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 Table of Contents 
Year : 2020  |  Volume : 9  |  Issue : 10  |  Page : 5394-5396  

Letter to editor: Re: “Primary care physician's approach for mental health impact of COVID-19”: Case of migrant workers mental health

1 Department of Health and Human Performance, Berea College, Berea, KY, United States
2 Department of Psychiatry, Dharwad Institute of Mental Health and Neurosciences, Dharwad, Karnataka, India
3 Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
4 Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, United States

Date of Submission22-Aug-2020
Date of Decision23-Aug-2020
Date of Acceptance30-Aug-2020
Date of Web Publication30-Oct-2020

Correspondence Address:
Dr. Ram Lakhan
Assistant Professor, Department of Health and Human Performance, CPO 2187, Room No# 229, Seabury Center, 101 Chestnut Street, Berea College, Berea - 40404, KY
United States
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_1716_20

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How to cite this article:
Lakhan R, Kosgi S, Agrawal A, Sharma M. Letter to editor: Re: “Primary care physician's approach for mental health impact of COVID-19”: Case of migrant workers mental health. J Family Med Prim Care 2020;9:5394-6

How to cite this URL:
Lakhan R, Kosgi S, Agrawal A, Sharma M. Letter to editor: Re: “Primary care physician's approach for mental health impact of COVID-19”: Case of migrant workers mental health. J Family Med Prim Care [serial online] 2020 [cited 2020 Nov 28];9:5394-6. Available from: https://www.jfmpc.com/text.asp?2020/9/10/5394/299360

Dear Editor,

We read the article by Rohilla[1] with great interest where the authors have described that how our primary care physician colleagues can share the responsibility and can manage the psychological burden of the COVID-19 pandemic. In addition to the many special groups identified by authors,[1] we would like to highlight the psychological issues related to needs of a very important subgroup, that is, “Migrant workers.”[2],[3] The migrant population is already very vulnerable and in addition to the recent outbreak of COVID-19 has brought tremendous challenges for this population.[4] Migration is a process in which people move to another place with the hope of making their lives better. Unskilled and uneducated people lacking job opportunities in local areas often migrate temporary from remote places to larger cities in India. Nationwide lockdown and travel restrictions placed in order of containing virus spread resulted in unbearable social stigma, isolation, income loss, fear and risk for mental health concerns, including suicide.[5],[6] Recently, an editorial “Mental health of migrant laborers in COVID-19 pandemic and lockdown: Challenges ahead” and another article “COVID-19 pandemic: Mental health challenges of internal migrant workers (IMW) of India” draws timely attention to the increased risk and rates of mental health problems among IMWs in India.[3],[7] Mental health problems can have biological, social, and environmental influences in etiopathogenesis and all these are at heightened interplay during the COVID-19 pandemic for IMWs.[8]

The attempts of virus containment affected all components of the social system and thus mental health of internal migrant workers globally but particularly in India. The present COVID-19 pandemic has created extremely challenging social situations. It resulted into more significant social exclusion and risk for mental health problems. Due to inherent vulnerability, migrant workers are at higher risk.[9] Four components of the social-ecological model, individual (intrapersonal), interpersonal relationships, community, and societal policies influence the mental health of an individual.[10] It is essential to recognize that the risk of increased mental health issues that have mainly originated due to social factors and distress should be handled in the context of social-ecological approaches of mental health intervention.[11] The need for mental health care has been sensed by the providers and government officials in several countries, including India. To address the present epidemic related challenges, as an alternative to the face-to-face, mental health services, interventions are being planned and need to be offered in an online mode [Table 1]. In the setting of online mode, psychiatric services offered by trained mental health professionals can be considered the main component to overcome the mental health-related problems.
Table 1: Suggestions for addressing concurrent mental health issues of migrants in social ecological health care framework

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  References Top

Rohilla J, Tak P, Jhanwar S, Hasan S. Primary care physician's approach for mental health impact of COVID-19. J Fam Med Prim Care 2020;9:3189-94.  Back to cited text no. 1
Porru S, Elmetti S, Arici C. Psychosocial risk among migrant workers: What we can learn from literature and field experiences. Med Lav 2014;105:109-29.  Back to cited text no. 2
Choudhari R. COVID 19 pandemic: Mental health challenges of internal migrant workers of India. Asian J Psychiatr 2020;54:102254.  Back to cited text no. 3
Schouler-Ocak M, Kastrup M, Vaishnav M, Javed A. Mental health of migrants. Indian J Psychiatry 2020;62:242-6.  Back to cited text no. 4
  [Full text]  
Mukhra R, Krishan K, Kanchan T. COVID-19 sets off mass migration in India. Arch Med Res 2020. doi: 10.1016/j.arcmed.2020.06.003  Back to cited text no. 5
The Lancet. India under COVID-19 lockdown. Lancet 2020;395:1315.  Back to cited text no. 6
Singh O. Mental health of migrant laborers in COVID-19 pandemic and lockdown: Challenges ahead. Indian J Psychiatry 2020;62:233-4.  Back to cited text no. 7
  [Full text]  
Ahn W-K, Proctor CC, Flanagan EH. Mental health clinicians' beliefs about the biological, psychological, and environmental bases of mental disorders. Cogn Sci 2009;33:147-82.  Back to cited text no. 8
Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, et al. Common mental health problems in immigrants and refugees: General approach in primary care. CMAJ 2011;183:E959-67.  Back to cited text no. 9
Thompson JN, McGee ER, Munoz CL, Walker RE. Reflections on mental health advocacy across differing ecological levels. J Ga Public Health Assoc 2015;5:126-34.  Back to cited text no. 10
Lakhan R, Ekúndayò OT. Application of the ecological framework in depression: An approach whose time has come. Arch Mental Health 2013;14:103-9.  Back to cited text no. 11


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