oa Mental health issues among migrant workers in the Gulf Cooperation Council countries: Literature review and case illustrations.

Background and Objectives: It is well established from the European and North American literature that migration has a great impact on the mental health of the migrant population. The Gulf Cooperation Council (GCC) states are home to more than 13 million non-nationals, yet the mental health status and psychological well-being of this large population has rarely been investigated. The majority of migrants are blue collar or domestic workers coming from the Indian subcontinent and southeast Asia. There are isolated reports of psychosis and/or suicide among this 'at risk' population, but no reliable data are available. For this reason, we decided to conduct a systematic search of the literature to review the epidemiology and characteristics of the mental health issues of the migrant workers in the GCC countries. Methods: The literature search was conducted in both English and Arabic. The English search consisted of various words and combinations including migrant worker, domestic worker, mental health, Middle East, GCC countries and the six countries contributing the majority of the migrants to the GCC (India, Pakistan, Nepal, Sri Lanka, Philippines, and Indonesia). The search was conducted mainly in databases for academic journal articles such as PubMed, Scopus, PsycInfo and Google Scholar. Also, for each of the six migrant countries of origin identified, a search through the country's own medical and psychiatric journals was performed. The Arabic search was carried out on ArabPsyNet.com using the aforementioned combinations in the English literature. Results: Our literature search revealed very little regarding the mental health of migrant workers in GCC countries. The available literature consisted mostly of theoretical presentations or isolated clinical reports. There was a suggestion of an increased rate of psychosis and suicidal attempts. Vey few systematic and/or quantitative studies have ever been published. We therefore present a series of brief clinical vignettes to illustrate the scope of the problem. Conclusion: The lack of available published data regarding the mental health status of migrant workers in the GCC countries is somewhat surprising. We discuss possible reasons for underreporting and present steps to be taken to address this important issue.