• child;
  • exploitation;
  • labour;
  • mental health;
  • working children


Background  There is increasing international concern over the rising number of children involved in labour, particularly in developing countries. Despite the multitude of related risk factors, and some evidence on their social needs, there has been limited research on these children's mental health.

Methods  The aim of this study was to establish the association between labour-related variables and mental health problems among 780 children in labour (aged 9–18 years, mean 15.8) in the Gaza Strip. Measures included a demographic checklist, the Strengths and Difficulties Questionnaire, the Spence Children's Anxiety Scale and the Depression Self-rating Scale for Children.

Results  Children came from large families (73.2% had eight or more siblings), mainly worked to increase family income, worked an average 6.8 h per day (range 1–16), and only 37.1% had regular rest. Ratings of mental health problems were predicted by different factors, i.e. total difficulties scores by poor friendship relationships and lack of health insurance; anxiety scores by selling in the streets, working to help family, low family income and lack of health insurance; and depression scores by parents' dissatisfaction with the job and longer working hours.

Conclusions  Mental health problems of children in labour are likely to be associated with socio economic determinants, as well as factors related to their under age employment. Policy, legislation and preventive programmes from statutory and voluntary agencies should adopt an integrated approach in meeting their mental health needs, by enhancing protective factors such as return to school.