Psychological distress among unaccompanied migrants and persons prone to statelessness in Ghana: prevalence and associated factors from a community-based cross-sectional study.

INTRODUCTION

Psychological distress is a major mental health concern among migrants. Yet evidence concerning unaccompanied migrants and persons prone to statelessness remains limited, particularly in sub-Saharan Africa. This gap constrains efforts to advance their mental well-being and social inclusion in line with Sustainable Development Goals (SDGs) 3.4 and 10.2. This study therefore examined the prevalence of psychological distress and associated factors among these populations in Ghana.

METHODS

Data were obtained from a cross-sectional survey of 481 participants who met predefined eligibility criteria in two purposively selected districts in Ghana. Guided by the Stress Process Model, psychological distress was measured using a study-specific 18-item scale adapted from the Kessler Psychological Distress Scale, Generalised Anxiety Disorder Scale, Post Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition and Patient Health Questionnaire. Data were analysed using descriptive statistics, Pearson's χ2 tests and a generalised ordinal logistic regression in SPSS V.27.0. Statistical significance was set at p<0.05.

RESULTS

Psychological distress was substantial, with 40.7% of respondents experiencing moderate-to-severe levels. Residence in rural/slum areas (adjusted OR (AOR)=2.159, 95% CI 1.502 to 3.104, p<0.001), the Greater Kumasi Metropolitan Area (AOR=1.640, 95% CI 1.020 to 2.636, p=0.041) and younger age (AOR=1.874, 95% CI 1.076 to 3.266, p=0.027) were independently associated with higher odds of psychological distress relative to urban residence, Awutu Senya East Municipal Area and older age, respectively. Conversely, unaccompanied migrants (AOR=0.365, 95% CI 0.201 to 0.665, p=0.001) had lower odds of psychological distress than respondents who were both unaccompanied and stateless-prone.

CONCLUSION

Psychological distress among unaccompanied migrants and persons prone to statelessness reflects intersecting structural and contextual vulnerabilities. Integrating targeted community-based mental health services with legal identity and documentation initiatives, and social protection programmes such as the National Health Insurance Scheme and the Livelihood Empowerment Against Poverty may advance psychological well-being and social inclusion in support of SDG 3.4 and SDG 10.2.