Every year, countless Nepalis leave the country in search of better employment opportunities abroad. The Department of Foreign Employment (DoFE) issued over 600,000 labor permits in Fiscal Year 2079/80 BS (2022/23 AD) alone. Nepal is heavily reliant on foreign employment as a primary economic activity, with an estimated 3.5 million to 3.8 million Nepalis working overseas. Their contribution to the economy remains significant. In 2022/23 AD (2079/80 BS), Nepal received NPR 1.24 trillion (USD 9.3 billion) in remittances, a 21.2 % increase from the previous year, making remittances the country’s largest source of foreign exchange and an important pillar of the national economy.
While much emphasis is put on the remittance Nepal receives, migrant workers returning to the country face neglect in many aspects. Each year, Nepali migrant workers return in large numbers, especially during crises. During the COVID-19 pandemic, an estimated 700,000 returned in 2020/21 AD (2077/78 BS). These returnees carry with them physical and psychological trauma as a result of exploitative or unsafe working conditions abroad. Such hurdles make reintegration into society difficult for many, leading to isolation and mental health issues. Nepal cannot afford to ignore these issues, as they indicate a structural failure with serious economic, social, and public health consequences.
The Weight Returnees Carry
The difficulties for Nepali migrant workers start before they even leave the country. Securing foreign employment is itself a costly and bureaucratically demanding process; workers must navigate manpower agencies, pay documentation fees, undergo medical examinations, and complete pre-departure orientation, all before they set foot on a plane. Labor migration costs are estimated between NPR 200,000 (USD 1,302.68) and NPR 500,000 (USD 3,256.69) for each migrant, the majority of which is taken as a debt at high interest rates around 24-36% per annum. With a significant debt already accrued, even before they start earning abroad, migrant workers arrive at their destinations under immediate pressure to earn enough to service it.
These pressures worsen from the conditions workers face abroad. Workers report withheld wages, passport confiscation, unsafe working conditions, and limited access to justice. This has a serious psychological impact. Studies by the International Organization for Migration (IOM) and Nepal’s National Human Rights Council have found that returnee migrant workers commonly experience high levels of depression, anxiety, stress, and trauma-related symptoms, largely linked to exploitative working conditions, debt burdens, and difficult reintegration processes.
Returning home also becomes difficult for many migrants. Families often invest heavily in migration, expecting remittances to repay debts and improve their future. However, many returnees come back without savings or financial stability, facing social stigma, especially in hill and Terai communities, where unsuccessful migration is often seen as a personal failure. This sense of shame contributes to social isolation, depression, and untreated mental health problems, particularly when financial insecurity prevents access to proper support and care.
The Economic Repercussions
The WHO estimates that depression and anxiety alone cost the global economy USD 1 trillion each year in lost productivity, a figure that translates directly into lost livelihoods, reduced household incomes, and weakened local economies in communities like those Nepal’s returnees come home to. Districts with the highest foreign migration rates in Nepal, such as Sindhupalchok, Ramechhap, and Bajura, face a quiet economic crisis at home. With much of the working-age population abroad, agricultural productivity has been declining for years as fields go untended and rural labor shortages deepen. Returnees represent a significant share of the local working-age population, and whether they can reintegrate productively has a direct bearing on the economic future of these districts. If a large percentage of these returnees turn unproductive due to depression, anxiety, or PTSD, the productivity of entire communities can be jeopardized.
Poor reintegration also creates a cycle of repeated migration. Many workers return home with debt, limited job opportunities, and little mental health support. Without stable incomes in Nepal, going abroad again often becomes the only option. This keeps families trapped in debt, continuing long periods of separation and increasing Nepal’s dependence on remittances. According to the Nepal Labor Migration Report 2024, around 37% of labor approvals issued in FY 2079/80 BS (2022/23 AD) and FY 2080/81 BS (2023/24 AD) were renewals, showing that many workers migrated repeatedly instead of being able to settle back home.
Returnee households experience higher rates of substance abuse, family conflict, and child neglect. These problems increase healthcare expenses, reduce productivity within households, and affect children’s well-being and development. In the long run, these social and economic costs became a burden not only for families, but for the state as well.
Nepal’s Response and What Other Countries Did Better
Nepal’s mental health system remains weak, even compared to other South Asian countries. According to WHO data from 2021, around 90% of psychiatrists and psychologists were based in Kathmandu, while rural districts with high migration rates had little or no access to professional mental health services. Government spending on mental health also remains among the lowest in the region.
For returnee migrants, support systems remain even more limited. Policies such as the Foreign Employment Act 2007 AD (2064 BS) and the Foreign Employment Welfare Fund (FEWF) mainly focus on sending workers abroad rather than supporting them after they return. Although the FEWF collects money from migrant workers, it prioritizes areas such as insurance and skills training, while giving little attention to psychosocial support and reintegration counseling.
Some civil society organisations have attempted to fill these gaps. Transcultural Psychosocial Organization (TPO) Nepal works on community-based mental health programs and trains local health workers, though its reach among returnee migrants remains limited.
Other labor-exporting countries have developed stronger reintegration systems. The Philippines has a broader rehabilitation program that combines livelihood support, psychosocial counseling, and peer support from former migrants. The Bureau of Foreign Employment in Sri Lanka also provides returnee assistance programs, though on a smaller scale. Bangladesh adopted a Recognition of Prior Learning (RPL) system to officially recognize skills gained abroad, helping returnees find jobs more easily after coming home. Though Nepal has discussed similar RPL frameworks for years, these haven’t come to fruition.
The Way Forward
Nepal already possesses institutions and mechanisms to support the mental health and reintegration of returnee migrants; they just require proper implementation. The country already has a network of around 52,000 Female Community Health Volunteers (FCHVs) working in rural areas where many returnees live. With proper psychosocial support training, developed together with organizations such as TPO Nepal, these community health workers can provide mental health support at the local level at a relatively low cost.
The Foreign Employment Welfare Fund (FEWF), financed through contributions from migrant workers, has accumulated substantial financial resources over the years. However, much of the fund has primarily been used for compensation related to death, injury, and resettlement, while comparatively little has been directed toward mental health and reintegration support. Even allocating a small portion of the fund for these services can help establish district-level reintegration centres, train counsellors, and expand tele-counseling services. With Nepal’s mobile penetration exceeding 130% in 2023, mobile-based support remains possible even in remote areas.
The Foreign Employment Act also needs major reforms. The law has remained largely unchanged since 2007 AD (2064 BS) despite major changes in the scale and impact of labor migration. Psychosocial screening and reintegration planning can be included as standard support services for migrant workers. International support also presents opportunities. For example, the World Bank’s Sustainable and Inclusive Finance grant for labor market development and small businesses can support reintegration programs for returnees.
In the long run, Nepal cannot continue depending heavily on remittances alone. Building a productive workforce inside the country requires proper support for returnee migrants and their reintegration into society. Supporting returnees’ mental health is not simply a social welfare issue; it is an investment in the country’s human capital and long-term economic future.
Grishma Dhungel is a Kathmandu-based social work and development professional with a background in psychology and community engagement. She has experience in youth programs, child protection initiatives, and education-focused projects, contributing to community development and psychosocial support efforts. She holds a Bachelor’s degree in Social Work and is currently pursuing a Master of Business Administration. Her interests include mental health, social development, and community-based interventions.
