Risk and protective factors for common mental disorders among populations during migration. A pilot cohort study among migrants and asylum seekers in Mexico

PROJECT SUMMARY Forced displacement has reached unprecedented levels and is becoming increasingly protracted with over 75% of the estimated 100 million displaced persons globally expected to live in exile for over five years. Latin America has experienced the greatest proportional increase in forced displacement across international borders since 2017. Due to delays in processing asylum applications and policies permitting the widespread expulsion of migrants and asylum seekers, many migrants and displaced persons are temporarily residing in northern Mexico near the US border awaiting safety and more durable solutions in another destination. Displaced populations face significant adversity, human rights violations, and potentially traumatic events that increase their risk for common mental disorders (CMDs) during their migration journey. The point prevalence of CMDs is more than three times higher in displaced populations relative to global averages. Despite this elevated burden, migrants without legal status in the transit or destination country face significant barriers in accessing basic needs and services, further contributing to distress and the risk of CMDs. Most available data on mental health among migrants is cross-sectional due to practical and ethical challenges following mobile populations over time. Longitudinal data are needed to identify modifiable risk and protective factors that could serve as targets for CMD prevention interventions in this population. Our study team, which represents an established academic-humanitarian partnership, has expertise conducting mental health research among displaced populations and providing community-based mental health and psychosocial support to these communities, including in Mexico. We aim to further this partnership by piloting feasible, effective, and ethical strategies for recruiting and retaining a prospective cohort of 300 migrants in transit to clarify the factors that contribute to prevention of CMDs. Using data from this cohort this study aims to: 1) identify risk and protective factors for CMDs; 2) Estimate the short-term effect of economic services, social protection, legal assistance, and mental health interventions on reducing the risk of CMDs; and 3) evaluate the feasibility and acceptability of conducting a fully powered prospective cohort study of migrants in transit in Mexico followed over three years. This research is the first longitudinal investigation of mental health among migrants in transit, including underrepresented groups (women, children, separated families), and will innovatively measure the impact of multisectoral services on mental health outcomes among migrants during this critical phase of migration. Results from this study will provide critical and novel insights into the epidemiology of CMDs and will enable the development of targeted and efficient strategies to reduce the incidence of CMDs among migrants in transit in humanitarian emergencies.