Daniel Fu Keung Wong

Mental health of migrant workers in China: prevalence and correlates

BackgroundThis study aimed to examine the prevalence and the socio-demographic correlates of mental health of migrant workers in Shanghai China.MethodsA total of 475 migrant workers from four major districts in Shanghai were recruited through a survey design with stratified random sampling. Male and female migrant workers were identified as mentally healthy or unhealthy using the brief symptom inventory. Socio-demographic characteristics and migration stress were explored as correlates of the mental health of the migrant workers.ResultsA total of 73 migrant workers could be classified as mentally unhealthy (25% for men and 6% for women). Male migrant workers who were married (OR 6.16, 95% CI 1.83–20.70), manual laborers (OR 1.56, 95% CI 0.97–2.51), and experienced more stress in “financial and employment-related difficulties” (OR 2.75, 95% CI 1.47–5.14) and “interpersonal tensions and conflicts” (OR 4.18, 95% CI 1.55–11.25) were more likely to be mentally unhealthy, whereas the female migrant workers who experienced more stress in “interpersonal tensions and conflicts” (OR 6.52, 95% CI 0.83–51.14) were more likely to have poor mental health.ConclusionThe findings provide information for the prevention of mental illness among migrant workers in China. The implications and limitations are also discussed.

Cognitive and Health-Related Outcomes of Group Cognitive Behavioural Treatment for People With Depressive Symptoms in Hong Kong: Randomized Wait-List Control Study

OBJECTIVES This study examined the efficacy of a territory-wide cognitive behavioural group treatment programme for Chinese people with depression launched in Hong Kong. METHOD Three hundred and forty-seven subjects with depressive symptoms (i.e. Beck Depression Inventory-Chinese version >9) were randomly assigned to CBT and waitlist control groups. RESULTS After 10 weeks of treatment, participants in the group CBT programme had significantly fewer symptoms of depression, fewer dysfunctional and perfectionist attitudes, and better quality of life when compared to the participants in the control group. Effect size statistics showed small to medium differences in symptoms of depression, dysfunctional and perfectionist attitudes and quality of life between the two groups (Cohens d, 0.22-0.74). Statistical analysis of the clinical significance indicated that approximately 27% of the participants in the experimental group could be considered as clinically remitted or recovered, respectively (RCI >1.28). Last, multiple regression provided some evidence of a linkage between cognition and depression among the participants in the experimental group. CONCLUSIONS The design and content of the group CBT programme, which aimed at facilitating the understanding and modification of automatic thoughts and dysfunctional attitudes among the participants, might have contributed to the initial positive results.Objectives: This study examined the efficacy of a territory-wide cognitive behavioural group treatment programme for Chinese people with depression launched in Hong Kong. Method: Three hundred and forty-seven subjects with depressive symptoms (i.e. Beck Depression Inventory Chinese version 9) were randomly assigned to CBT and waitlist control groups. Results: After 10 weeks of treatment, participants in the group CBT programme had significantly fewer symptoms of depression, fewer dysfunctional and perfectionist attitudes, and better quality of life when compared to the participants in the control group. Effect size statistics showed small to medium differences in symptoms of depression, dysfunctional and perfectionist attitudes and quality of life between the two groups (Cohen’s d, 0.22 0.74). Statistical analysis of the clinical significance indicated that approximately 27% of the participants in the experimental group could be considered as clinically remitted or recovered, respectively (RCI 1.28). Last, multiple regression provided some evidence of a linkage between cognition and depression among the participants in the experimental group. Conclusions: The design and content of the group CBT programme, which aimed at facilitating the understanding and modification of automatic thoughts and dysfunctional attitudes among the participants, might have contributed to the initial positive results.

The Protective Function of Meaning of Life on Life Satisfaction among Chinese Students in Australia and Hong Kong: A Cross-Cultural Comparative Study.

Objective: The authors compared the predictive effects of acculturative stressors and meaning of life on life satisfaction between Chinese students in Australia and in Hong Kong. Participants: In 2006, the researchers recruited 606 Chinese students studying abroad at the University of Melbourne in Australia and at 6 universities in Hong Kong. Methods: Participants completed a questionnaire that included measures of acculturative stressors, meaning of life, life satisfaction, and demographic information. Results: The Australian sample experienced a significantly higher level of acculturative stressors than did the Hong Kong sample, but life satisfaction did not differ significantly between the 2 samples. Meaning of life had a strong positive contribution and acculturative stressors had a negative contribution in predicting life satisfaction in both samples. Meaning of life partially mediated the relationship between acculturative stressors and life satisfaction in both samples. Conclusions: The authors discuss the theoretical and practical implications for Chinese students studying abroad.

Acculturative Stressor and Meaning of Life as Predictors of Negative Affect in Acculturation: A Cross-Cultural Comparative Study between Chinese International Students in Australia and Hong Kong

Objective: The purpose of the present study was to compare the predictive effects of acculturative stressor and meaning of life on negative affect in the process of acculturation between Chinese international students in Australia and Hong Kong. Method: Four hundred mainland Chinese students studying at six universities in Hong Kong and 227 Chinese international students studying at the University of Melbourne in Australia completed a questionnaire that included measures of acculturative stressor, meaning of life, negative affect and demographic information. Results: The Australian sample was found to have a higher level of acculturative stressor and negative affect than the Hong Kong sample. Acculturative stressor had a positive impact on negative affect in both samples, but the impact of different domains of acculturative stressor on negative affect varied between the two groups. Finally, meaning of life partially mediated the relationship between acculturative stressor and negative affect in the Hong Kong sample, but no such effect was found in the Australia sample. Conclusions: Acculturative stressor is a critical risk factor for negative affect in acculturation for Chinese international students in Australia and Hong Kong. Meaning of life acted as a protective factor that mitigated negative affect for mainland Chinese students in Hong Kong, but not for the Chinese international students in Australia. The theoretical and practical implications for resilience-based and meaning-oriented intervention for Chinese international students are discussed.

Depression literacy among Chinese in Shanghai, China: a comparison with Chinese-speaking Australians in Melbourne and Chinese in Hong Kong

ObjectiveThe study reported in this paper was aimed at developing understanding of depression-related knowledge and preferences surrounding professional help, medication, and treatment methods among Chinese living in Shanghai, China.MethodsA multi-stage cluster sampling method in which participants were taken from 6 of the 20 districts in Shanghai was adopted for this study. The 522 Shanghai Chinese participants were presented with a vignette describing an individual with depression before being asked questions designed to assess both their understanding of depression and their preferences surrounding professional help, medication, and treatment methods. A comparative approach was adopted to identify similarities and differences between our findings and those of two previous studies on the mental health literacy of Chinese living in Melbourne, Australia, and Hong Kong, respectively.ResultsA similarly low percentage of Chinese people in each of Shanghai, Hong Kong, and Australia recognized depression. Fewer Shanghai Chinese than Chinese living in Hong Kong and Australia ascribed the ‘anxiety/stress’ label to the depression vignette and endorsed professionals and informal network members as helpful. Although a far lower percentage of Shanghai Chinese endorsed the use of counseling professionals, a much higher percentage of the same group endorsed Chinese medical doctors and herbal medication. A lower percentage of Shanghai Chinese endorsed ‘lifestyle changes’ as a strategy for combating depression than did Chinese subjects living in Australia and Hong Kong. On the other hand, a higher percentage of Shanghai residents endorsed psychiatric treatment and the traditional Chinese practices of ‘eating nutritious food/taking supplements’ and ‘qigong’ than among the other two groups of Chinese.ConclusionsThis study underlines the need for campaigns aimed at improving the mental health literacy of Chinese in Shanghai. Such campaigns must take into consideration the socially and culturally driven beliefs to facilitate the development of specific education programs.

The Protective Functions of Relationships, Social Support and Self-Esteem in the Life Satisfaction of Children of Migrant Workers in Shanghai, China

Background: At present, China has approximately 20 million migrant school-aged children accompanying their parents in relocating to the cities. However, very little is known about them. Using a resilience framework, the present study attempted to examine the psychosocial factors affecting their life satisfaction in Shanghai, China. Methods: A total of 625 migrant children were recruited from 10 schools in Shanghai through a cross-sectional survey design using multi-stage cluster sampling method. The questionnaire included measures of life satisfaction, self-esteem, social support, relationships at school and the parent—child and peer relationships. Results: Hierarchical regression analysis was performed to explore the relative effects of different relationship domains, self-esteem and social support on the life satisfaction of migrant children. The results suggested that parent—child and peer relationships significantly influenced the life satisfaction of children of migrant workers. Relationships in school did not exert such effect. Both social support and self-esteem had significant effects on the life satisfaction of migrant children. Conclusions: Relationship factors, social support and self-esteem are critical factors affecting the life satisfaction of migrant children. The findings and implications were discussed in relation to developmental and migration-related issues and the social contexts of the lives of children of migrant workers in Shanghai, China.BACKGROUND At present, China has approximately 20 million migrant school-aged children accompanying their parents in relocating to the cities. However, very little is known about them. Using a resilience framework, the present study attempted to examine the psychosocial factors affecting their life satisfaction in Shanghai, China. METHODS A total of 625 migrant children were recruited from 10 schools in Shanghai through a cross-sectional survey design using multi-stage cluster sampling method. The questionnaire included measures of life satisfaction, self-esteem, social support, relationships at school and the parent-child and peer relationships. RESULTS Hierarchical regression analysis was performed to explore the relative effects of different relationship domains, self-esteem and social support on the life satisfaction of migrant children. The results suggested that parent-child and peer relationships significantly influenced the life satisfaction of children of migrant workers. Relationships in school did not exert such effect. Both social support and self-esteem had significant effects on the life satisfaction of migrant children. CONCLUSIONS Relationship factors, social support and self-esteem are critical factors affecting the life satisfaction of migrant children. The findings and implications were discussed in relation to developmental and migration-related issues and the social contexts of the lives of children of migrant workers in Shanghai, China.

A comparison of female migrant workers’ mental health in four cities in China

Background: There are approximately 47.5 million female migrant workers living in major cities in China. Numerous studies have documented the marginalized living conditions confronting migrant workers in cities, such as employment difficulties, unjustifiably demanding working conditions, lack of medical insurance and social provision, poor housing conditions, unfavourable educational arrangements for migrant children, and discrimination by urban residents. In addition, female migrant workers may suffer from discrimination, exploitation and oppression. Aim: This study aimed to explore the difficulties and perceived meaningfulness of migration and their effect on the mental health status of female migrant workers in Shanghai, Kunshan, Dongguan and Shenzhen. Methods: A total of 959 female migrant workers from 12 factories completed the questionnaires, which included the Brief Symptom Inventory, the Migration Stress Scale and the Meaning in Migration Scale. Results: The findings indicate that 24% of female migrant workers could be classified as having poor mental health and the percentage in Shenzhen (35%) was far greater than in the three other cities in China. ‘Financial and employment-related difficulties’, ‘cultural differences’, gender-specific stressors and ‘better future for self and children’ significantly accounted for the mental health outcomes of female migrant workers. Conclusion: Recommendations for policy change and service initiatives targeted at improving the mental health of female migrant workers are discussed.

Schizophrenia literacy among Chinese in Shanghai, China: a comparison with Chinese-speaking Australians in Melbourne and Chinese in Hong Kong

Objective: The study reported in this paper was aimed at developing understanding of schizophrenia-related knowledge and preferences surrounding professional help, medication, and treatment methods among Chinese living in Shanghai, China. Method: A multi-stage cluster sampling method in which participants were taken from six of the 20 districts in Shanghai was adopted for this study. The 522 Shanghai Chinese participants were presented with a vignette describing an individual with schizophrenia before being asked questions designed to assess both their understanding of schizophrenia and their preferences surrounding professional help, medication, and treatment methods. A comparative approach was adopted to identify similarities and differences between our findings and those of two previous studies on the mental health literacy of Chinese living in Melbourne, Australia and Hong Kong, respectively. Results: A lower percentage of Shanghai Chinese than Hong Kong Chinese and Australian Chinese could correctly identify the condition described in the vignette as a case of acute schizophrenia. Although a far lower percentage of Shanghai Chinese endorsed the use of counselling professionals, a much higher percentage of the same group endorsed Chinese medical doctors and herbal medication. A lower percentage of Shanghai Chinese endorsed ‘lifestyle changes’ as a strategy for dealing with schizophrenia than did Chinese subjects living in Australia and Hong Kong. On the other hand, a higher percentage of Shanghai residents endorsed psychiatric treatment and the traditional Chinese practices of ‘eating nutritious food/taking supplements’ than among the other two groups of Chinese. Conclusions: This study highlights the need for educating Chinese in Shanghai to improve their schizophrenia literacy. The contents of the education programmes will need to take into consideration the socially and culturally driven beliefs that may have been influencing the knowledge and preferences of Shanghai Chinese concerning professional help, medication, and treatment methods for people suffering from schizophrenia.

Gender differences in mental health literacy among Chinese-speaking Australians in Melbourne, Australia

Objective: This study attempted to understand gender differences in knowledge of mental illness, preference for professional help, and medications and treatment methods among Australians of Chinese-speaking background. Methods: This study adopted a cluster convenience sampling method in which subjects were taken from the four major areas in cosmopolitan Melbourne where most Chinese people are living. A total of 200 Chinese-speaking Australians participated in the study. They were presented with two vignettes describing an individual with acute depression or acute schizophrenia and then questions were asked to assess their understanding of the conditions, preference for professional help, medications and treatment methods. Results: More female than male respondents could correctly identify the conditions in the two vignettes. Female participants also perceived medications to be relatively more harmful than their male counterparts. In contrast, there were significantly more males than females who adhered to traditional views on the causation of mental illness; had significantly higher percentages of endorsement of ‘deal with it alone’; believed ‘traditional Chinese medical doctor’ and ‘Chinese herbal medicines’ to be helpful to the person in the schizophrenia vignette; and significantly endorsed ‘psychiatric ward’, ‘electro-convulsive treatment’, ‘changing fungshui’ and ‘traditional Chinese worship’ to be helpful for the persons in both vignettes. A combination of factors, which included age, duration of migration and traditional Chinese cultural values, were put forward to explain the above differences. Conclusions: Campaigns to improve the mental health literacy of Chinese-speaking Australians must take into account the gender differences between male and female Chinese-speaking Australians so that culturally relevant and gender-specific education programmes can be developed.

Erratum to: A Preliminary Study of an Integrated and Culturally Attuned Cognitive Behavioral Group Treatment for Chinese Problem Gamblers in Hong Kong

Chinese people may have a higher rate of gambling problems than other cultural groups. However, there are very few clinical outcome studies that have demonstrated the effectiveness of clinical interventions for helping Chinese gamblers. Cognitive behavioural therapy (CBT) has been found to be effective for helping problem gamblers to significantly reduce their gambling problems in western countries. Very few CBT clinical trials have been conducted with the Chinese populations, and the results were masked by methodological limitations. This preliminary study attempted to test the effectiveness of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. This study adopted a randomized control design and 38 participants were allocated randomly to the experimental condition (n = 18) and control condition (n = 20). The experimental group received 10 weekly CBT group sessions and individual counseling services while control group only received the individual counseling services. Significant decreases in gambling severity and frequencies of gambling were found in the experimental group. The findings also showed that a change in gambling cognitions predicted the changes in gambling severity and gambling urge while a change in gambling severity was also linked to a change in depression. Preliminary evidence highlights the potential benefits of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. However, a more vigorous research design with a larger sample is needed to provide solid evidence of the effectiveness of the model for Chinese problem gamblers.