Mental Health and the Floundering Informal Worker

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    Syllabus: GS2/ Health, Management of Social Sector, Government Policies & Interventions, Issues related to development of social sector involving healthcare etc

    In Context

    • The theme of World Mental Health Day (October 10) this year is ‘mental health as a universal human right’.
      • A segment often overlooked when it concerns mental health is the informal worker.

    Unorganised/Informal sector in India 

    • Around 80% of India’s labour force is employed in the informal sector and the remaining 20% in the formal sector. 
    • Of the 80% informal sector workforce, half work in agriculture and the remaining in non-agricultural sectors.
    • Informal workers, despite their significant contribution to national income, are perennially exposed to economic, physical, and, in turn, mental vulnerabilities.

    Correlation of employment & mental health

    • On one hand, decent work influences mental health in a positive way while on the other, unemployment, or unstable or precarious employment, workplace discrimination, or poor and particularly unsafe working environments, can all pose a risk to a worker’s mental health. 
    • Workers in low-paid, unrewarding or insecure jobs, or working in isolation, are more likely to be exposed to psychosocial risks, thus compromising their mental health.
    • According to the United Nations Development Programme (UNDP), unemployment and poor-quality employment have consistently been detrimental to mental health.

    India’s informal workforce & issues of mental health

    • Challenges faced by India’s informal workforce:
      • India’s informal workforce accounts for more than 90% of the working population. 
      • These workers often operate without regulatory protection, work in unsafe working environments, endure long hours, have little access to social or financial protections, suffer high uncertainty and deep precarity, and face discrimination — all of which further undermine mental health and limit access to mental health care. 
    • Gender disparities:
      • Gender disparities are also stark, with over 95% of India’s working women engaged in informal, low-paying, and precarious employment, often without social protection, in addition to suffering patriarchal structures and practices in their social and familial spaces.
    • Youth unemployment:
      • Youth unemployment is one of the highest in India which, along with the stigma around unemployment, significantly impacts their mental health. 
      • Moreover, an ILO report highlights how young workers are shifting to more precarious and informal work, accepting less pay and poorer working conditions, out of desperation, and, sometimes, giving up and exiting the labour force altogether. 
      • The State of Inequality in India Report 2022 observes that the unemployment rate actually increases with educational levels, particularly for educated young women who show an unemployment rate of 42%.
    • India’s elderly population seeking employment:
      • The Census of India 2011 shows that 33 million elderly people are working post-retirement in informal work. 
      • Another study, by the ILO on elderly employment in India, shows high poverty among them, in terms of economic dependency and access to financial assets. 
      • The absence of proper financial and health-care security among the working elderly can severely impact their physical and mental health, aggravating their vulnerability.

    Government of India Initiatives 

    • Constitution and Legal Provisions:
      • Article 21: The right to a dignified life extends to the right to seek Mental Health care.
      • Article 47: Duty of the state to raise the level of nutrition and the standard of living and to improve public health.
    • National Mental Health Programme (NMHP) in 1982:
      • To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of the population.
    • Mental Healthcare Act, 2017:
      • It was passed in 2017, came into effect in May 2018 and replaced the Mental Health Act of 1987. 
      • The act decriminalised suicide attempts in India. It also included WHO guidelines in the categorisation of mental illnesses
      • The most significant provision in the act was “advanced directives”, which allowed individuals with mental illnesses to decide the course of their treatment and also appoint someone to be their representative. 
      • It also restricted the use of electro-convulsive therapy (ECT), and banned its use on minors, finally introducing measures to tackle stigma in Indian society.
    • Kiran Helpline:
      • The helpline is a giant step towards suicide prevention and can help with support and crisis management.
      • The helpline aims to provide early screening, first-aid, psychological support, distress management, mental well-being, and psychological crisis management and will be managed by the Department of Empowerment of Persons with Disabilities (DEPwD).
    • SAATHI:
      • It is a South-Asian Mental Health Outreach Program of ASHA International that aims to:
        • Promote awareness about mental health and emotional wellbeing
        • Improve access to care.

    Suggestions & way ahead

    • As the World Mental Health Report 2022 observed, addressing mental health involves strengthening community-based care, and people-centred, recovery-oriented and human rights-oriented care. 
    • There is an urgent need for proactive policies to improve mental health recognition and action.
    • This is critical in upholding the basic human right to good health, including mental health, and in advancing the Sustainable Development Goals (SDGs), especially SDG 3 on ‘good health and well-being’ and SDG 8 on ‘decent work for all/economic growth’.
    World Mental Health Day
    – World Mental Health Day is celebrated every year on October 10th.
    – It was first observed on October 10, 1992 as an annual activity of the World Federation for Mental Health.
    – The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.
    Overall Objectives: To raise awareness of mental health issues around the world and to mobilize efforts in support of mental health.
    Determinants of Mental Health
    – Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time.
    –  For example, violence and persistent socio-economic pressures are recognized risks to mental health. The clearest evidence is associated with sexual violence.
    – Poor mental health is also associated with: 
    1. rapid social change, 
    2. stressful work conditions, 
    3. gender discrimination, 
    4. social exclusion, 
    5. unhealthy lifestyle, 
    6. physical ill-health and 
    7. human rights violations.
    – There are specific psychological and personality factors that make people vulnerable to mental health problems. Biological risks include genetic factors.
    State of mental health 
    Globally: A study by the International Labour Organization (ILO) says that 15% of working-age adults, globally, live with a mental disorder. 
    In India: WHO estimates that about 7.5 percent of Indians suffer from some mental disorder and predicts that by the end of this year roughly 20 percent of India will suffer from mental illnesses. 
    Daily Mains Question
    [Q] What are the Determinants of Mental Health? Examine the concerns of mental health in the informal workers in India.