MENTAL HEALTH

Why It Needs More Attention In Cities

THERAPY
Approx. 55.3% of the world’s population live in urban areas as per the Cities and Happiness: A
Global Ranking and Analysis 2020 report. In India, approx. 35% of the population dwell in urban
areas. As per the joint report by CBRE and CREDAI published in 2019, the urban population will
contribute 75% of India’s GDP by 2030.

While urbanisation fosters sustainable growth and is a hub of economic opportunities, there is an
increasing worry of emotional distress and anxiety among the people living in urban areas. Many
studies have also pointed out, the increase in mental illness and depression rates.

In this ebook, we will decode mental health in India and the disparities in urban and rural
well-being. Plus, this ebook highlights a few ideas that you can implement to help urban dwellers
in your organisation tackle the mental health problems associated with big cities.
The state of mental health in India

Problems plaguing the mental health of Indians

The stigma attached to mental issues

Abysmal number of counselors/psychiatrists

Lack of mental health awareness

Limited access to expert help

The impact of mental health challenges on urban dwellers

Stress Fear

Agitation Loneliness

Anxiety Depression

Isolation
 The paradox of Indian cities. Are you taking notice?

In April 2020, TRA research released a whitepaper

that showcased the findings of its survey
conducted across 16 cities with 902 responders.
The objective was to understand mental well-being
in different cities and how they navigate worries
related to the pandemic, including family, health,
and economy. The graph given below highlights the
findings from the whitepaper.

Mental well-being index (in %)

Note: The mental well-being index was calculated as a coping index (based on four parameters) divided by a worry index (based on six parameters).
Source: TRA Research

Here are two important

observations from the graph:

Amongst metro cities, Delhi showed the highest mental well-being score (63%), while Mumbai ranked at
1 the bottom (28%).

2
Out of the top eight cities in India, four (Kolkata, Ahmedabad, Chennai, and Mumbai) showed mental
well-being scores below 55%.

Along with the TRA research, many other surveys support the perturbing situation of employees in
urban cities.

The India Cities Happiness Report 2020 also exhibits the grim reality. As per the report, smaller cities
such as Ludhiana, Ahmedabad, and Chandigarh topped the happiness ranking, while Bengaluru, Cochin,
and Kolkata lagged behind.
The report by World Health Organization (WHO)
reveals the state of mental health in India

As per the report, the burden of mental health disorders/problems is calculated at

2,443 disability-adjusted life years (DALYs) per 1,00,000 population. DALYs means the
1 overall impact of disease (in terms of ill health, disability, death) expressed in years lost
due to health challenges.

2 Age-adjusted suicide rate is 21.1 per 1,00,000 Indian population.

Close to 56 million Indians suffer from depression, and around 38 million people suffer
3 from anxiety.

4 7.5% of the Indian population suffers from a mental disorder.

Economic loss due to mental health issues/conditions between 2012-2030 is projected

5 to reach $1.03 trillion.

There are only 0.3 psychiatrists, 0.12 nurses, 0.07 psychologists and 0.07 social workers
6 per 1,00,000 population. The recommended number is at least 3 psychiatrists and
psychologists per 1,00,000 population.

Mental health is a global

challenge

Approx. 1 in 4 people experience

mental health problems across
the globe.

Mental health disorders

constitute about 7.4% of the
total diseases.

It is one of the main reasons for

long-term disability.

Mental health concern ranks 3rd

after Coronavirus and Cancer, as
per Ipsos Global Health Monitor
2020 report.
Decoding the urban-rural happiness difference enigma

Urban areas are economic powerhouses. They are a hub of new ideas, innovations,
opportunities, increasing income and living standards. Hence, cities are attractive places to live.

However, cities have challenges and risks idiosyncratic to them. Let us look at the underlying
challenges that eventually lead to mental health problems in cities.

Physical environment

Infrastructural design
The infrastructural design can positively or
negatively impact mental and physical
well-being. People living in metro cities
experience increased stimulus levels. The
reasons are many – pollution, population
density, poor public transport, traffic
noise, insufficient open and green spaces
to facilitate interaction, lack of hygiene
(due to population), etc.

Increased stimulus levels can propel your

employees into a stressful condition that
can impact performance.

Lack of affordable housing

Lack of affordable housing and urban sprawl results in people living
in informal, vulnerable, and unhygienic housing settlements. This is Mental Health
more relevant for low-income groups residing in cities. Also, urban Problem in Cities
cities contribute to the majority of the world’s energy consumption
and greenhouse gas emissions. As per the Cities and Happiness: A
40% higher risk of
depression as compared
Global Ranking and Analysis 2020 report, approx. 90% of urban to rural areas
dwellers worldwide breathe unsafe air, resulting in 4.2 bn deaths.
20% more of anxiety as
Housing affordability also steers people towards financial liabilities, compared to rural areas
adding to the already elevated stress levels in the cities.
Double the risk of
The fast pace of urban life schizophrenia

While cities offer more growth opportunities and better healthcare

Increased risk of
facilities, it has its own set of challenges. Traffic congestion, air & drug/ alcohol/ cigarettes/
noise pollution, and hectic schedules leave limited time for leisure, addiction
aggravating the stress. The increase in stress levels can force
Mental Health Challenges in Cities:
people into a vicious circle. As more people seek quiet and private Loneliness, Isolation and Stress
spaces to relieve stress, it may further push them towards
social isolation. Source: Centre for Urban Design and
Mental Health (UD/MH)
Social environment

Prejudice and discrimination

People belonging to minority status or
experiencing mental health challenges
frequently encounter many social
challenges. This includes prejudice,
geographical and psychological
segregation, injustice, and feeling of
inferiority. These feelings may further
magnify mental health issues and increase
the risk of depression.

Limited interaction
Many of the employees who migrate to urban cities leave behind their close network of family
and friends in search of better opportunities. However, due to hectic schedules, lack of open
spaces, and safety concerns, the urban population is less likely to interact and build sustaining
social relationships, which further adds to mental health problems and isolation.

Fragile relationships
Due to various social and economic factors, fragile relationships are more common in big cities
as compared to smaller ones. Strong interpersonal support is the key to mental well-being.
Digital environment

With the outset of the pandemic, there has been a surge in the adoption of digital
technologies. The amplification of digital life and the need to stay perpetually connected has
blurred the line between personal and professional life. With the speeding digitisation, people
wish for a slower and simpler life with more time for themselves and their families.
How to create happier workplaces?

Mental health disorders can have a serious impact on your company and business. Hence, it is
important to raise awareness and help urban dwellers combat mental health issues. When it
comes to physical health, people become more conscious. They hit the gym, follow a healthy
diet, and indulge in superfoods. However, most people are reluctant to openly discuss mental
health issues due to the fear of being judged. Here are a few initiatives that you can adopt to
create a happier and healthier workspace.

Promote discussions around

Mental Health

As an employer, you can encourage open

discussions with your employees to mobilize
support and create a more inclusive workplace
for employees residing in bigger cities.
Here are a few examples:

Did you know?

Keep the conversation active: Conduct mental
As per WHO, every $1
health awareness initiatives and encourage an
invested in treating mental
open-door policy to help employees comfortably
health issues, the return is
talk about their mental health challenges.
4 times via improved
productivity and health.

Encourage mindfulness: You can also facilitate easy

access to psychological or mindfulness health platforms
to help them live a healthy and happy life and deal with
sleep disorders, depression, or anxiety.

Invest in training and display empathy: Train managers and leaders

on what steps to take if they see signs of emotional distress and
how they can display care and empathy.

Introduce networking opportunities: Create opportunities for employees to

interact and connect with their coworkers within and outside of work.

Encourage self-care: Encourage employees to set their priorities, prioritise self-care, and build and
protect the boundaries they need, to avoid mental burnout.
Provide mental health
Support

While designing employee benefit healthcare programs, ensure you craft an all-inclusive and
holistic coverage not just for physical health but also mental health.

ACKO helps you address mental health problems in your organisation and create a healthy and
happy workspace. With the ACKO Health app, you can offer a host of wellness benefits along
with insurance coverage to your employees. Your employees get access to an unlimited number
of online appointments with mental health coaches, nutritionists, psychologists, psychiatrists at
no additional costs.

Promote 21st-century
Time-Off Programs
To help your employees cope with digital life,
you may consider building flexibility in their
daily schedules. You may try to incorporate the
below ideas to promote mental well-being in
your organisation.

Give paid time off and encourage your

employees to go on vacations. To
Paid vacations encourage employees to go on a vacation,
many employers limit the number of leaves
employees can roll next year.

Allow flexible work hours and

work-from-home for urban dwellers. This
Encourage work-life balance will help them reduce commute time,
allowing more time for rejuvenation, leisure,
and personal growth.

Design return-to-work policies for

Employee-friendly policies employees that took a sabbatical break
because of mental health issues.
Preventive healthcare
Benefits
Due to stress, urban dwellers are at a higher risk of suffering from hypertension, diabetes,
and other diseases. This amplifies mental stress of the employees. As an employer, you can
help reduce their impact by encouraging your employees to undergo periodic preventive
health check-ups.

With the ACKO Health app, your employees can book preventive health check-ups at a
discounted rate. Plus, they can book such check-ups in under 2 minutes from the
convenience of their smartphone.

Buy Policy
Becoming torchbearers of change

To counter city mental health problems, employees need modern programs to rejuvenate and
relieve stress. Hence, to help your employees (more important for people residing in cities), it
is critical to help them find purpose and meaning in their work.

This can be achieved by giving them autonomy and independence. Also, if your team
experiences care, appreciation, and trust, they are more likely to stay happier at work,
reducing the possibility of mental health problems.

Stay Safe,
Team Acko.