Migration unequivocally affects mental health. Yet it is not treated with the serious attention it deserves. Funding Assistant, Caresse Brown, explores what can be done better.
Across India, thousands either choose to or are forced to migrate in the pursuit of livelihood opportunities. Their contributions, 10% of India’s GDP, span various sectors. [1] Their movements between rural and urban areas bring forth a complex web of experiences and emotions. While there is the promise of better job prospects and improved working conditions, migration can also lead to discrimination, severed familial ties, limited social networks, and cultural alienation. [2] The burden of navigating this compounded stress amidst economic uncertainties can exacerbate mental health issues for migrants. Research suggests that migrants have an additional need for mental health support but simultaneously less access to it. [3] Access can be structural such as a lack of public facilities, financial constraints, or exacerbated by social barriers like stigma and shame around ‘getting help’, and language issues. Migrants often describe their experience as being neither here nor there. This precarious situation further contributes to their difficulties.
The 2030 Agenda for Sustainable Development prioritizes “promoting sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all”. But what exactly is decent work and why is it important? Decent work should create an environment free of exploitative tendencies which prioritizes the well-being of all involved individuals. For migrant workers, this translates into protecting their human right to safe and sustainable migration pathways, fostering opportunities for skill development, ensuring fair wages, and providing avenues for personal and professional growth. Notably, such efforts not only benefit individual workers but also contribute to the larger picture. They feed economic growth by unlocking labor supply. There are also-micro level effects including a sense of fulfillment and lower stress individually and at the community level. However, migrant workers remain a largely neglected workforce in India (especially those employed in unorganized labor). They lack access to social security measures and networks of support. A study reported that over half the population of migrant workers residing in Delhi, Gujarat, Haryana or Maharashtra have poor access to public benefits. [4] India and its growing population are facing significant policy challenges, further strained by recent events like the COVID-19 pandemic, highlighting the insufficiency of existing legislation in addressing the complexities of migrant workers’ experiences. [5] Not far back in our memories is one of the largest cases of reverse-migration in Indian history – when masses of migrant workers crossed state borders and walked distances of hundreds of kilometers, to return home during the national lockdown. Unfortunately, some did not survive the journey. It seems whether migrant workers stayed put or journeyed home, they faced hostility and hunger, illustrating the extent to which they are often overlooked, and their priorities invisibilized.
The road to achieving decent work for all calls for a multi-sectoral engagement and an intersectional approach that puts the individual first. This can mean ensuring a robust support system to mediate adverse circumstances associated with the journey. In India, The Mental Health Policy 2014 upholds a participatory and rights-based approach to providing accessible, affordable, and quality health and social care to all persons throughout their lifespan. [6] While the Mental Healthcare Act 2017 provides the legal framework for citizens’ right to mental health care; only 15% of people with depression receive the necessary care. [7] Challenges to effective implementation like fragmented governance, consistent funding, shortage of trained human resources, and others continue. Though significant improvements concerning these issues have been made, some aspects leave room for improvement.
There is evidence that the prevalence of mental health conditions, like depression, can cause an individual to hold negative beliefs about returns to effort, which can lead to a lower labor supply level. [8] The prevalence of mental health issues makes one more likely to be unemployed. [9] Complicated mental health needs become a barrier to not only finding decent work, but also sustaining the same. Flexibilities, such as being able to work from home or work unusual hours, are few and far between. There are also gender disparities as this trend affects women more than men. For example, women’s health brings forth more to consider, such as the effects of menstruation, pregnancy, and menopause, to name a few conditions. The lack of comprehensive social support for women can contribute to poorer mental health and depression in some cases. Migrant women, specifically, will find it harder to navigate such insecure livelihood conditions and transitions while also navigating their personal health developments without any communities of support around them. Similarly, the onset of maternal depression can have a significant effect on women’s intra-household empowerment, which consequently affects their ability to find paid work outside the home. Another study found that psychological empowerment has the potential to break this poverty trap. Improving women’s determination and changing their negative self-perception can be vital to tackle the “failure of aspirations” (Ghosal et al. 2020). Mental health support which can effectively reduce these symptoms can add to women’s earning capabilities. A study conducted in Pakistan [10] looked at the long-term effects of cognitive behavioral therapy (CBT) among women with perinatal depression; it found women who underwent CBT and had improved mental health, scored higher on a financial empowerment index. Investments into improving the mental health of migrants can go a long way.
A study from the University of Stirling found that gig workers were not satisfied with the amount of hours they were working, as it is usually not sufficient or stable. The nature of the gig economy, which includes fluctuations in work, pushes workers into distress and can negatively impact lifestyle quality. Increased earnings don’t just relieve financial strain on a household. Financial security has the potential to improve the overall wellbeing of families and communities. It improves the standard of living for generations to come while inspiring aspirations beyond the immediate earner. Mental health support can improve self-confidence and efficacy, motivation, and productivity.
More rigorous research should be undertaken to understand the correlation between mental health and earning capacity. According to a paper in The Lancet, factors such as income sources, social settings, and geographical contexts should be taken into consideration when studying this correlation. [11] Regardless, the need for evidence-based context-aware interventions that aim to improve mental health for migrant workers from diverse backgrounds are critical. Along with a human rights approach, there is also a strong economic case to be made.. The global economic loss due to mental health conditions is expected to increase to $6.1 trillion in 2030. Most of this will be due to lost productivity. [12] According to the World Health Organization (WHO), approximately 12 billion working days are lost every year to adverse mental health conditions, like depression and anxiety. The WHO recommends managerial training to help managers notice early signs of emotional buildup, action interpersonal skills, and more conducive communication and further develop a better understanding of job stressors and how they may be alleviated. Our project, STITCH, highlights the pivotal role of well-trained female managers in addressing these issues and creating a safer and healthier work environment for women. Soft-skills training technologies can play a key role in creating a new managerial cadre that is able to both improve worker wellbeing and also boost firm productivity. STITCH has been purpose-built to promote the best candidates for the role by removing bias from managerial screening while also measuring and remediating any skill deficiencies identified amongst prospective candidates. By removing bias from the screening process, it promotes gender diversity and empowerment at the workplace.
Mental health is often invisibilized at the workplace. Interventions like STITCH should be encouraged in the private sector to ensure that the needs of vulnerable groups like migrant workers are safeguarded. Prioritizing migrant workers’ mental health can unlock higher earning capacities, thereby leading to higher economic growth and quality of life for millions of people in India and beyond.
Photo by Atul Pandey on Unsplash.
Have any thoughts, ideas or questions that you would like to share? Write to caresse.b@goodbusinesslab.org
Citations:
[1] Road map for developing a policy framework for the inclusion of internal migrant workers in India (ILO)
[2] When people choose to migrate (IDR)
[3] Mental health of migrants (LWW)
[4] A Study on Social Security and Health Rights of Migrant Workers in India (KDS, NHRC)
[5] The gendered crisis: Livelihoods and mental wellbeing in India during COVID-19 (UNU-WIDER)
[6] New Pathways, New Hope – National Mental Health Policy of India (MOHFW-GOI)
[7] The Impacts of Mental Health Treatment on Productivity in India (GASS, JPAL)
[8] Mind the mental health income gap (MMHPI)
[9] Women’s Mental Health and Financial Empowerment (A-ID)
[10] Depression & Anxiety! Know How Gig Economy Can Negatively Impact On Mental Health (TLI)
[11] How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis (Lancet)
[12] The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature (Springer)