Inhibition or promotion: a study on the impact of relocation on the mental health of left-behind women

China’s poverty alleviation relocation program aims to improve living standards in impoverished areas through population resettlement. However, the mechanisms through which it affects the psychological well-being of left-behind women have not been clearly elucidated. Existing research predominantly focuses on the material outcomes of the policy, lacking systematic investigation into the often overlooked dimension of psychological stress. Based on field survey data collected from July to November 2024, this study employs an Ordered Probit model for baseline regression and utilizes an instrumental variable approach to address endogeneity concerns. Robustness checks are conducted through replacing dependent variables and excluding specific samples. Mediation effect models analyze the intermediary roles of consumption costs and livelihood risks, while a moderation effect model examines the buffering effect of support policies. The study finds that relocation significantly increases work stress (β = 1.342, p < 0.01) and life stress (β = 0.613, p < 0.01) among left-behind women. Instrumental variable estimates further confirm the robustness of these negative effects. Mechanism analysis demonstrates that relocation exacerbates psychological stress through two pathways: increasing household consumption costs and elevating perceived livelihood risks. Moderating effect analysis indicates that support policies can effectively mitigate the negative psychological impact of relocation. Heterogeneity analysis reveals that low-income households and those lacking industrial support experience greater psychological pressure. This study reveals the inhibitory effect of relocation on the mental health of left-behind women. While the relocation policy improves material conditions, it may negatively affect the mental health of vulnerable groups due to livelihood transition pressures and social network disruption. The study recommends that subsequent policies should establish a tiered subsidy system, improve mental health services, implement differentiated support measures, and develop local industries along with universal childcare services to build a sustainable psychological support system.