A health worker rests before the burial of a woman who died due to COVID-19, at a graveyard in New Delhi, August 7, 2020. Photo: Reuters/Adnan Abidi
Mental wellbeing considerably influences countries through their social, economic and human capital. Robust cognitive abilities, overall wellness and enhanced productivity require sound mental health capital. Ergo, the presence of such capital aids with economic growth and development.
This said, India remains a lower-middle income country, and mental healthcare here has been a second-class citizen – more so during the pandemic. The ongoing crisis together with the economic slump has had detrimental effects on the psychological health of several individuals. As such, India is unprepared for the mental health crisis this pandemic has brought along.
At this point, we’re faced with a critical question: How will the long-term effects of deteriorated mental health affect the country’s economic performance in future?
In the US, 32% of adults experienced depressive or anxiety disorders in 2020. The average share of adults reporting anxiety or depression in 2019 was 11%, and which increased to 41.1% in January 2021. The pandemic-induced isolation, unemployment and financial desolation are likely to have contributed significantly to lower cognitive wellness. A little over 56% of young adults aged 18-24 years suffered mental health disorders – versus 29.3% of adults aged 65 years or more.
Closer home, India is ranked 139 out of 149 countries in the latest happiness index. In various reports, people around the country have reported being anxious and fearful of losing their loved ones to COVID-19. Harrowing images of bodies floating in the Ganga, helpless healthcare workers and many ministers’ continued inability to acknowledge the scale of the crisis, especially in May, are all likely to have depreciated the population’s mental wellbeing, especially – as the US data suggests – younger adults.
Currently, more than 65% of those aged 18-24 years in India suffer from depression. The International Labor Organisation (ILO) has already said that if we don’t take timely action to stem the mental health crisis, India’s youth may suffer severe and long-term effects that will affect their productivity, and in turn the national economy.
Such effects are likely to take two forms: brain drain and inefficient use of the demographic dividend. India is living through a period of political incompetence, poor access to physical and mental healthcare and scarce economic opportunities. These forces have already encouraged brain drain. And unemployment, poverty and poor psychological health have inhibited India from taking advantage of its demographic dividend.
Unemployment and poverty due to economic distress can be causes of poor mental health; the latter leads in turn to lower economic productivity and poor performance. Taken together, this vicious cycle is driving India’s mental health crisis. The government can break it with sustainable investments in mental and physical healthcare.
On one hand, the economic recession has cost India 41 lakh jobs, and on the other, those still with jobs have become vulnerable to a volatile job market. Many fear losing their jobs and competition is often stiff, creating fertile ground for employers to not increase salaries in return for demanding more work.
There have already been scattered reports of employees being expected to work even when a family member or two is sick with COVID-19 – and they do, often in the context of a culture known popularly as ‘hustling’. One explanation for this is the scarcity mindset: to compensate for the insecurity of being grossly under-salaried, some worship their work. Opportunistic firms have also offered unpaid internships.
Powering through work with family crises in the background can be exhausting, further depreciating the mental health capital and driving the country’s workers towards mass burnout.
The depression and anxiety brought on by the COVID-19 pandemic’s social, political and economic effects have affected men and women differently. During the lockdown, intimate partner violence in dyadic relationships – physical, economic, emotional and sexual – increased significantly around the world. Around 70% of women frontline healthcare workers reported psychological distress. In the US, 27% of women reported a drop in mental wellbeing compared to just 10% of men.
One reason for this disparity is that women perform most unpaid household chores and attend to the family’s health and food needs. A survey in West Bengal found that only 26 out of 160 persons who turned up to collect ration and medicines for their families were men. As such, employed women bear a double burden of work – at home and outside.
In addition, over half of all women suffered income loss during the pandemic, versus a third of men. Thanks to pandemic-induced stress at work, burnout rates among women jumped from 34% in 2019 to 75% in 2020. In 2020, more women (75%) burnt out than men (59%). Even before the pandemic, 38% of working women developed psychiatric morbidities that contributed to absenteeism.
Some 71% of India’s population still addresses mental illness with prejudice. Before COVID-19 came along, one estimate suggested India would lose $1.03 trillion between 2012 and 2030 due to poor mental health; the pandemic is likely to have increased this cost.
Considering its population is one of India’s major strengths, it’s important that we nurture a healthy and productive labour force. The need of the hour is to use our current window of opportunity by acknowledging the link between mental health and economic development soon, and working to promote mental wellbeing. Doing so will prevent India’s demographic dividend from turning into a demographic disaster.
Unfortunately, the Indian government has been silencing criticism – as The Lancet called out in its scathing editorial. It allocated a measly 1.2% of its GDP for healthcare in 2020 and 1.26% in 2021. The country also ranks 179th among 189 countries in prioritising healthcare through government budgets.
To get out of this ditch, the government needs to invest in mental wellness programmes, improve job security and organise social and family support programs. Financial provisions supplemented with mental health awareness camps can help victims overcome their insecurities and enhance their economic performance. Fortifying community and specialist mental health services can help over workforce absenteeism.
A physically and mentally healthy economy will have a greater saving and investment capacity. Strong mental health capital, especially among young adults, will also help build resilience within communities against disasters, such as pandemics. But sweeping the crisis will leave India lamenting its losses for years to come.
Poulomi Roy currently teaches in the Department of Economics, Syamaprasad College, and is a research scholar in the University of Calcutta.