Between leaves and lives: Maternal mental health among tea garden workers in Bangladesh and its association with children's behavioural difficulties.

Despite growing recognition of the intergenerational effects of maternal mental health, evidence from tea garden communities remains limited. This study assessed the mental health status of working mothers in tea gardens of Moulvibazar, Bangladesh, examined its association with children's well-being, and explored contextual factors shaping maternal mental health. A convergent cross-sectional mixed-methods study was conducted. Using a purposive and stratified random sampling technique, the quantitative data were collected from 451 working mothers with at least one child aged 2-7 years. Mothers' psychological well-being was assessed using the Depression, Anxiety, Stress Scale-21 and World Health Organisation-Five scales, while children's behavioural and emotional well-being was measured using the Strengths and Difficulties Questionnaire (SDQ). The qualitative component included 11 key informant interviews and two focus group discussions (FGDs) from Moulvibazar, Bangladesh. Quantitative data were analysed using descriptive and inferential statistics, and qualitative data were thematically analysed. A substantial proportion of mothers reported high levels of psychological distress, with 32.4%, 29.9% and 31.7% experiencing moderate to extremely severe depression, anxiety and stress, respectively, while 33.9% had poor well-being. Age was significantly associated with stress (p = 0.014) and overall well-being (p = 0.002), whereas no significant association was observed between childcare arrangements and anxiety (p = 0.171). Among children, 87.8% were classified as having abnormal SDQ scores based on maternal report. Addressing maternal mental health through improved working conditions, accessible childcare and targeted mental health interventions is critical for breaking cycles of intergenerational vulnerability.