Singapore’s migrant workers fearful for health, jobs amid COVID-19

Low-waged migrant workers in Singapore suffer from a high mental health burden amid the coronavirus disease 2019 (COVID-19) pandemic, driven by fears for their health and jobs and compounded by their poor access to quality health services, according to a recent study.

“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,” the researchers said. “At the same time, we documented resilience within the cohort as a whole.”

Through questionnaires, 1,011 migrant workers (median age 32 years, 100 percent men) subjected to extended movement restrictions were surveyed. The 21-item Depression, Anxiety, and Stress Scale (DASS-21) was used to measure their mental health symptoms, while linear regression analysis was performed to identify correlates.

DASS-21 responses showed a median depression score of 4 (interquartile range [IQR], 0–8), with 3.1 percent of participants meeting the criteria for severe or extremely severe depression. The median anxiety and stress scores were 2 (IQR, 0–4; 4.1 percent severe or extremely severe) and 4 (IQR, 0–8; 1.3 percent severe or extremely severe), respectively. [J Migr Health 2021;4:100062]

These observed scores and rates were not significantly higher than in community comparators in Singapore, where severe or extremely severe depression, anxiety, and stress had prevalence rates of 5.3 percent, 4.5 percent, and 2.5 percent, respectively.

Such mental health burdens were driven significantly by movement restrictions. The researchers documented higher subscale scores for depression (b, 2.38; p<0.001) and stress (b, 1.98; p<0.001) when participants were surveyed under complete vs minimal restrictions.

Health concerns also emerged as an important predictor of participant distress, with those diagnosed with COVID-19 showing significantly increased anxiety (b, 1.56; p<0.001); diagnosis had no interaction with stress or depression.

Fear was also an important correlate of mental health. Respondents who said that they were concerned about their health during the pandemic were more likely to have higher symptom scores for depression (b, 2.73; p<0.001), anxiety (b, 2.34; p<0.001), and stress (b, 2.76; p<0.001). The same was true for those who feared losing their jobs (depression: b, 2.13; p<0.001; anxiety: b, 1.35; p<0.001; stress: b, 1.49; p<0.001).

In contrast, participants who assessed themselves to be of good health status had less depression (b, –1.91; p<0.001), anxiety (b, –1.93; p<0.001), and stress (b, –2.63; p<0.001) symptoms than counterparts with normal or pool health status.

Notably, high exposure to rumours related to COVID-19 also negatively affected mental health (depression: b, 1.53; p<0.001; anxiety: b, 1.32; p<0.001; stress: b, 1.36; p<0.001).

“To the best of our knowledge, this is the first such survey since the pandemic started and remains one of the largest mental health studies involving dormitory-housed migrant workers to date, even prepandemic,” the researchers said.

“Although we observed resilience within our sample, the risk factors we identified underscore the need to ensure COVID- 19 policies do not leave vulnerable groups behind,” they added.