Mental health crisis deepened in India during COVID-19, especially for women

Research has shown that women’s employment has been worse hit than men in the US, as well as in developing countries like India. Apart from economic hardships, research in developed countries like the US also demonstrated that women appear to have suffered greater mental health problems relative to men due to the COVID-19 pandemic and associated lockdowns.

However research from 2021, conducted by me and my colleagues, Professor Amrita Dhillon from the Department of Political Economy and Professor Farzana Afridi from the Indian Statistical Institute, was the first study on this issue for a developing country.

We conducted a survey of 1,500 low-income households in urban Delhi during the first wave of the COVID-19 pandemic. From the research we found there were very high levels of psychological stress – something that hadn’t received much attention in either academic or policy circles at the time.

Understanding how the pandemic impacted mental health in India

Financial insecurity was one of the biggest drivers of psychological stress and women suffered worse mental health impacts compared to men. In particular, they were more likely to feel anxious, depressed and suffer from sleep disorders.

To understand if these gender differences persisted as the pandemic continued in India, we collected two further rounds of follow-up data from our study participants – one during August-October 2020, as the first wave began to subside and lockdown lifted, and one in April-June 2021, during the more devastating second wave of the pandemic that led the government to impose more concentrated and localised lockdowns.

In particular, by interviewing husbands and wives in the same household, we could see how the experiences of the pandemic differed within couples across various phases of the COVID-19 crisis in India.

A mental health crisis during the second wave

The second wave was particularly devastating in India, and in particular, in Delhi. There was consistently record high daily figures of COVID-19 infections and deaths for weeks – due to the highly infectious Delta variant as well as the collapse of the healthcare system.

This meant health worries were heightened across the board as the pandemic advanced. These health worries became equally important in triggering psychological distress during the second wave, especially for men. However, more women than men reported health worries in the first wave, which continued into the second wave.

Across all dimensions of mental stress, women reported their mental well-being continued to be worse than men. Financial insecurity remained a key driver of reported mental stress in the second wave – again, more so for women than men.

Although women did report higher anxiety, the gender gap in anxiety shrunk from 13% to 6% with more men reporting suffering from anxiety in the second wave than the first one. This could be linked to the rising levels of health worries, compounded by financial concerns, reported by men in the second wave.

The opposite was reported for depression. While more women than men reported being depressed in the first wave, this gap doubled in the second wave as reported female depression spiked to 11%, compared to 7% for males.

This trend is also mirrored in sleep disorders, with women reporting experiencing more sleep disorders than men in the second wave compared to the first. We also foundnd preliminary evidence that sleep disorders were worse among women with larger social networks – especially if they lived in areas where the Delhi government imposed severe, localised restrictions on mobility to control the spread of COVID-19.

The pandemic and India’s most vulnerable

These surveys over the first year of the pandemic give us a unique insight into the dynamic effects of the pandemic on the urban poor in India, who constitute one of the most vulnerable sections of the country’s population.

Even though the economic consequences of localised lockdowns during the second wave were less damaging, the psychological toll was higher than at the beginning of the pandemic, particularly as health concerns were heightened.

The adverse effects on emotional well-being not only persisted as the pandemic raged on in India but worsened. Potentially impacting the long-run productivity of these workers, which could in turn slow economic recovery. The pandemic also continued to impose greater mental health costs on women compared to men, especially in terms of depression and sleep disorders.

This piece draws from media articles written by the authors of this study, Farzana Afridi, Amrita Dhillon and Sanchari Roy, for the Wire and Ideas for India.