The ties that bind: migrant worker social networks, mental health, loneliness and self-rated health.

AIMS: Migrant domestic workers (MDWs) are separated from family and at-home support networks while working abroad. This may affect their mental health due to stressors, social isolation and loneliness. Evidence shows mixed results on whether social capital and social support enhance MDWs' mental health, warranting further investigation. This study assessed how positive and negative dimensions of social network capital are associated with mental health, loneliness and self-rated health among MDWs in Macao SAR, China. METHODS: Using respondent-driven sampling, 1,681 MDWs (Filipino n = 1329; Indonesian n = 352) were enrolled. Egocentric name-generating questions captured network size, emotional closeness, social support helpfulness, reciprocity burden and financial support access. Multivariable linear regression examined associations stratified by nationality, and subgroup analysis by network type were examined. To address multiple comparisons across five network capital measures and five outcomes, p-values were adjusted using the Benjamini-Hochberg (BH) false discovery rate procedure. RESULTS: Network capital characteristics differed across network types. The mean (standard deviation) overall network size was 6.00 (3.77) for Filipino MDWs and 3.69 (2.52) for Indonesian MDWs. Following BH adjustment, among Filipino MDWs, greater social support helpfulness was associated with lower loneliness (Standardized β [Stdβ] = -0.15, Standard error [SE] = 0.02, p < 0.001) and better self-rated health [Stdβ = 0.15, SE = 0.01, p < 0.001]), while higher reciprocity burden was consistently associated with poorer outcomes (e.g., post-traumatic stress disorder [PTSD]: Stdβ = 0.21, SE = 0.63, p < 0.001). Network size was associated with higher mental health symptom scores (Depression: Stdβ = 0.08, SE = 0.04, p = 0.004; Anxiety: Stdβ = 0.08, SE = 0.04, p = 0.003; PTSD: Stdβ = 0.08, SE = 0.11, p = 0.003), but less loneliness (Stdβ = -0.07, SE = 0.01, p = 0.007). Among Indonesian MDWs, reciprocity burden and financial support access showed associations primarily with depression (reciprocity burden: Stdβ = 0.44, SE = 0.60, p < 0.001; financial support: Stdβ = 0.22, SE = 0.97, p = 0.007) and anxiety (reciprocity burden: Stdβ = 0.32, SE = 0.60, p < 0.001; financial support: Stdβ = 0.23, SE = 0.97, p = 0.008) within roommate networks. Most standardized effect sizes were modest (Stdβ < 0.25). CONCLUSIONS: Network capital is associated with mental health, loneliness and self-rated health among MDWs, but patterns differ by nationality and network type. Culturally responsive and context-specific strategies that strengthen supportive ties and reduce network-related burdens may improve MDWs' health.