COMMENTARY: In April 2020, a group of social workers started a volunteer-run helpline called Here With You to provide psychological aid to migrant workers, amidst the height of the Covid-19 outbreak in Singapore.
One of the social workers who helped to start the hotline, Edwin Soh, shares his insights into how Covid-19 has had a profound psychological impact on migrant workers. He also argues that more can be done to tackle their well-being of migrant workers:
- Matters which are already an ongoing source of mental health problems for migrant workers are amplified during the pandemic
- Prolonged isolation faced from serving quarantine orders can have debilitating effects on migrant workers
- For many of these workers, they fear how their employers will react when they discover that their employees are seeking help
- It is important for existing frameworks meant to help migrant workers to be expanded to include their mental well-being
By Edwin Soh
A group of us, who are social workers, banded together in April to start a volunteer-run helpline called Here With You Helpline to provide psychological first aid and render immediate assistance to distressed migrant workers.
As of today, migrant workers living in dormitories account for nearly 95 per cent of about 57,000 total confirmed infections, according to Ministry of Health data.
The severe disruption to projects within the construction industry has threatened both construction companies’ financial health and the livelihoods of the migrant workers, dependent on these companies’ wages to remit money back home.
Many experts have also raised the alarm about the long-term impact of this crisis on their mental and physical health.
Issues that are a source of mental health issues for migrant workers have been amplified by Covid-19
Since the circuit-break began in April, we have attended to over 1,300 calls from workers who have called this helpline.
Previous research by a Singapore Management University has found that the three main drivers of psychological distress for migrant workers are (1) the housing problems of injury and salary claim workers, (2) threats of repatriation against both injured and regular workers, and (3) agent fee debt.
The calls we receive range from asking for clarifications on MOM advisories to crisis calls which require working closely with authorities to provide immediate help and psychological first aid to emotionally distressed workers.
A few pertinent issues also emerged.
Being able to overcome the language and cultural barrier is crucial
From the start, we realized the need for cultural and language-appropriate services to increase the accessibility and quality of help we can render to the workers calling in.
Migrant workers encounter barriers to access services for mental health, such as language barriers and a lack of mental health literacy in knowing when to seek help.
It is also important to adopt a culture-centred approach in designing services that best meet these needs.
For distressed workers with greater psychological needs, it was necessary to pair Bengali-speaking volunteers with trained social workers or psychologists to assist them adequately.
Native speakers often remind workers of their families back home, and help us to bridge any communication gap that might occur.
Prolonged isolation during Covid-19
While everyone experienced the hardships and the difficulty of being cooped up at home during the two months of circuit-breaker, imagine enduring a quarantine from the start of circuit-breaker until right now. That is the situation that a few of these workers find themselves facing.
As a helpline, we have supported workers who are serving their quarantine orders in the respective facilities like hotels and the mass quarantine facilities like Singapore Expo.
In one case, Adam (pseudonym) was referred to us by the National Care Helpline and was feeling despondent after being quarantined for four months with an uncertainty on when he can be finally discharged from his ordeal.
At the start, he shared that staying in a well-furnished hotel room felt like a holiday. However, after such a long time, watching TV and surfing the internet on his phone has become meaningless.
He was homesick and grew tiresome of the meals in hotel rooms.
While he was able to call his mother in Bangladesh, it did not necessarily alleviate his emotional torment as he faced the stress of convincing his mother that everything was fine for him, when he was not emotionally well. By then, it had become so difficult that the thought of self-harm had crossed his mind. Thankfully, he found strength in his faith as a Muslim, which stopped him from self-harming.
While he was able to see a doctor and was given some medication to help with his anxiety, it was this feeling of languishing in limbo, that he had also started to lose sense of himself and a sense of time in the room that he was in.
He needed the continued assurances from a native speaker on our helpline that his sense of entrapment which came with the endless rounds of quarantine would end.
It was also important for us to remind him of hope and how there is a definite end to his suffering, which stemmed largely from the extended quarantine.
Stories like these are not uncommon during this period.
Migrant workers fear their employers’ reaction after finding out that they have been looking for help
Many migrant workers may choose not to seek help due to the fear of their employers finding out.
When they encounter troubles, they often have to shoulder the burden of proving their grievances to the authorities. At the same time, they also have to continue to live under the management of their employers.
Take the example of what happened for Saad and Balveer (both pseudonyms). They came to Singapore in December last year.
When the Covid-19 pandemic hit, their construction firm faced work stoppage. During this period, their employer owed salaries to many of the workers. When they started calling our helpline, only Saad and Balveer were assertive enough to be willing to come forward in seeking redress with the authorities.
When confiding in us, they said that once their employer found out about their report, they were harassed and verbally abused, eventually leading to them being dismissed.
For us, a significant challenge was for us to understand their accounts, organise their salary claims and demonstrate that they were unfairly dismissed so that the authorities could best help them.
As with many migrants, they had come here as sole breadwinners and it was important for them to hold a job in Singapore. The language barriers did not help and it was not easy for them to prove the allegations of mistreatment by their employer.
From speaking to migrant workers, it is common to hear about errant and abusive employers who harass workers, confiscate their passports, and even threaten to repatriate them. Many of them also feel pressured to accept settlements in order to retain their employment contracts and work permits.
As Saad and Balveer confided in us, we could see that prolonged exposure to these stressors took a toll on their mental well-being. They appeared to be very anxious and often had a depressive mood.
Eventually, both of them were given a stern warning for leaving the dormitory to seek help at MOM Services Centre without their employer’s permission. They also managed to settle on their claims.
However, only Saad was able to find new employment while Balveer had to go back, being unable to clear his initial debt of coming to Singapore.
This entire episode demonstrated how new Covid-19 regulations on movement of workers can affect them during disputes.
When migrant workers are in precarious employment circumstances, this creates ripe conditions for their mental well-being to deteriorate.
Unequal bargaining power can easily escalate small incidents into complicated issues -- when faced with workplace conflicts with their employers, migrant workers are even more susceptible to mental health conditions.
Mental health support should be integrated within existing systems for our migrant workers
Both employers and stakeholders in this ecosystem need to have a higher degree of empathetic understanding for the mental wellness of workers in knowing what they are experiencing. This is especially so, when workers are placed under great stress in trying to negotiate a dispute between themselves and their employers.
All employers should have to undergo mental health awareness training, and observe non-discriminatory policies. Guidelines must be given on what constitutes such policies. Migrant workers also often face arbitrary rules not enforceable under law.
The new MOM division, Assurance, Care and Engagement (ACE) Group, is a good initiative that should be built upon, to include provisions to care for the mental well-being of these workers.
There is also the Workplace Safety and Health Act which covers different aspects of safety, including the responsibilities of the stakeholders.
Aside from ensuring that the migrant workers have sufficient instruction, training and supervision, it would also be important to include aspects of the mental wellbeing of those engaging in the different works as well.
In the industries dominated by migrant workers, given the dangerous nature of manual labour that can lead to traumatic injuries, it is important to have a conducive workplace that allows workers to focus on their tasks at hand.
It is also important to raise awareness of mental health and well-being among these workers; to sufficiently educate them on the issues identified, including their entitlement to medical care, importance of mental wellness, ways to better cope with stress and situations which warrant timely medical attention.
The mental health of workers must be accounted for
“We must not allow stigma to push people away from the assistance they need,” UN Secretary-General António Guterres said on Oct. 10.
Beyond this public health crisis, prioritising and protecting the mental health and well-being has never been more important than before.
It is on us to reimagine an ecosystem that is both inclusive of their voices and needs.
While we can applaud the efforts of our healthcare and public services’ tireless efforts during this pandemic whereby infection numbers have dropped to single digits, we need stronger investments in services for the most vulnerable among us.
Greater considerations in policy-making for the well-being of migrant workers must be made to cater to their psychosocial needs and their cohesive integration within our society.
As much as their working experiences in Singapore are transient, our commitment to taking care of their well-being would pave the reputation of Singapore as a truly global, compassionate and first-world city.
The virtues by which we treat our migrant workers, reflect the societal values we intend to cultivate and pass on to future generations when it is their turn to take on the reins of the nation to combat the crisis of their generation.
In doing our part to support vulnerable groups among us, we can nurture a societal resilience and empathetic strength that contributes to our social compact as a stronger Singapore.
The campaign of “Project Open Doors” also hopes to raise awareness of mental distress faced by migrant workers and galvanise Singaporeans from all walks of life to support the mental well-being of both male and female migrant workers.
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Top photo from Ministry of Manpower