The mediating role of psychological distress in the association between migration experiences and stigma and coping strategies: a cross-sectional study on Ethiopian migrant returnees.

Background: Ethiopian migrants to the Middle East and South Africa are exposed to dangerous traveling and working conditions and their experiences are mostly tragic. They are unwelcomed not only by the situation in the destination but also by the community at home which is an important indicator of stigma and discrimination. However, there is lack of evidence on how psychological distress is associated with migration experiences, stigma and coping strategies. Therefore, it was aimed to determine the mediating effect of psychological distress in the association between migration experiences and stigma and discrimination and coping strategies.

Methods: A total of 739 Ethiopian migrant returnees from the Middle East and South Africa were included in the study. A cross-sectional study was conducted in five migration hotspot areas in Ethiopia, namely Addis Ababa, Dessie, Shashemene, Hossana, and Gondar. Data related to socio-demographic, economic, migration experiences, psychological distress, coping strategies, and stigma and discrimination were collected. Psychological distress was measured using the 21- item version of the Depression, Anxiety and Stress Scale and coping strategies were measured with the Brief-COPE. Structural equation modeling was employed to estimate the relationship among variables.

Results: About 395 (57.33%) of the participants reported symptoms of depression, 428 (59.86%) anxiety symptoms, and 313 (45.21%) stress symptoms. The mediated association between physical violence and coping strategy through psychological distress was 0.29 (adjusted β = 0.29, 95%CI: 0.15, 0.44). Denial of salary had positive direct (adjusted β = 1.00, 95%CI: 0.50, 1.50) and mediated (adjusted β = 1.20, 95%CI: 0.71, 1.68) associations with stigma and discrimination through psychological distress. Restricted freedom had positive mediated (adjusted β = 0.39, 95%CI: 0.13, 0.65) and total (adjusted β = 0.94, 95%CI: 0.59, 1.29) associations with stigma and discrimination through psychological distress.

Conclusion: Depression, anxiety, and stress symptoms are common among migrant returnees. Religious practice is the most commonly used coping mechanism. Psychological distress has positive mediating association with the relationships between denial of salary by employers and stigma and discrimination, physical violence and coping strategy, and restricted freedom and stigma and discrimination. Psychological interventions to deal with the psychological distress and stigma and discrimination of migrant returnees and to encourage the practice of positive coping strategies are warranted.