Vahabi Mandana, Wong Josephine Pui-Hing
Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada.
Daphne Cockwell School of Nursing, Faculty of Community Services Ryerson University, Toronto, ON, Canada.
BMC Public Health. 2017 May 23;17(1):498. doi: 10.1186/s12889-017-4431-4.
Canada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services.
In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis.
A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants' narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women.
A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant caregivers to apply for permanent residence upon arrival; the TFWs Program to establish fair wages and subsidized housing so that caregivers can truly access the live-out option; and local ethno-specific, settlement and faith organizations be leveraged to provide TFWs with social support as well as information about their rights and how to access health and social care.
加拿大依靠临时外国工人（TFWs），也被称为移民工人，来填补农业、酒店业、建筑业、儿童/老年人护理及其他低技能职业的劳动力短缺。有证据表明，临时外国工人，尤其是女性住家护理员（LC），构成了弱势群体。她们的健康因所面临的不稳定且恶劣的工作和生活条件而受到损害。关于住家护理员的心理健康、她们的支持系统以及获得心理健康服务的研究匮乏。
在这项基于社区的探索性研究中，我们使用调查和焦点小组的混合方法，来探究加拿大安大略省大多伦多地区移民住家护理员的工作相关经历和心理健康状况。采用便利抽样和滚雪球抽样的方法招募参与者。纳入标准为：年龄在18岁及以上，最初作为住家护理员项目下的临时外国工人移民到加拿大，居住在大多伦多地区，且根据自我报告能够理解并使用英语交流。本文报告了基于归纳主题分析得出的焦点小组结果。
共有30名女性住家护理员参与了该研究。她们大多来自菲律宾。从参与者的叙述中出现了一些关键主题：（1）不稳定的移民 - 就业状况（重新）产生剥削；（2）技能退化和社会地位下降加剧了疏离感；（3）为家乡的家人忍受艰难困苦；（4）公开的快乐与私下的痛苦并存的双重生活；以及（4）未被认识到的心理健康需求。研究结果反映了这些女性所经历的严重不公。
需要采取多方面的方法来改善这一弱势群体的工作和生活条件，并最终改善她们的健康状况。我们建议如下：政府进行检查，以确保雇主遵守劳动标准并提供安全的工作和生活条件；改变移民政策，允许移民护理员一到加拿大就申请永久居留权；临时外国工人项目制定公平工资并提供补贴住房，以便护理员能够真正选择不住家工作；利用当地特定族裔、定居点和宗教组织为临时外国工人提供社会支持以及关于他们权利的信息，以及如何获得健康和社会护理的信息。
