Mental health and psychosocial problems among Chinese left-behind children: A cross-sectional comparative study

Separation from migrant parents threatens the mental health of approximately 61 million left-behind children (LBC) in China. This study compared the prevalence of mental health and psychosocial problems between LBC and controls in Sichuan province, China.

We randomly recruited LBC and adolescents aged 12-16 years old from 16 rural high schools in 8 counties in Sichuan province. We compared frequency of school bullying, self-esteem, panic symptoms, depression and severe psychological distress(SPD) between LBC and controls from the same schools. These variables were assessed through face-to-face interviews and self-report questionnaires.

The prevalence of mental health problems was 43.4% among LBC(n = 1663) but 30.8% among controls(n = 1683), and the prevalence of specific psychological symptoms was also higher among LBC: SPD, 12.1% vs. 4.8%; panic, 32.4% vs. 22.1%; and depressive symptoms, 26.5% vs. 16.3%. Low self-esteem was more prevalent among LBC(26.6% vs. 18.2%) as was severe school bullying(18.5% vs. 11.3%). Among LBC, low self-esteem was associated with an increased risk of depression or SPD, and school bullying was a significant predictor of depression, panic symptoms and SPD. Low self-esteem and depression increased with longer separation from parents, and this risk was higher when the primary caregivers were LBC themselves or relatives compared to single parents or grandparents.

LBC misbehavior, such as internet addiction, smoking and drinking, may also explain our findings; these factors need to be explored in future studies.

Our results highlight the urgent need for school-based and targeted interventions for LBC to prevent negative mental health outcomes.