Mental Health of International Migrant Workers Amidst Large-Scale Dormitory Outbreaks of COVID-19: A Population Survey

Background: In the COVID-19 pandemic, international migrant workers have faced increased vulnerability on account of their status. This study examined the mental health burden of COVID-19 amongst low-waged migrant workers involved in large-scale dormitory outbreaks within Singapore. Methods: Between 22 June to 11 October 2020, questionnaires were distributed in-person and online to 1011 migrant workers undergoing 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 each DASS-21 subscale. Findings: 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). Interpretation: The risk factors identified underscore how the ongoing pandemic may impact the mental health of migrant workers. At the same time, we observed resilience within the cohort, with no evidence of increased symptomology (relative to the general population).Trial Registration: NCT04448704: Understanding the mental health of migrant workers during the COVID-19 outbreak (https://clinicaltrials.gov/ct2/show/study/NCT04448704)Funding Statement: JY Pillay Global Asia GrantDeclaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The study was approved by the Institutional Review Boards of the National University of Singapore and Singapore Health Services.