Mental Health Problems And Health-risk Behaviors Of Left-behind Adolescents In Rural Areas

Objectives The study aims to investigate the current situation of parental migrant working of rural middle-school students , and to explore the prevalence of psychopathological symptoms and health-risk behaviors of left-behind adolescents, providing evidence for the adverse effects of parents'migrant working on adolescents'psychological and behavioral health.Methods The cross-sectional investigation was conducted in 3 410 students from 7th grade to 12th grade in two middle schools in X county of Anhui Province. The students completed the anonymous questionnaire including the demographic characteristics, migrant working of parents, psychopathological symptoms and health risk behaviors and unintentional injuries. The group difference of mental health status and the incidences of health risk behaviors related to parental migrant working were estimated according to different demographic characteristics respectively. 3246 questionnaires of the intact family were included and analyzed.Results Of 3 246 students investigated in this survey, 2 244 students (69.1%) whose fathers are migrant workers,1 209 (37.2%) students whose mothers are migrant workers, 1 130 (34.8%) whose parents are both migrant workers and 71.6% of all students are left-behind adolescents. The mean age of left-behind students (15.77±1.46) is significantly older than that of non-left behind ones (15.66±1.47) (t=2.08,P﹤0.05). There is no significantly statistical difference in gender distribution between left-behind and non-left behind students (χ2=0.39, P=0.20). Mean time of paternal migrant working (10.7±4.2 years) is statistically longer than that of maternal migrant working (6.3±3.9 years) (U =30.8,P﹤0.01). 46.2% of left-behind students were supervised by their single parents, 33.7% students by their grandparents, up to 11.6% students by themselves, and 2.3% and 6.1% students by compeers and other relatives respectively. Generally, the educational level of migrant working parents is rather low, the care that left-behind students received from parents mainly focus on daily life and seldom on learning.The incidence of psychopathological problems among left-behind students (32.2%) is significantly higher than that of non-left behind ones (12.7%) (χ2=128.337,P=0.000). Moreover, the incidence of psychopathological problems among female students (40.4%) is significantly higher than male students (25.3%) (χ2=60.372,P=0.000). The prevalences of obsession-compulsion,interpersonal sensitivity and psychoticism among students above 16 years old are significantly higher than the students below 16 years old. Parental migrant working significantly affects the psychological development of adolescents. The prevalence of mental health problems among the students (36.3%) whose parents are both migrant workers is significantly higher compare to other students whose father or mother are migrant workers (26.2%) (χ2=17.174,P=0.000). The prevalence of mental health problems among the students (22.5%) supervised by single parents is statistically lower than the students supervised by grandparents (43.5%) and by compeers, other relatives and themselves (36.4%) (χ2=96.167,P=0.000). Using multivariate logistic regression model, it showed that migrant working of mothers and parents was the risk factor for adolescents'mental health problems, with mother and father's education level, sex and age of adolescents, settlement of family controlled as covariants.There is no statistical difference of health risk behaviors between left-behind and non-left behind students. The incidences of lack of physical exercise, being mocked, Internet addiction, fighting and having the idea of going away from home are 39.9%, 20.1%, 14.8%, 9.1% and 7.4% respectively. There is significant relationship between parental migrant working and health risk behaviors of adolescents. The incidences of health risk behaviors (except Internet addiction) and unintentional injuries among the students whose parents are both migrant workers are statistically higher, compared with students whose father or mother are migrant workers. There is significant gender difference in health risk behaviors among left behind students with boys are at much more risk.Conclusions High proportions of middle-school students in rural areas are left-behind. These left-behind students are mostly supervised by their single parents or grandparents. Left-behind students have more psychopathological symptoms compared with non-left behind ones, indicating that bonding of parents and children is the leading cause of adolescent mental health problems and it is essential to encourage parents staying home and taking care of their school-age children. The prevalence of psychopathological symptoms is higher among the students whose parents are both migrant workers than other students whose father or mother are migrant workers. Among these left-behind students,boys have more health risk behaviors than the girls,while girls have more mental health problems than boys. Therefore, more attention should be paid to prevent psychopathological symptoms of female students and health risk behaviors of male students. The incidences of health risk behaviors and unintentional injuries are higher among the students whose both parents are migrant workers than other students whose single parents are migrant workers. There is no statistical difference of health risk behavior between left-behind and non-left behind students,however,the incidences of health risk behaviors and unintentional injuries among the students whose parents are both migrant workers are higher than students whose father or mother are migrant workers,which indicated the lack of effective supervision of parents might increase the health risk behaviors of left-behind students.