0.51)	1.02 (0.51)*
Relationship with people inThe community	1.62 (0.09)	0.58 (0.42)	0.68 (0.42)
Relationship with coworkers	1.56 (0.10)	1.12 (0.36)**	1.11 (0.36)**
N	103	103

Adjusted for age, gender and education.

p < .05. **p < .01.

In depth interviews – major areas of concern of migrants

The in-depth interviews were reviewed to try to identify sources of anxiety and depression for the migrants. Several areas provided some insight into these matters including family issues, attitudes of Malaysians toward migrants, immigration status, and suspicion of association with the insurgency in Thailand.

Concerns about family at home in the southern provinces of Thailand

The migrants had many concerns about the family back in Thailand. When migrants are far from home, they are unable to provide or receive some forms of support to children and to older family members. If the migrants had left children behind, they were concerned about their secular and religious education. Migrants wanted children to read the Koran while they were away. The health of family members in Thailand was also a concern, particularly concern for elderly family members. A migrant expressed also concern that elderly family members might pass away while they are in Malaysia and he would not be able to comfort them.

I’m worried that my children won’t read the Qur’an. Because if something happens to me, if my children can’t read the Qur’an, who will be sending me to god? I am very worried about this. (male, 56, cook)

I’m worried that my parents may pass away and I couldn’t reach them to take care and encourage them on time for the last time. If that really happens I would be very sad. (male, 26, order taker)

I’m worried about health of my family members. (male, age 29, market seller))

I worry about getting sick because I don’t have children. I’m afraid that I will be a liability for others. (female, 52, cook)

The only thought is I have to be able to support my children to study as high as one mother can provide. (female, 45, market stall owner)

Attitudes of Malaysians toward migrants

The migrants reported both positive and negative comments about the attitudes of Malaysians toward migrants. The Malaysians may view the Thai migrants from the southernmost provinces as being close to them because they share a similar language and the Muslim religion. On the other hand, some reported that Malaysians looked down on them. In Malaysia, the Thai migrants were often the preferred employees, compared to those from Indonesia and Bangladesh. The Thai migrants reported that migrants were from other more often treated badly than the Thais and were limited to less desirable types of jobs.

Malaysian people look down on us. It’s the same as Thai people that look down on Burmese people. Malaysian people look at us like that. (female, 49, restaurant owner)

my direct experience showed that Malaysian people will look down on us a little bit. Because at first, we came here as laborers. And I don't like it when the Malay people call me Siam, I will answer that I am Islam, a Melayu. (male, 48, restaurant owner)

No, I’ve never been belittled. Because we’ll all Melayu people after all. Even though I’m a Thai by nationality, I am Melayu. But we must not behave to make them look down on us. Because we’ve come to live here. We have to respect them so that we can live here. It’s when Malays come to our country, they have to respect us as well. It’s the same. (male, 39, clothing store, restaurant owner)

If the employer chooses between Thai and Indonesians, the employee would definitely choose Thai employees. For Indonesians, they can only wash the dishes. They are strictly not preferred to be working in the restaurant. (male, 56, cook)

Malaysians are likely to look down on Bangladeshis more than Thais. Because we’re just like them. Both language and religion. (7) I feel like I’m superior to Indonesians in terms of work position. Indonesians who are employees are envious people. Their position is dish cleaning. But our position is much easier. . . There are Malaysians who speak badly to Indonesians because Malaysians think that Indonesians are like slaves. . . But I noticed that if Thai people are arrested, they wouldn’t do anything much to us. But with Indonesians, Bangladeshis, or Burmans, they will manage them harshly. They’ll use meaner words. There are some words that I can’t even bare. Belittled and insulted. But with the three-province people, it’s not like that. I think that might understand us. (male, 26, order taker).

Migrant legal status

Most Thai migrants working in the restaurant industry in Malaysia do not have legal documents. Obtaining a work permit can be an expensive and lengthy process. Each month, the migrants travel to the Thai border and have their passports stamped for 1 month of entry that is legal for entering into Malaysia, but not for work in Malaysia. Consequently, the threat of arrest is present for many migrants.

My experience was about the time I was arrested and put in jail. Because I was arrested for having the invalid type of passport. My passport hadn’t expired but it is only for travel purposes. It can’t be used for working in Malaysia. I was in jail for about 1 month. And my employer bailed me but my feeling when I was in jail was like falling from a coconut tree. It was like I can’t even move my body. I felt like not having any encouragement to live. (male, 26, order taker)

I’m afraid that when the police come check and arrest me. Because there were many incidents that the police searched the place and arrested many people. But fortunately, I escaped in time. Because I have a motorcycle. And for those who couldn’t escape, they will be prosecuted. (male, 29, market seller)

The first time I came here I was arrested by the police because my passport expired. I did not renew it. I did not go through immigration. It was my intention not to go through immigration. So, the police came searching the shop and arrested me. I was in the prison for about 1 month. The prison was very cramped. Crowded with around 50 people in there. My feeling at that time was very sad and I was really down. (male, 32, restaurant owner)

I don’t want them (my family) to come (to join me in Malaysia). Because it’s difficult here. Passports need to be stamped every month. Have to travel all the time. And we’re worried about getting arrested too. Wouldn’t be happy working here. We’ll be paranoid about this and that. (male, 56, cook).

Suspicion of involvement in insurgency

As discussed above, there has been a long period of civil unrest in the three southernmost provinces. There have been reports of insurgents traveling to Malaysia to avoid the Thai authorities. Consequently, some migrants have been suspected of being insurgents while in Malaysia.

The Malaysian people viewed me as a terrorist. Because at that time I was accused of supporting terrorists in the area with both money and weapons. . . someone photographed me and my friends and wrote on the news that this is the face of those who support the terrorists in our area. We gathered and sued them back. They were from Bangkok. Came to fight the case against us. We also had lawyers from the three provinces helping us. We lost about a million baht at that time. Finally, we won the case (male, 48, restaurant owner)

There was a person from Saba state. A Malaysian. Because the person kind of watched and listened to the news in the T.V. and asked me why I don’t work in Thailand or maybe I can’t work in Thailand. Suspecting if I was related to the insurgencies in the three provinces that I came to work here. Something like that. But I answered that I wasn’t related to the situation. I’ve only come here to work. And for the matters whether the person would believe me or not, I’ll let it be. I don’t care because I came here with good intentions. I didn’t come to hurt anyone. (male, 26, order takert)

Discussion

In agreement with the literature on mental health of migrants, we have found aspects of the data that support both positive and negative associations of migration with mental health. On the positive side, the overall scores from the SRQ shows, on average, a normal range of psychiatric symptoms for the migrants. On the negative side, measured by the SRQ, more migrants had a high number of psychiatric symptoms, compared to the resident population of the southern provinces. A number of factors were related to an increased reporting of SRQ symptoms. These included children left at home in the southern provinces and being a witness or victim of discrimination of exploitation. Seeing other migrant groups, including those from Indonesia and Bangladesh, treated badly was also related to an increased reporting of symptoms. On the other hand, celebrating the Muslim holiday, Eidul Fitri, an indication of the presence of social connection, was associated with a reduced reporting of symptoms.

In Malaysia, Thai food is very popular, creating a demand for Thai cooks to insure an ‘authentic’ taste. However, due to expense and bureaucratic procedures, these migrants are often working with only monthly ‘visitor stamps.” The comments of the migrants who participated in the in-depth interviews described some very difficult experiences after being arrested for not having a work permit. Difficulty obtaining legal documents may also prevent migrants from bringing family members with them.

Household and family stress is often reported in association with migration (Bhugra, 2004; Ford et al., 2019). Considering the quantitative data, more psychiatric symptoms were reported if there were children left behind. The qualitative data also noted concerns of the migrants due to being away from children and family members.

With its strengths, this study has some limitations. The migrant sample is a small convenience sample. Further study should include a larger number of respondents from a more diverse set of work settings. In addition, we do not have information about the migrant’s mental health before migration.

In summary, this study found that the majority of the migrants, overall, have levels of psychiatric symptoms in a normal range, despite the stresses of migration and pre-migration experience with civil conflict. Furthermore, there are many stressors in their lives including distance from families, reduced social support, homesickness, job insecurity, relationships with coworkers, legal matters surrounding immigration, and discrimination/exploitation of migrant groups. The study highlights the need for policy makers and non-governmental organizations to give attention to migrants’ mental health, well-being and sustainable livelihoods.

Footnotes

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for the project was provided by Mahidol University and the Thai Research Fund of the Southeast Asian Studies Program at the University of Michigan.

ORCID iD

Kathleen Ford

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