Abstract
BACKGROUND: Migration through the Darién Gap en route to the US peaked in 2023, with hundreds of thousands of people in transit exposed to physical and psychological health hazards. However, systematic data on mental health conditions for this population remain limited. This study explored the prevalence of psychological symptoms, mental disorders, exposure to psychological trauma, and health-related quality of life among migrants in transit through Darién and described age- and sex-based differences. METHODS: In January 2022, we conducted a cross-sectional mental health assessment at a government-run Migrant Reception Station in Darién, Panama. Randomly selected adults and adolescents aged ≥12 years completed the Refugee Health Screener-15 (RHS-15) and the EUROHIS-QoL-8. Those who screened positive were offered clinical evaluation by mental health specialists using the Mini International Neuropsychiatric Interview. RESULTS: Among 137 participants (median 30.0 years [IQR 11.0]; 54.1 % male), 65.0 % screened positive for psychological distress, and 35.6 % met the diagnostic criteria for at least one psychiatric disorder. Trauma- and stress-related disorders (24.4 %) and depressive disorders (17.0 %) were most prevalent. Females reported higher exposure to psychological trauma during the crossing relative to males (43.6 % vs. 23.3 %; p = 0.01) and higher prevalence of history of mental disorder (25.8 % vs. 5.5 %; p = 0.001). A larger proportion of adolescents and younger adults [12-24 years] scored at-risk for suicide compared with older participants [ages 25 years and older] (36.7 % vs. 10.5 %, p = 0.001). Findings highlight significant mental health burden during transit and suggest the potential utility of targeted screening and referral mechanisms in reception settings.