At a dyeing company in Tamil Nadu’s Erode, Sunita (name changed), 30, spends long hours doing packing work. Although it does not fall under her job profile, on many days, she is asked to lift heavy loads, sacks that strain her back and leave her nauseous. She has cried in frustration, but supervisors have dismissed her complaints, she says. Ms. Sunita, a migrant worker from Patna, Bihar, lives with her husband and three young children in a rented accommodation, about 30 minutes away on foot from her workplace. With no bus service, she walks daily. If she tells her supervisors she is too tired, they simply ask her to “go elsewhere and find another job.”
“Some days, my mind is as exhausted as my body,” Ms. Sunita says. “I cry then, but what is the point? I must go back because I must earn money for my family.”
For women like her, physical fatigue cannot be separated from mental strain. Across Tamil Nadu, women migrants working in garment factories, small units, and homes speak of the same distress. A February 2025 survey involving unskilled inter-State migrants in the country found that 47.9% showed symptoms of depression and anxiety. Women reported higher rates, with acculturative stress, discrimination, and harsh living conditions identified as key contributing factors.
Tamil Nadu, being a hub for construction and manufacturing, draws thousands of women migrants from Bihar, Uttar Pradesh, Chhattisgarh, West Bengal, and Odisha. They are employed in garment factories in Tiruppur, Coimbatore, and Erode, in small-scale manufacturing units in Chennai, and as domestic labourers. But their daily lives are shaped by discrimination, language barriers, heightened surveillance, delayed wages, lack of clean water and sanitation, limited access to healthcare, long hours, and sexual harassment. Many also endure domestic abuse, alcoholism in families, and the constant fear of losing their jobs.
The Hindu visited Burma Nagar, in Chennai’s Manali, where migrants from Bihar, Uttar Pradesh, and other States live in cramped rented rooms. Conversations with women workers there, with those in other districts over the phone, as well as with activists and mental health experts, painted a picture of distress hidden behind factory lines and inside homes.
Pooja (name changed), 17, is one such young worker. Hailing from Patna, Bihar, she lives in Burma Nagar with her parents and works at a small bag-making unit to support her family. “As soon as I wake up, I feel sadness and hopelessness,” she says. Her father, an alcoholic, comes home drunk and beats her, while her mother blames her for the violence. “If I talk to someone about it and my parents find out, they beat me more.” Ms. Pooja earns ₹9,000 a month, all of which is taken by her parents. “How much more can I give, as a daughter?” she asks.
In the same neighbourhood, Bharati (name changed), 45, has not slept well in weeks. “Bahut chinta hoti hai,” she says. “I am always worried – about rent, my husband’s job, my children’s problems, and our loans. When someone we owe money calls, I am scared. I never know what to say.”
Her most recent concern arose during a visit to a government hospital in Chennai for joint pain. “I was told I have a problem with my kidneys. But to get further treatment at a better hospital, I would need a local ID proof to avail of insurance. How will I get that? We cannot afford treatment at a private hospital,” says Ms. Bharati, who also migrated from Patna and works at the same bag-making unit as Ms. Pooja.
Social sector professionals say such stories reveal how mental health struggles are tied to exploitative work and living conditions. Where even basic amenities are missing, access to mental health services is virtually non-existent, notes Deepika Rao, executive director of CIVIDEP India, a social impact organisation working with garment workers. “And because the fight is still for wages and basic needs, awareness of mental health is almost seen as a luxury.”
Body as symptom
Vikhram Ramasubramanian, psychiatrist and CEO of Ahana Hospitals, Madurai, explains that mental health concerns among migrants often show up as physical ailments. “The women may face issues with sleep and appetite, feel tired, experience joint pain, chest pain, or stomach pain,” he says.
In some cases, when women experience bodily symptoms and report them to a supervisor, they may be taken to a local doctor, says Dr. Ramasubramanian, who has worked extensively with migrant workers. “The medical practitioner may prescribe medication, but the symptoms typically do not subside. The supervisor may then feel that the worker is not productive enough, and when their job is at risk, these women tend to mask their complaints and continue working. In extreme cases, there are suicide attempts; but in most cases, they leave their workplace and return home,” he explains.
When asked whether she has ever considered seeking treatment for her symptoms, Ms. Sunita explains that missing work to visit a doctor is rarely an option, and even if it were, the high cost of treatment is unaffordable. Although government hospitals in Tamil Nadu offer free treatment to migrant workers too, accessing the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) requires having their names on a Tamil Nadu ration card or holding a migration certificate.
A senior official in the State Labour Department notes that in such cases, migrant workers can instead use the Union government’s PM-JAY cards – given by their source States – which allow them to receive treatment at empanelled private hospitals across the State.
Inside the garment industry
The garment factories in Tiruppur, where several migrant women are employed, are infamous for their high attrition rates, owing to their oppressive working and living conditions, says Benoy Peter, executive director at the Centre for Migration and Inclusive Development (CMID), a non-profit based in Kerala. The industry encourages strenuous, target-oriented work, and workers must do as much as possible in a short time to earn more.
Often, workers cannot even take toilet breaks or drink enough water, leading to nutritional deficiencies and musculoskeletal problems, adds Ms. Deepika. She points out that constant verbal harassment is another factor harming physical and mental health of workers in this industry. “This sector has extremely high productivity demands, which are often unscientific and arbitrary. To meet these targets, workers face constant verbal abuse from supervisors and line managers, and it takes a direct toll on their mental health.”
Moreover, the migrant women who work here live almost a captive life. “Under the guise of making them feel safe, they are usually accommodated near their workplaces by their employer, and there, surveillance is high and mobility restrictions are common,” explains Mr. Peter.
Because they have less access to outlets or any social life outside of their limited environment, they face isolation. This, in turn, impedes any support they may receive and foils any sense of belonging they may have.
Dr. Ramasubramanian adds that in some of these accommodations, mobile phones are not allowed, and the women can only communicate with their families and friends – sometimes even their children – back home through the warden’s number. Limiting their freedom to communicate with people also takes a huge toll on their mental health, he adds.
Domestic work and isolation
For migrant women working as domestic labourers in private homes too, isolation is a major concern; they are often expected to stay inside the house 24×7. “Their physical and mental health comes at the cost of serving the families they work for. They may have to face humiliating circumstances due to caste and class divides. In many cases, their salary is taken by the agent who brought them to the State, or sent to their family back home. They rarely get to keep anything. And without access to mobile phones, they are also left with no outlet,” Mr. Peter explains.
R. Karuppasamy, founder of Rights Education and Development (READ), says women migrant workers who migrate with their families also do not have it easy. “Alcoholism is very common among men, and it is the women who have to shoulder the responsibility of running the family,” he says.
Language barrier and discrimination based on their identity as migrant workers are also common among both these subsets. “Because they are poor and speak another language, they are often viewed through the lens of suspicion. When a crime is committed, fingers are pointed at them. It makes them feel like second-class citizens,” he adds.
There are reported cases of suicides and attempted suicides too among women migrant labourers, but they are often brushed off as issues due to “love affairs or familial problems,” distancing them from the social realities of these women, adds Mr. Karuppusamy.
Coping mechanisms
Madhuri, 20, residing in Burma Nagar, has not been to work for over a week, as the tailoring unit she works at has been facing losses. She is the eldest of five siblings – three sisters and a brother – and migrated with her family from Uttar Pradesh several months ago.
“My father is very upset because of our financial constraints. Watching him makes me upset. Sometimes I go nights without sleeping, worrying about him, about money,” she says.
Still, she says having her siblings around makes things easier. “We do not have mobile phones or a TV. When we have nothing to do, my siblings and I talk, or even stitch clothes,” says Ms. Madhuri, who scored good marks in Class 12 and hopes to study further someday.
“Community is central to the mental well-being of these workers, which is why community-level interventions are essential,” says Father Simolin, Director of Don Bosco Migrant Services, an organisation that works closely with migrant workers in Chennai and surrounding districts.
Raising awareness
Fr. Simolin says that raising awareness about a migrant worker’s rights, including available government schemes, registration processes, and legal entitlements, along with providing legal assistance to help them claim those rights, will greatly contribute to their general well-being. This awareness, however, should not be limited to workers alone. Employers too must be sensitised, as their understanding and cooperation are crucial for ensuring just practices and supportive working environments.
Dr. Ramasubramanian says that Tamil Nadu has a functional District Mental Health Programme (DMHP), which aims to reach underserved populations, but migrant workers often miss out “because there are not enough professionals who speak their language.”
The senior Labour Department official says having multilingual persons engage in providing services through the DMHP is something that could be considered by the government.
Mr. Karuppusamy adds this issue could also be addressed by involving the source State governments of migrant workers. “The source State governments must set up a helpline for them, or the Tamil Nadu government should take the lead by setting up one. It should have someone who speaks their language and can address their grievances, wage issues, mental health concerns, among others.”
Systemic gaps
Sudarshan R. Kottai, clinical psychologist and assistant professor at IIT Palakkad, says that while addressing mental health among migrant workers, “we must also be careful not to overlook the fundamental human rights issues they face.”
“Even if migrant workers are given access to mental health care, most professionals are not trained to understand the complex social realities they live in. We often mimic and clone Western psychological models that do not fit their context.”
He stresses the need for sensitisation among mental health professionals too. “If the cause is structural, then the intervention must also be structural. But our current system is largely individualistic. Mental health care today is focused on ‘cure’, when it should be centred on ‘care’.”
He adds that it is essential to foreground the person – in this case, the migrant worker – and ensure their stories are heard. According to him, meaningful change must begin with policy-level interventions to address labour conditions. “Only then,” he says, “will mental health issues be addressed.”
(This article was produced with the support of Laadli Media Fellowship. The opinions and views expressed are those of the author. Laadli and UNFPA do not necessarily endorse the views)
