The mental health cost of an economic slowdown in India: 'My hope is dying, I feel isolated and depressed'

Prateek Sharma

"I don't know what lies ahead in the future. I am still trying to find a job but my hope is dying. I feel isolated and depressed," says Jyoti, a 24-year-old with a postgraduate degree in business studies. "Every time I read about the economy of India, it is barely happy news." Like Jyoti, many are worried about the depleting state of the Indian economy. Despite being consoled by the Home Ministry, that it is temporary, the consequences of an unstable economy on psychosocial well-being cannot be overlooked.

From 6.6 to 4.5 percent in gross domestic product, the country's economy propelled into an insidious slowdown. Reportedly it is carrying with itself a demonising inflation, a job crisis with the highest unemployment rate in 45 years, and a subtle possibility of a recession as recently warned by Nobel laureate, Abhijit Banerjee. What this means to the common individual is evident in the context of livelihood but in India, less attention has been given to the mental health outcomes of the poor economy.

The first step to exploring this connection stems from recognising the mental health of a person as a significant contributor to a nation's economic capacity. Mental health is an amalgam of biological, psychological, social, interpersonal and occupational functioning which is eventually responsible for growth not just of the individual alone but also of the community they are a part of. Hence, in this context, mental health is equivalent to being addressed as mental capital.

The World Health Organization (WHO) recognises economic crisis having a major role in the development of mental health problems. In a report that studied this impact in the European continent highlighted a reciprocal relationship between poor mental health and economic depletion. Unemployment, poverty, job insecurity, inflation are all drivers of poor mental health outcomes but conversely mental health issues also affect economic growth.

The "signs and symptoms"

The overall economic slowdown shows up into the perils of mental turmoil in ways it is associated with people's lives €" be it about jobs, affordability or other financial matters such as debts. Unemployment becomes one of the primary "symptoms" that lead to mood-based issues such as depression and anxiety or an increase in consumption of substances such as alcohol.

In the month of December, the unemployment rate in India escalated to 7.7 percent as per the data released by the Center for Monitoring Indian Economy (CMIE). Synchronising to this information, 14 percent of all the suicides recorded by the National Crime Records Bureau in 2018 were due to joblessness.

It is likely for companies and organisations to lay off employees in large numbers to survive economic slowdowns causing a surge in stress that may escalate quickly. Major firms such as OYO, Cognizant and OLA have reportedly let go of many employees as a result of this decline. "I don't think I am suicidal but I am definitely on that path," says Vaibhav*, an IT worker based in Delhi who was recently a part of a massive lay off in one of the companies. "I am applying to other places but this has affected what I think of myself and my abilities."

Feelings of worthlessness, helplessness, insecurity, loss of autonomy become primary markers of distress caused by mass unemployment rates. Research on mental health impact of recessions in Spain has highlighted such feelings among people who were laid off following a negative labour demand shock €" an abrupt downfall in demand of workers.

"What the slow economy does is that it really intensifies the already prevailing ideas of capitalism. It asks people to work harder than ever before. Competition is not only implied but normalised, promoted as the only way to be," says Radhika Sharma, a Mumbai-based psychiatric social worker. "What workplaces tell people about themselves becomes a strong voice that guides their sense of self and their identity."

Other than joblessness, job-burnout is also a critical consequence of economic slowdown. Now recognised as a diagnosable condition as per WHO, burnout is a prolonged response to workplace stress, characterised by emotional exhaustion, detachment from customers/clients and feelings of personal inefficacy. In the 2008 slowdown in India, employees belonging to manufacturing and healthcare sectors suffered moderate to high levels of burnout.

"One of the primary feelings that I work with in therapeutic conversations is that of 'I am not good enough'. Where did this really come from? With dwindling jobs and economy, where is the space to even think about these links? As always with the economy taking a hit, we see mental health being pushed to the margins," Radhika adds.

Who will suffer the most?

3,92,705 is the projected number of farmer suicides between 1995-2020 as predicted by PC Bodh, an Indian Economic Officer (1987 Batch) in his recent book, Farmer Suicides in India: A Policy Malignancy. There have been debates whether farmer suicides are mental health or an economic issue but this polarisation does not benefit anyone. Rather there is a push for a narrative which views mental health as both an economic and eventually a political issue.

Farmers remain one of the most adversely affected groups of a poor economy in India despite their ample contribution to the country's growth. Additionally, people from low socioeconomic backgrounds and those intersecting with other marginalisations are bound to experience more distress resulting from economic strains. As per the report by WHO, these groups include but are not limited to children, single-parent families, ethnic minorities, migrants and older people.

"There is a whole lot of data telling us that mental health and economic class are deeply interlinked. So are other factors such as caste and gender. It is indeed very likely for people belonging to such sections to be on the primary receiving end of such blows," Radhika adds, reflecting on the populations likely to suffer the most from a bad economy.

A population usually left out of such discussions includes women working in informal sectors. In a paper, Indra Chakravarthi highlights the plight of women and how their working conditions affect physical and mental health. The paper quotes, "The impact on women's health, of the double burden of poor working conditions as well as of taking care of families with such poor wages, its implications for access to essential goods and services, can only be understated."

"Informal sector is a whole different gamut," Radhika says. "Homemakers yet another. I also do know that many mothers I work with are finding it harder to get back to jobs after having children or having to work harder if they find a job to prove their relevance."

It is not surprising to note that in a world dominated by capitalist thought more people seem to be worried about how a person's deteriorating mental health will prove to be a "burden" on the country's economy instead the other way around. The question remains: what solutions are suggestible to fight this deeply complex malady?

While psychotherapy and medications account for primary responses to issues, they only operate on the surface. Radhika advocates for changes on the larger scale to reach the roots of the problem. "We definitely need systemic level changes to support people's personal journeys of healing. Else, sustainable well-being will always continue to remain a challenge. People who have access to modes of healing such as therapy struggle to meet challenges when they go outside because the outside world (for eg, economy) continues to fail them by pushing the finish line farther and farther away."

*Some names have been changed to protect the identities of the individual.

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