"A chance to open my heart": Protective factors for mental health in left-behind family members of Nepalese labor migrants and their implications for future psychosocial interventions.

Labor migration is prevalent in Nepal, however, the psychosocial impacts on left-behind families remain underexplored. This study aims to address this gap by examining the lived experiences, coping mechanisms, and social dynamics of left-behind family members in Chitwan District, Nepal. This qualitative study employed a modified phenomenological approach, incorporating in-depth interviews (n = 18) and two focus groups (n = 11) with left-behind family members in Nepal. Transcripts were coded and categorized using Dedoose, facilitating the identification of themes related to the experiences of left-behind family members. Findings revealed that left-behind family members engaged in activities such as household chores, religious practices, physical exercise, creative pursuits, and social media use to cope with the absence of their migrant relatives. Emotional responses included gratitude, loneliness, grief, and anxiety. A significant shift in responsibilities was noted, particularly for left-behind spouses and first-born children, who often assumed traditional paternal roles within Nepalese society. Some families experienced improved financial stability, while others faced greater stigma and social isolation. Resilience was a recurring theme, with many participants demonstrating remarkable adaptability despite the challenges that arose from family separation. Our study suggests that left-behind family members experienced important changes in their roles as well as in emotional and social relationships. Future studies could extend this work to identify factors leading to changes that promote resilience.