18 Mental health status and barriers to seeking mental health care among migrant tea plantation workers of South India

Abstract OP 23: Mental Health 3, B304 (FCSH), September 4, 2025, 14:45 - 15:45 Introduction The tea plantation industry one of the oldest and largest private employment sectors in India is facing a significant labour shortage, leading to a large influx of migrant workers. Objective To identify the mental health status of workers in tea plantations in South India, emphasizing the differences between local and migrant populations. 2. To assess the barriers to seeking mental health care in this population. Materials and methods This cross-sectional study was conducted between June 2023- Jul 2024, among 378 workers (217 local, 161 migrant) working at 7 tea plantations in South India. Tools included socio-demographic and occupational characteristics, mental health screening using PHQ-9, GAD-7, and AUDIT scales and a mental illness knowledge scale. Barriers to seeking mental healthcare were assessed across six domains using a 27-item scale. Data were analysed using SPSS v25, employing descriptive statistics, bivariate analysis and logistic regression. Results Migrant workers were younger (median age: 30 years vs. 42 years, p 0.001) and predominantly male (51.6% vs. 17.5%, p 0.001). Mental illness knowledge scores were higher among local workers (median: 7 vs. 4, p = 0.002). Approximately 48.7% of the population reported chronic illnesses, with musculoskeletal disorders (19%) and diabetes/hypertension (14.6%) being most prevalent. Depression prevalence (PHQ-9 ≥5) was low across both groups (local: 6.5%, migrant: 6.9%, p = 0.756). Anxiety(GAD-7 ≥5) was higher among female workers (p 0.05). Alcohol use disorder (AUDIT ≥8) was rare (3.9%) with no significant group differences (p = 0.528). Financial and access related barriers, illness related knowledge barriers were the top barriers to accessing care. Unmarried workers, those working for less than 1 year, with chronic illnesses and tobacco users reported significantly higher depressive symptoms on logistic regression. Conclusions The study underscores the need for targeted mental health interventions among migrant workers. Task-sharing and task-shifting strategies, leveraging local health functionaries, could improve mental health service access at plantations.