Internal Migration in India: An Overview of the Concerns with Mental Health

Internal migration refers to the relocating of individuals inside a nation, often from rural to urban regions, for a variety of reasons such as family, education, work, marriage, or other personal reasons. India, which has a population of over 1.3 billion and is both huge and diversified, frequently experiences internal migration. More than 450 million individuals relocated inside India, which accounts for around 37% of the population, according to the 2011 census.

Both good and bad effects on migrants' mental health may result from internal migration. Internal migration can, on the one hand, provide chances for social and economic advancement, improved access to amenities and services, and exposure to different cultures and ways of life. Internal migration, on the other hand, can also present difficulties and dangers for mental health, including stress, prejudice, isolation, exploitation, violence, and trauma. The reasons for the migration, the length of the migration, the type of migration (permanent or temporary), the location of the migration (urban or rural), and the personal and social characteristics of the migrants (age, gender, education, caste, religion, etc.) can all affect the mental health of internal migrants in India.

Mental health challenges faced by internal migrants in India

• Lack of social support and integration: When internal migrants encounter linguistic hurdles or prejudice because of their regional or ethnic identities, they may find it challenging to adapt to new contexts and customs. They could also feel lonely and cut off from the towns and families they left behind. Their feeling of self-worth, belonging, and of mental health may be impacted by these elements.
• Poor living and working conditions: Internal migrants may experience challenges and exploitation in their living and working circumstances, including squalor, inadequate sanitation, low pay, long hours, dangerous working conditions, and abusive bosses. These elements may expose them to more risks for their bodily and emotional health, including infections, wounds, assault, and harassment.
• Trauma and distress: Before or during their movement, internal migrants may have gone through terrible experiences including natural catastrophes, war, violence, accidents, or the death of loved ones. Psychological discomfort and illnesses including post-traumatic stress disorder (PTSD), depression, anxiety, or psychosis might be brought on by these occurrences.
• Limited access to mental health care: Due to lack of knowledge, stigma, cost, availability, or quality, internal migrants may have difficulty getting mental health treatments. They could also have trouble explaining their requirements and preferences to medical professionals who might not be familiar with their languages or cultural backgrounds.

The productivity and well-being of internal migrants and their families may suffer as a result of these mental health issues. They may also have an impact on the growth and social cohesiveness of the host towns and regions. Therefore, it is crucial to address the needs of internal migrants in India who have mental health issues through suitable policies and treatments that are considerate of their varied settings and experiences.

Mental Health policies that have been implemented to help internal migrants in India

1. The National Mental Health Programme (NMHP), which was launched in 1982 and revised in 2017, aims to provide comprehensive, community-based, and decentralized mental health care services to the population, including internal migrants. The NMHP also seeks to promote awareness and reduce stigma about mental health issues, as well as to train and empower health workers and volunteers to deliver mental health care.
2. The National Urban Health Mission (NUHM), which was launched in 2013, is a sub-mission of the National Health Mission that focuses on improving the health status of the urban poor, especially slum dwellers and other vulnerable groups such as internal migrants. The NUHM aims to provide equitable, affordable, and quality primary health care services, including mental health care, through urban primary health centers, outreach camps, and mobile clinics.
3. The National Policy on Internal Migration, which was drafted in 2019 by the Ministry of Housing and Urban Affairs, is a proposed policy framework that seeks to address the challenges and opportunities of internal migration in India. The policy recognizes the need to protect the rights and entitlements of internal migrants, including their access to health care and social security. The policy also proposes to establish a national database on internal migrants, as well as to create migrant resource centers and helplines to provide information, guidance, and support to migrants.

These are a few of the mental health measures that have been put into place or advocated for in India to assist internal migrants. There is still a disconnect between policy and practice, though, since many internal migrants encounter difficulties getting mental health care owing to stigma, a lack of knowledge, cost, scarcity, or poor quality. To guarantee that the needs of internal migrants are handled effectively and efficiently, more research, advocacy, and collaboration across diverse stakeholders are required.

The most frequent myths and misunderstandings concerning mental health among Indian internal migrants

Some of the common myths and misconceptions about mental health among internal migrants in India are:

• Mental health problems are rare and only affect a few people. This is not true, as mental health problems are very common and can affect anyone, regardless of their age, gender, education, income, or migration status. According to a study by Li et al. (2019), the overall prevalence of depression and anxiety among migrant workers in India was 38.99% and 27.31%, respectively.
• Mental health problems are a sign of weakness or madness. This is not true, as mental health problems are not a personal flaw or a character defect, but rather a result of various biological, psychological, and social factors that can affect anyone. Mental health problems are not synonymous with insanity or craziness, but rather a spectrum of conditions that can range from mild to severe and can be treated effectively.
• Mental health problems are caused by bad karma or evil spirits. This is not true, as mental health problems are not a punishment for past sins or a curse from supernatural forces, but rather a medical condition that can be explained by scientific evidence and rational causes. Mental health problems are not influenced by one’s religion or spirituality, but rather by one’s genes, environment, experiences, and coping skills.
• Mental health problems can be cured by faith healers or traditional remedies. This is not true, as mental health problems cannot be cured by magic spells, rituals, or potions, but rather by evidence-based treatments that have been proven to be safe and effective. Mental health problems require professional help from qualified and trained mental health care providers who can offer appropriate diagnosis, treatment, and support.
• Mental health problems are contagious or shameful. This is not true, as mental health problems are not infectious or transmissible diseases that can spread from one person to another, but rather individual and personal experiences that can vary from person to person. Mental health problems are not something to be ashamed of or to hide from others, but rather something to be acknowledged and accepted as part of one’s identity and well-being.

These are some of the most prominent mental health myths and misconceptions among Indian internal migrants. Internal migrants suffering from mental health difficulties may face stigma and prejudice as a result of these beliefs and misunderstandings, preventing them from getting treatment or obtaining support. As a result, it is critical to educate internal migrants and the general public on the reality and importance of mental health, as well as to build a culture of empathy and inclusiveness for all.

Actions that might be taken to promote the mental health of India's internal migrants?

1. Promoting social inclusion and integration: Internal migrants must be treated with decency and respect by host communities and authorities. Cultural events, sports activities, neighborhood clubs, or peer networks should give them chances for social involvement and contact. They should also be provided with information and instruction about their rights and responsibilities as citizens.
2. Improving living and working conditions: Internal migrants should be provided with appropriate living and working circumstances that fulfill basic health and safety requirements. Employers and intermediaries should safeguard them against exploitation and abuse. In the event of an emergency or a crisis, they should also be assisted financially or through social security programs.
3. Providing psychosocial support and counseling: Internal migrants should be provided with accessible, inexpensive, and culturally appropriate psychological support and counseling services. They should be assessed for mental health issues and, if necessary, sent to specialized care. They should also be given coping skills and resilience tactics to help them deal with pressures and obstacles.
4. Strengthening mental health care systems: Internal migrants should be involved in the development and implementation of national and municipal mental health policies and programs. They should be included in the planning and implementation of mental health services that are tailored to their specific needs and preferences. They should also be taught as peer educators or counselors to help them develop their own skills and reach out to other migrants.

Internal migration is a complicated topic that has a negative impact on the mental health of millions of Indians. By addressing the mental health difficulties that internal migrants in India experience through these measures, we can enhance their quality of life and well-being while also contributing to the country's social and economic progress.

How can the mental health of internal migrants be addressed on an individual level?

Internal migrants' mental health is a complicated and diverse issue that needs collaborative efforts from a variety of stakeholders, including the government, civic society, companies, and host communities. Internal migrants, on the other hand, can take certain efforts on an individual level to deal with the stress and sadness that may occur as a result of their migrating experience. Among them are:

• Seek social support and integration: Internal migrants might strive to establish and maintain strong ties with family, friends, coworkers, or other migrants with comparable origins or experiences. They can also take part in social and cultural events that will make them feel more connected to and welcomed by the host community. They can also seek support from local organizations or networks that aid or guide migrants.
• Improve living and working conditions: Internal migrants can strive to improve their living and working situations by negotiating of better salaries and benefits, maintaining safe and sanitary conditions and denouncing any abuse or exploitation by authorities or the media. If they are unsatisfied or uncomfortable with their existing circumstances, they might look for alternate sources of income or work.
• Practice self-care and coping skills: Internal migrants may take care of their physical and mental health by eating a well-balanced diet, exercising frequently, getting enough sleep, and avoiding harmful substances such as alcohol, cigarettes, and narcotics. They can also use relaxation techniques like meditation, yoga, breathing exercises, or massage to help quiet their mind and body and cope with negative feelings. They can also pursue hobbies or activities that provide them joy and fulfillment.

• Seek professional help if needed: Internal migrants should not be afraid to seek professional assistance if they are feeling overwhelmed or concerned by their mental health issues. They can seek the advice of a doctor, a counselor, a therapist, or a psychiatrist, who will diagnose their illness and give suitable therapy. They can also get discreet and anonymous help through online or phone-based mental health programs that are accessible 24 hours a day, seven days a week.

These are some of the specific approaches that internal migrants might take to address their mental health issues. These initiatives, however, are not intended to replace or substitute for the need for systemic and structural reforms that might address the underlying causes and consequences of internal migration and its influence on mental health. As a result, internal migrants should campaign for their rights and entitlements as citizens, as well as improve policies and programs that safeguard and promote their well-being.

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