Mental health of international migrant workers amidst large-scale dormitory outbreaks of COVID-19: A population survey in Singapore

Abstract

Introduction Worldwide, COVID-19 clusters have emerged within communities of international migrant workers operating in high-density work and living environments. Despite their increased vulnerability, no study has documented the mental health burden of COVID-19 amongst these groups. To address this gap, we conducted a survey of migrant workers involved in large-scale dormitory outbreaks within Singapore. Methods Between 22 June to 11 October 2020, questionnaires were distributed to 1011 migrant workers undergoing extended movement restrictions. Mental health symptoms were measured using the 21-item Depression, Anxiety and Stress Scale (DASS-21). As covariates, we assessed participants’ socio-demographics, quarantine status, COVID-19 health concerns, financial stability, and exposure to news and misinformation. Linear regression models were fitted to identify factors associated with DASS-21 scores. Results Complete movement restrictions were associated with increased depression and stress symptoms, while being diagnosed with COVID-19 was associated with increased anxiety. Participants who harboured fears about their health or job, perceived their health to be poorer, or had greater exposure to COVID-19 rumours reported higher depression, anxiety, and stress levels. Across the cohort, rates of severe or extremely severe depression (3.1%, 95% CI: 2.1-4.3%), anxiety (4.1%, 95% CI: 2.9-5.5%), and stress (1.3%, 95% CI: 0.7-2.2%) were similar to those observed in the general population for the host country (Singapore). Conclusions As the first mental health survey of low-waged migrant workers during the pandemic, our findings provide a basis to identify and support at-risk individuals. This is critical as migrant workers often have limited access to healthcare services. At the same time, we documented resilience within the cohort as a whole.

Exploring COVID-19 circuit breaker (CB) restrictions at a migrant worker dormitory in Singapore: a case study and nested mixed-method analysis of stress management and mental health

“…Our findings align with existing studies of migrant worker prepandemic and during COVID-19 times,8 9 22–26 yet drill down explicitly to illustrate insights from Indian and Bangladeshi migrant workers on mental health related experiences under dormitory lockdown. Identified sources of tension and solutions can be best understood, overarchingly, when mapped according to the socioecological model (see figure 3).…”

“…A study of infected migrant workers in recovery in a mass quarantine facility in Singapore showed that major stressors were the inability to continue providing for families and feeling susceptible to infection in crowded dorms 8. Another study examining the mental health burden of migrant workers involved in movement restrictions between June and October 2020 via online and in-person surveys showed that the overall level of mental health was on par with the rest of the community 9…”

“… 8 Another study examining the mental health burden of migrant workers involved in movement restrictions between June and October 2020 via online and in-person surveys showed that the overall level of mental health was on par with the rest of the community. 9 …”

Psychological and financial impacts of COVID-19-related travel measures: An international cross-sectional study

“…The respondents in the current study reported higher values in depression and stress when compared to stranded citizens/permanent residents, who scored 64.2%, 64.4% and 41.7% respectively for depression, anxiety, and stress. Furthermore, when compared to DASS in the published COVID-19 studies and especially in studies focused on migrant workers (23-25), healthcare workers (20) or the general population (19, 21, 26), the scores of the present study are dramatically higher, over 50% more severe in some cases. Along with research indicating that those negatively impacted by Australian international border closures were at an increased risk of elevated psychological distress (27), these scores combined provide additional evidence that travel restrictions have negative psychological consequences towards those directly impacted by them.…”

Estimating transmission dynamics of SARS-CoV-2 at different intraspatial levels in an institutional outbreak

“…While cordons sanitaires was effective in preventing spillover of infection back into the general population which was the ultimate goal of the approach. However, the length of lockdown in crowded conditions, and restrictions that lasted over a year on their social activities and freedom to go to third places beyond their work or home, had been reported to have a deleterious effect on their mental well-being ( Saw et al, 2021 ).…”