The systematic review from Fellmeth et al. (2018) in The Lancet included 111 previous studies on the effects that forced or labor migration had on the children left behind. The majority of studies concerned the left-behind children in rural China with results finding that although families benefit economically from remittances left back home, the health effects on left-behind children are not at all positive. Compared to children who have both parents present, the children with parent(s) that migrated have among others an increased risk of serious mental health problems, such as depression, anxiety, substance use, and even suicidal thoughts. The alarming number of left-behind children worldwide as well as the extensively reported detrimental health effects of parental migration on left-behind children should mobilize healthcare professionals and policy-makers to take action in battling or minimizing the injurious effects on children’s mental well-being. While the majority of studies concerning left-behind children give emphasis on the effects of parental migration on children, there are only a few studies that deal with prevention measures, thus focusing on the needs of children in the first place, rather than the effects of physical abandonment. Consequently, very little is known on which are the most effective public interventions that could support the children’s mental security.
In response, the United Nations Transforming our world: the 2030 agenda for sustainable development, among its 17 SDGs identifies the importance of migration and requests countries to implement research and policies to safeguard the well-being of migrant workers and their left-behind children. To face the adverse effects of migration, governments around the world are gradually implementing a holistic approach, with a focus on poverty reduction (thus limiting the number of labor migrant parents), family-oriented education programs, education in the form of community-based clubs, community support and increased awareness of the common mental disorders of left-behind children to support the early identification of risks. Other policies include free nursery school for all children up to the age of six (in some EU countries), incentives for health care professionals to practice in rural areas (Australia and New Zealand), or free medical care for pre-school children (Japan) (World Health Organization, 2013). In China, where the phenomenon of parental migration from rural to urban areas is extreme, key programs have been initiated in the past couple of years. For instance, psychological counseling rooms have been established in all schools and the National Health and Family Planning Commission has set guidelines for future funding and public education(Ministry of Health of China, 2017).
The European Report on Preventing Child Maltreatment (2013) offers a preventive approach to policy-makers to support them in responding to the increased demands of tackling child maltreatment. Child maltreatment can be defined as physical, sexual, or mental abuse or physical or mental neglect. The report first takes a psychological approach to why children need special attention. Childhood, from the neonatal period to adolescence is a period of brain, physical, emotional, and behavioral development. Child maltreatment can result in stress, behavioral changes, and cognitive impairment which in turn result in impaired physical and mental health, with effects similar to the ones reported in research on the impact of migration on left-behind children (see above). Stable environments and relationships of nurture with parents and caregivers are essential for the child’s healthy development. The lack of a stable environment, especially in the early developmental stages is deemed to influence neurodevelopmental changes in the brain.
The first fifteen years of a child’s life are especially crucial for physical, intellectual, and social-emotional development. At that age, children start to mature and sense their own individuality which can help them identify their own values and simultaneously boost their discipline. Gradually, they will expand opportunities for more independence as they take on responsibility. Despite the struggles that children often experience with changing dynamics of their family relationship, parental support and dedication remain critical throughout this time. With the above being said, it is fair to say that a child’s well-being can be achieved if their parent(s) focus on being around, keep conversations positive, be supportive, and set clear limits with high but reasonable expectations. Maintaining a positive and respectful parent-child relationship during these crucial years will most definitely promote healthy development and a smooth transition toward the next phase of adulthood. Τhe question remains as to how a parent(s) who migrated can foster healthy relationships with his/her children without being physically present and what is to be done for these children to reduce the adverse feelings of leaving.
Turning the focus on prevention measures and public interventions, the UNICEF Working Paper on Children left-behind provides some general recommendations that can support and safeguard (to a certain extent) the rights and well-being of both parents who migrated and the children left behind. The first recommendation concerns the increase of regular channels for migrant workers to move with their families and be afforded family visits during temporary work programs. Yet, until the existing legal structures in various countries change (including EU countries), such a recommendation does not seem feasible for implementation. There is a lack of safe and legal pathways to prevent parents from migrating with their children or even to support family reunification. In the context of labor migration, which is the most widespread case of migration, many work visas do not permit migrants to move with their families. Moreover, family reunification in various countries (for instance see the article “FDW in Cyprus”), can only take place if the migrant worker has prospects of acquiring permanent residency, or at the financial expense of the migrant worker (which is often impossible considering the very low remuneration that low-skilled migrant workers are afforded) with the issuance of a visitor’s visa (which is in turn difficult for children to obtain).
Further recommendations include considering the “left-behind” factor as a vulnerability factor when assessing if a child is in need of social services. As unreasonable as it might sound, being a “left-behind” child is often a factor that does not lead to further support from social services, on the contrary, left-behind children are often excluded from support. Legislation must be adjusted to ensure that these children are not excluded from monetary assistance or food programs based on the expectation that remittances sent back home will cover their needs for care and education. Child protection systems should provide appropriate legal protections and parents should be aided in passing legal guardianship to caregivers who reside in the country of origin. Failure to do so can make it more difficult for children to get fundamental services like schooling or medical treatment. It is of pressing importance that children who are vulnerable in any sense, not just financially, are incorporated into social support programs.
The last recommendation worth mentioning is the need to provide pre-departure information to parents and legal guardians with ways of supporting their children. There should be channels that provide information in the form of risk awareness to best identify any potential emotional and psychological risks that children left behind might face. Parents should undergo educational programs that instruct them on ways to support their children based on the developmental stage of each child and even on personal specificities that can lead a child to need further attention and care. The modern uses of technology as instant communication channels can be proven vastly beneficial for the facilitation of regular/everyday contact between migrant parents and the children they left behind. This is an additional area where parents should be educated and encouraged to engage with to best maintain regular contact with their children. The rationale behind this Erasmus+ project stems from this need; to better educate parents on how to be present even if they are thousands of miles away and provide them with a digital platform where this regular contact can be facilitated.
-  Fellmeth, G., Rose-Clarke, K., Zhao, C., Busert, L. K., Zheng, Y., Massazza, A., Sonmez, H., Eder, B., Blewitt, A., Lertgrai, W., Orcutt, M., Ricci, K., Mohamed-Ahmed, O., Burns, R., Knipe, D., Hargreaves, S., Hesketh, T., Opondo, C., & Devakumar, D. (2018). Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. The Lancet, 392(10164), 2567–2582. https://doi.org/10.1016/s0140-6736(18)32558-3
-  European report on preventing child maltreatment. Copenhagen: World Health Organization; 2013
-  Notice on healthcare work for the left-behind children in 2017. Beijing: Ministry of Health of China; 2017. Chinese.
-  UNICEF, Children left-behind: https://www.unicef.org/documents/children-left-behind