# Strength and Vulnerability: A Qualitative Study of Mental Health and Unmitigated Communion Among Female Migrants in Southeast England

## TL;DR

This study explores how female migrants in Southeast England experience mental health challenges linked to caregiving and self-sacrifice, highlighting the need for inclusive and gender-aware public health approaches.

## Contribution

The study reframes unmitigated communion as a socially patterned determinant of mental health inequity among migrant women.

## Key findings

- Unmitigated communion is linked to mental distress through gendered expectations of caregiving and self-sacrifice.
- Migrant women often conceal mental health struggles due to stigma and reluctance to seek support.
- Feminist participatory methods reveal tensions between resilience and vulnerability in migrant women's narratives.

## Abstract

Public health relevance—How does this work relate to a public health issue?

Mental health inequities among female migrants are shaped not only by service barriers but by gendered expectations of care and self-sacrifice embedded within migration contexts.

Unmitigated communion functions as a psychosocial pathway through which social determinants of health become embodied as mental distress.

Public health significance—Why is this work of significance to public health?

The study reframes unmitigated communion from an individual vulnerability to a socially patterned determinant of mental health inequity among migrant women.

Co-produced qualitative evidence reveals forms of distress that remain largely invisible within conventional public health surveillance and service models.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or re-searchers in public health?

Public health and mental health services must recognise gendered caregiving and emotional labour as determinants of health when designing equitable, migrant-inclusive interventions.

Equity-oriented co-production frameworks such as EMBaRK (Engaging Marginalised Communities by Building Relationships and Knowledge) offer scalable approaches for engaging marginalised populations and informing inclusive public health policy and research.

Unmitigated communion (UC), the prioritisation of others’ needs over one’s own well-being, is a critical lens for understanding the mental health of female migrants. This qualitative study explores how UC intersects with constructions of strength and vulnerability within this population, particularly amid challenges such as adaptation, discrimination, and gendered roles. Using a feminist participatory methodology, the study was co-produced with 10 migrant women and three professionals. Semi-structured interviews were conducted with 18 female migrants from 13 countries, representing diverse languages, cultures, and lengths of stay in the UK. Data were thematically analysed using the Engaging Marginalised Communities by Building Relationships and Knowledge (EMBaRK) framework, which centres lived experience and equitable collaboration. Through this analytic process, three key themes were generated: (1) perceived strength and resilience shaped by societal pressures and internalised self-reliance; (2) gender roles and self-sacrifice, including traditional caregiving expectations and neglect of personal health; and (3) isolation and reluctance to seek support, marked by concealed mental health struggles and stigma. Participants’ narratives revealed shared tensions between resilience and vulnerability. The findings highlight the central role of unmitigated communion in shaping migrant women’s mental health and underscore the need for gender-responsive, culturally informed interventions that support women to balance caregiving with self-care.