Adolescence is a crucial stage of development, and the unique health needs associated with this stage of life have been increasingly recognized in recent years. One of the most pressing concerns is the mental health of adolescents, as self-harm is the third-ranked global cause of adolescent deaths in 2015, with almost half of these deaths occurring in the South-East Asia region. In addition, self-harm and depressive disorders are leading causes of disability among adolescents in the region.
However, access to mental health services for children and adolescents is limited, particularly in low- and middle-income countries (LMICs) like Nepal. According to the WHO Mental Health Atlas 2017, the median number of child and adolescent mental health beds is less than 1 per 100,000 population in LMICs, compared to over 1.5 per 100,000 in high-income countries. The median availability of child and adolescent mental health care was lower than 9% across the 78 nations that reported them.
The situation is further exacerbated for a specific subset of adolescents: those who have been left behind by one or both parents who have migrated for work. Labour migration is an important phenomenon in Nepal and other LMICs, where one or both parents migrate for work, either internally within the same country or abroad, leaving their adolescent dependents at home. An estimated 3.5 million Nepali are working abroad, primarily in India, Malaysia and the Middle East. This has led to families being separated, and thousands of adolescents are left behind in Nepal as a spouse, child or sibling.
This can increase psychological and emotional stress and feelings of loneliness and abandonment, as well as reducing self-esteem among left-behind adolescents, which in turn may have a negative impact on their psychosocial health. Studies have shown that left-behind children and adolescents have worse outcomes than children of non-migrant parents, specifically with regards to mental health and nutrition. A global school-based student health survey among Nepali adolescents aged 13–17 years showed that lower perceived parental engagement was significantly associated with higher odds for suicide attempt and anxiety in both boys and girls. These findings suggest a need for focused mental health interventions for left-behind adolescents in Nepal and other low- and middle-income countries to address the negative impact of labour migration on adolescent mental health.
The unique health needs associated with the second decade of life, particularly mental health, is a pressing concern for adolescents globally, and particularly in low- and middle-income countries like Nepal. The limited access to mental health services and the added stress and challenges faced by left-behind adolescents due to labor migration, highlights the need for focused interventions and a more comprehensive approach to addressing adolescent mental health in these countries.
Labour migration has become an increasingly common phenomenon, with many parents leaving their home country in search of better opportunities or work. However, this migration can have significant psychological and emotional effects on the family members left behind, particularly on children and older adults. Studies have shown that left-behind children and older adults in Nepal are vulnerable to feelings of loneliness, abandonment, and loss, which can lead to mental health issues such as anxiety, depression, and stress.
The term “Dubai Syndrome” was coined by Ahmed et. al. in 1991 while studying migrants from Karachi to Dubai for psychosocial disorders among members of the families where one of them (usually male and head of the family) goes out of the country (usually Gulf States) for better jobs. It is not unusual to migrate to far and distant lands in search of better pastures. Presumably the families left behind in rural or suburban setup have social support of traditional joint families with established duties and obligations of various members. The mechanism of stress management is built within the social and moral values and religious practices but the family member abroad has to face the stress of a new environment, culture and work setting alone and away from his/her family. Similar issues have been faced by Nepali migrants and their families left behind. Research has shown that migrant workers from Nepal, particularly those who have migrated for work often experience a range of mental health issues. Atteraya et. al. found that Nepalese migrant workers in South Korea have high rates of depression and anxiety. Multiple other studies have found that poor working conditions, lack of social support, and difficulty adjusting to a new culture were major contributing factors to these mental health issues. The studies also found that these workers often have limited access to mental health services and support, which can exacerbate their mental health problems.
Technology, however, has the potential to help bridge the psychological gap created by labor migration, and social mobile games have emerged as a powerful tool for achieving this. Social mobile games, such as those that are played on smartphones or tablets, provide a platform for people to connect and interact with others, regardless of their location. Engaging in these games can help take the mind off of negative thoughts and emotions, and provide a sense of accomplishment and satisfaction. Through these games, left-behind children and older adults in Nepal can connect with their parents or other family members who have migrated, as well as with others in similar situations. The ability to communicate and interact with others can help reduce feelings of isolation and loneliness, which can have a positive impact on mental health and well-being.
Social mobile games can also serve as an educational tool, providing children and older adults with the opportunity to learn new skills, improve their cognitive abilities and even learn new languages. This can be particularly beneficial for children who may be struggling in school, as well as for older adults who may be looking for ways to keep their minds active and engaged.
Furthermore, social mobile games have the potential to bridge the psychological gap created by labor migration by providing a platform for connection, entertainment, and education. By using these games, left-behind children and older adults in Nepal can reduce feelings of isolation and loneliness, while also improving their mental health and well-being. It is important for family members and caregivers to be aware of this potential and encourage their loved ones to engage in these games.
Mobile phone games, specifically those with social features, can be an effective way to reduce stress and anxiety for people who are separated from their loved ones due to migration. Participants who played social mobile games reported a decrease in stress and anxiety, as well as an increase in feelings of social connectedness.
Additionally, social mobile games can also have a positive impact on the emotional well-being of older adults who are separated from their loved ones due to migration. The study found that social mobile games can help to reduce feelings of loneliness, depression and anxiety. Social mobile games can also have a positive impact on the emotional well-being of older adults.
Social card games, which are games that simulate traditional casino games such as slots, poker, and blackjack, call break, marriage (rummy), are effective tools for teaching computer science, mathematics, statistics, probability, and decision-making strategies. They provide an engaging and interactive way for students to learn and practice these concepts, which can lead to better understanding and retention of the material.
Mobile card games can also be used to teach decision-making strategies. Research presented at the International Conference on Games and Learning Alliance suggests that playing card games can help players learn to make more informed decisions, statistics and risk management. The study found that students who played card games demonstrated a deeper understanding of probability and statistics concepts compared to students who did not play the games.
Social mobile games like Callbreak and Marriage developed by Bhoos Games can be an effective way to reduce stress, anxiety, feelings of loneliness, and abandonment due to family members being separated by international borders as the game developers can integrate props and narrative that are loved by the Nepalese populace at large. Family members can interact among themselves while playing a fun game instead of just talking about how their lives are going on at their respective locations.They provide a sense of social interaction and connection, which can help alleviate these negative feelings while the players can learn strategic decision making and risk management. As a result, playing games can strengthen the bond between family members.