As a mental health professional, a question that I am often asked is if millennials (the term used to refer to those born between 1982 and 1996 – a generation I belong to as well), are worse off from a mental health point of view than any generation ever before. The answer to that, at least in my opinion is ‘Yes’. But it’s not that simple.
For something to be considered an illness, the minimum qualifying criteria is that the experience should not be ‘normal’. This means that it cannot be considered the norm for an overwhelming majority of the given cohort being considered. However, talk to a millennial around you and ask them the last time they felt happy and fulfilled, well-rested and calm, and hopeful about their futures. You will see that a pervasive sense of fatigue, gloom, and worry are not exceptional but normative experiences for most millennials today.
The Vicious Cycle of Mental Health
The World Health Organization in 1948 defined well-being as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. At the time, the world we lived in one was a simpler one, and the health-related challenges faced were mostly acute life-threatening conditions. Fast-forward to today, and the health-related challenges most adults of working age are chronic illnesses – be they physical or mental.
Maintaining good health as the WHO definition suggests, while holding down a full-time job in one of India’s metros can seem like a Sisyphean task for many young Indians. Working with clients for whom mental health presents the biggest stumbling block to professional success constitutes a majority of the work I do in my practice as a mental health professional.
The catch-22, however, is that one needs a full-time job to be able to afford regular therapy. Life, for most working young adults with mental health challenges, is a never-ending struggle between finding a full-time job that helps them afford regular mental healthcare and staying mentally healthy enough to hold down a full-time job.
The Vicious Cycle of Poor Mental Health and Poor Work Performance
The Cost of Mental Health for Millennials
The acute shortage of mental health professionals in India (almost 1 for 1 lac people), means that most people needing regular mental healthcare need to access private mental health professionals. This comes at a heavy cost. The average cost of a counseling session/psychiatric consult in any Indian metro is around Rs. 1500/-, with some professionals charging as high as Rs.2000-4000/- per one-hour appointment.
Say you need a weekly therapy appointment (Rs. 1500*4), a monthly psychiatric consult (Rs. 1500*1) and daily medicines (~Rs.500). That itself is a monthly expense of Rs. 8000/- on average (not including the loss-of-pay due to late-coming and days missed due to mental health).
Persons with mental illness are not only likely to find it difficult to get employed full-time, but they are also likely to get lesser pay-packages and fare lower on their performance appraisals as compared to those who live without mental illness. Ultimately, they may also be asked to leave on grounds of poor performance.
What that leaves one with is a situation where one needs to bear significant financial expenses just to stay mentally healthy, but with little or no guarantee of financial security.
The Commodification of ‘Self-Care’
Putting aside money to buy a house of one’s own is a distant, unattainable dream for most young professionals today. Therapy is an expensive, long-term project. The space in the middle is now being exploited by the ‘Self-Care’ Industry.
It is not uncommon for me to see clients spend their last rupee on a weekend ‘wellness retreat’, a piece of pop-culture nostalgia, expensive hobby classes, luxurious electronics, and automobiles. This does not come from a place of pragmatism but solely for the emotional succor, these purchases offer. While ‘impulsive’ purchases like these earn millennials a bad rap for being ‘financially irresponsible’ one cannot also be blamed for grasping at straws in desperate times.
Making Therapy Accessible and Affordable
While the questions are many – one answer is to make mental healthcare affordable and accessible. Individuals who stay in therapy regularly can negotiate personal and professional challenges better, without having to resort to expensive ‘self-care’ distractions.
Often one may be willing to access therapy but find it financially prohibitive. On other occasions, the unavailability of a therapist means that even someone willing to pay for therapy cannot access it. Online therapy solves part of this problem by making therapy accessible to a wider audience geographically. From an economic point-of-view, as well, online practice is far more operationally sustainable. However, that still leaves out a large chunk of people who may be able to afford to pay some, but not the entire amount charged by therapists. Sliding scales, such as Pay-What-You-Want options help address these concerns by ensuring that those needing therapy continue to do so without therapy becoming a source of financial strain in itself.
While the problem at hand is one that has come into being and sustained due to the collapse of multiple systemic factors, this perhaps is one of the ways forward.
By Paras Sharma, a Bengaluru-based Counselling Psychologist
who can be reached at paras@thealternativestory.in.