Mental implosion: New study reveals 51% of 18-24 year old are in distress

Hyderabad: A pan-India study has revealed that there is a decline in post-pandemic mental health, especially in Generation Z (18 to 24 age group).

The survey findings come at a time when medical experts are calling for prioritizing mental health, whose importance is often undermined,

Not surprisingly, one comes across so many cases of suicides among teenagers and youth apart from depression and anxiety issues sweeping the urban, educated youth.

Between 2020 and 2023, Indian adults in distress or struggling increased by 12 percent. In 2023, 51 percent of 18-24-year-olds reported being in distress or struggling irrespective of their economic condition, as per the largest survey of its kind in the country, undertaken by a non-profit organization `Sapien Labs Centre for the Human Brain and Mind’ as part of the Global Mind Project.

The study

The study examined the state of mental health primarily among the educated, internet-enabled users.’ The findings are based on data from 1,06,427 respondents obtained online between April 2020 and August 2023.

Data were collected using an assessment questionnaire called the Mental Health Quotient (MHQ), which assesses 47 aspects of mental feeling and function that are aggregated into a composite mental well-being score that relates linearly to the individual’s ability to function.

Data on mental health in India continues to be sparse with the last comprehensive survey by NIMHANS conducted in 2015-2016 covering 12 states. The total sample size was 34,802.

Previous findings on mental health across Indian states have been reported in two studies (Lancet study using the Global Burden of Disease (GBD) in 2020 and NIMHANS Mental Health Survey of India 2015-16). The GBD study found that roughly one in seven individuals have mental health disorders overall.

Since then, there have been global economic changes, technological advances, and an overall increase in smartphone demand in India, a slew of development projects, and the Covid pandemic.

The study observes that treatment alone may not be the solution given the scale of the problem and the population of India. A prevention-based approach is rather needed by getting into the root causes.

Key findings of the study

The pandemic struck in 2020. After two years of the pandemic that reduced social interactions, increased unemployment rates, and increased use of the internet and social media, the mental health of the internet-enabled population in India was found to be lower than in 2020. Covid forced the internet-enabled population to be online even more, with more time indoors and minimal social interaction. Reports of high prevalence of depressive and other mental disorders have been documented during the pandemic.

While variations in mental health are observed across states when including all ages from 18-74 years, almost all states in India are doing poorly when just youth (18-24 year olds) were considered.

There has been a decline in MHQ scores in 2020, 2021, 2022 and 2023. For all adults between 18 and 74, distressed or struggling scores increased by 12% in 2023. The decline in mental health among 18 to 24-year-olds is the maximum in 2022 (4.1 percent decline). Among the youth, the percentage of distressed people increased from about 46 percent in 2020 to over 50 percent in 2021, 2022, and 2023.

Geographic variation in mental health

Though the mental health condition in all the states declined between 2020 and 2023, the Southern states especially Kerala and Tamil Nadu still fared marginally better than their northern counterparts as per the study. Among 18-74 year-olds, the states of Tamil Nadu and Kerala have the best mental health scores -- MHQ scores overall were between 60 and 69, which is considered in the ‘Managing’ range on the MHQ scale, while those in Rajasthan, Uttar Pradesh, and Bihar have low scores (40-49), which is in the band considered ‘Enduring.’ However, among the 18-24 year-old youth, mental health scores are very low in all states.

The underlying drivers of poor mental health

The findings suggest that poor mental health is not attributable to economic factors alone as it persists across income levels.

Several factors can explain the poor mental health of youth in India. These include low economic prospects, lower or no social interaction, less opportunity for free play as children, a diet that has diverted from traditional ‘whole’ foods, and an increase in the use of smartphones and social media.

Two recent global reports by Sapien Labs have pointed to the possibility that early age of smartphone ownership is associated with worse mental health outcomes among the youth (Sapien Labs report May 15, 2023), and more frequent consumption of ultra-processed foods is also associated with worse mental health (Sapien Labs report October 2, 2023), both of which have proliferated in India in recent years.

Economic factors alone do not determine poor mental health

There are many potential reasons for this, including uncertainty about job prospects (according to the Centre for Monitoring the India Economy, the unemployment rate for those under 25 is 45.8% in 2020), and the associated lower earnings potential. Thus, it may be possible that the youth in wealthier households are less worried about job prospects and lower earnings than their counterparts in less affluent households -- a possibility that would imply that the age-mental health gradient is steeper in less affluent households and conversely flatter in more affluent households.

However, there is a non-linear relationship between income and mental health, with higher levels of income not associated with higher mental health after reaching an income level of Rs 1-3 lakhs per year. Indeed, there is a slight decline in average MHQ after annual household income reaches Rs 20 lakhs annually.

A preventive approach is needed

Referring to the study report, Shailender Swaminathan, director, Sapien Labs Centre for the Human Brain and Mind, India, said, “Across states in India, we find that the youth, considered the ‘Demographic Dividend’ for India, are in increasing distress post-pandemic. The current policy paradigm seeks to manage and treat mental health ailments through access to psychosocial support and crisis interventions. Given the sheer scale and complexity of the problem, a more preventative approach may be necessary. As we attempt to ‘unlock’ the potential of youth to spur development, robust data is the need of the hour to provide early warning signals and inform policy and advocacy efforts. For instance, we have found some evidence in a previously published global report that delaying the adoption of smartphones is linked with better mental health outcomes for 18 to 24-year-olds. Through these large-scale rapid projects, we are attempting to bridge a critical data gap.”