Illustration: CDD20/pixabay
- Despite its disease burden in low- and middle- income societies, mental health is widely acknowledged to be under-researched.
- The relationship between mental health and religion-based and caste-based inequalities is also still poorly understood.
- Different socioeconomic statuses alone can’t completely explain health-related disparities; we must address inequalities in the social and material environments as well.
- Studies have also concluded that redistributed wealth and better access to good-quality education alone won’t close the disparities in mental wellbeing.
We are all growing more conscious of mental health as we learn more about it. Mental health is an issue of major concern worldwide and it is no different in India. The country currently doesn’t track the values of mental health indicators at the national level.
However, 5.5% of the population is estimated to be suffering from depression, according to a 2017 WHO report on mental health. On the other hand, the National Mental Health Survey that the National Institute of Mental Health and Neurosciences, Bengaluru, conducted in 2015 in 12 states, estimated that depression affects 2.7% of the population. Neither report discusses how mental health affects marginal groups in India.
Despite its disease burden in low- and middle- income societies, mental health is widely acknowledged to be under-researched. The relationship between mental health and religion-based and caste-based inequalities is also still poorly understood.
SC groups and Muslims
For several reasons, we need to examine the social disparities that lead to different mental health outcomes in different communities. According to the 2011 Census, the population of people in marginal communities (‘Scheduled Caste’ groups and Muslims) was around 373 million.
In his pioneering work, Annihilation of Caste (1936), B.R. Ambedkar argued that the caste system is characterised by endogamous marriages and a hereditary social status, which together divide Indians into groups and subgroups called jatis, with each group accorded different social statuses and privileges. Under the Indian Constitution, the so-called ‘lowest’ castes are collectively known as the ‘Scheduled Castes’ (SCs).
Next, the largest religious minority group in India are Muslims. (India in fact has the world’s third-largest population of Muslims, after Indonesia and Pakistan.)
Comparative sociologists have observed similarities between religious and caste stratification in India – but there also are key differences between these two systems. Caste distinction is commonly held to be based on occupational rules segregated along the lines of ‘purity’. Muslims in India have often been subjected to political violence and left out of important decisions, and in the process have been increasingly disenfranchised.
Dalits and Muslims have thus been subjected to multiple levels of discrimination and violence, and it is only obvious to expect researchers to understand their effects on the mental health of people belonging to these communities.
Social inequality
Many studies have pointed out that caste and religious discrimination play a significant role in maintaining economic disparities and limiting access to education, employment and healthcare. In 2003, economist Angus Deaton argued that socioeconomic factors and health can have a two-way causal relationship: that is, low socioeconomic status could lead to poor health as well as vice versa.
However, different socioeconomic statuses alone can’t completely explain health-related disparities, which suggests we must address inequalities in the social and material environments as well.
In 2008, researchers from the US and South Africa reported that discrimination can negatively affect mental health and trigger stress responses if experienced or even perceived. Another study by researchers from New Delhi and Australia in 2015 suggested that people from ‘lower’ caste groups were more likely to experience depression in Uttarakhand than people belonging to ‘higher’ castes.
A different research group reported in 2012 based on a study of mothers in Jharkhand who had recently given birth that women belonging to so-called ‘lower’ caste groups had a higher risk of psychological stress than their ‘upper’ caste counterparts.
In 2016, Dean Spears reported that members of SCs are less likely than others to be satisfied with their lives, based on a survey conducted in 13 districts in North India. Similarly, Ashish Gupta and Diane Coffey discussed the potential reasons for why members of SC groups and Muslims have a disproportionately higher risk of depression than members of other caste groups, in a 2020 paper.
Recently, psychiatrist Sushrut Jadhav and anthropologists David Mosse and Ned Dostaler highlighted that we know little about the mechanisms of social suffering in these instances.
All of these studies have at one point or another concluded that the redistribution of wealth and better access to good-quality education alone won’t close the disparities in mental wellbeing. This is why more research is important if we are to tackle effectively social inequality in India.
Santosh Kumar is assistant professor at Department of Sociology, Hindu College, University of Delhi.