According to a recent Gallup poll, the Maltese are the fourth biggest worriers in the world ̶ close to two-thirds (63%) reported feelings of worry. In addition, more than half (55%) reported feeling stressed. Not to worry, we came below Afghanistan, Israel, and Guinea, who reportedly had higher levels of worry than Malta, while just nine countries out of the 142 reported feeling more stressed.
Why? One would think that a robust and growing economy would make people feel good. But GDP is not the be-all and end-all of happiness, as some might retort. Well, how about Malta scoring highly for civil liberties and political rights (according to the reputable Freedom House)? Sorry, most people are still not convinced.
Their plight is also compounded by how they feel about their work. According to psychotherapist Matthew Bartolo, who led a study for the Willingness mental health clinic and the Malta Chamber of Commerce, some 54% of managers report feeling "regularly burnt out". Meanwhile, according to a MISCO report, 86% of respondents reported experiencing poor mental health related to work, including stress and anxiety due to heavy workloads and tight deadlines.
Recently, I was flabbergasted when one of my granddaughters said she was "burned out". Now, I know that nowadays youngsters are prone to repeat jargon they hear from their peers or read on social media, but it makes you wonder if we or society in general are putting too much pressure on them. The masking of emotions, together with high expectations, creates an ideal environment for a "burnout culture".
To cap it all, we recently had Associate Professor and anthropologist David Zammit of the University of Malta say that he thinks he knows why people are having mental health problems. "There's a sense of impending doom," he says. "There's a sense Malta is becoming less liveable, and that partisan politics are taking us towards a mafia state and increased environmental degradation."
There is now a growing debate as to whether socio-economic ideologies might have a hitherto unacknowledged role in the mental crisis afflicting advanced countries. Specifically, some scientists are positing that the neo-liberal ideology that has dominated Western countries since the late 20th century might be to blame. Could neoliberalism, with its emphasis on the invisible hand of the market and individual responsibility, be to blame?
Is there some cause and effect at play here? Some experts certainly think so. Michèle Lamont of Harvard University argues that the neoliberal narrative's amplification of individualism, competitiveness, and self-interest can impair mental well-being. If individuals internalise societal tensions and ignore other factors, they can fall prey to higher anxiety, depression, and a sense of social disconnection.
The neoliberal ideology was supposed to deliver a superior world order. Instead, many advanced economies have moved to the dual-economy model elaborated by West Indian economist and Nobel prize winner W. Arthur Lewis. One part of the economy ̶ the "FTE sector" (named for finance, technology, and electronics, the industries which largely support growth ̶ is where around one-fifth of employees enjoy high educations, have good jobs, and have enough money to meet life's challenges. The other part of the economy ̶ the low-wage sector ̶ is where the other three quarters of the workforce have low-productivity and insecure jobs, cannot plan for the long term, and are focused on surviving.
Some elements of this model are also present in Malta. We now have an economy where some 48 percent of the workers earn an average salary that is 77 percent higher than that earned by the other 51 percent. Many of the latter are third-country nationals doing menial and low-skilled jobs.
If, as neoliberalism suggests, one's worth can be defined by one's productivity on the job and how much he can contribute to economic growth, what happens when some people are told or become convinced that they are unable to meet the expectations of their managers, their fellow-workers, even possibly their family and society as a whole? Surely, this will foster a sense of inadequacy and make them feel responsible for the failures that they experience, causing shame and chronic illness.
Richard Wilkinson and Kate Pickett ̶ two British eminent health scholars ̶ have contended that the economic inequality generated by neoliberalism has not only eroded trust in politicians and institutions but also increased rates of anxiety, depression, and social disconnection. Their book "The Spirit Level; Why More Equal Societies Almost Always Do Better" makes a strong case that social and health outcomes are significantly worse in more unequal rich countries.
Young people are particularly vulnerable to the mental health impacts of neoliberalism. It is easy to see why. Our educational systems are governed by standardised testing and are engineered to give students marketable skills, while competition and early achievements are lauded. There is too much emphasis on academic excellence and on being able to secure a stable job. All too often, this leads to anxiety and depression.
Wilkinson and Pickett might have a point. Between 2013 and 2019, our GDP grew by an impressive 51.5% but income inequality started raising its head. The S80/20 and Gini coefficient that measure inequality have since become even worse. Meanwhile, some 10% of the Maltese population admit to suffering from depression, some 17% of children are said to suffer from it, and the severity of depressive symptoms among those admitting to suffering limitation of their activities has increased by a whopping 26% to just under 30% of the population.
One can only imagine that the situation would be worse among those who have not benefited from economic growth or, even if they have done so, their relative position has deteriorated. Once people do not have the financial resources they need to live a decent life and fulfil their psychological needs, then it is only natural that they will experience higher rates of stress, depression, or anxiety.
To make matters worse, the neoliberal mentality has commodified mental health, making it a personal responsibility rather than a collective issue. We are inundated by advertising from the wellness and personal fitness industries, while lifestyle influencers harp on a self-help culture. Individuals beset by all sorts of issues and challenges are expected to come up with personal solutions to what are, at the end of the day, systemic problems. Can we realistically expect an individual to rush about in his bike in a personal effort to beat the structural inability of the country to deliver efficient public transportation? In all probability, his effort to avoid anxiety in being stuck in a traffic jam will be defeated by the risk (I was tempted to say, near-certainty) of being injured or killed in a traffic accident.
As a result, we have been digging ourselves into a hole where, as the economist Peter Temin says, we have a model that predetermines winners and losers. In the process, we lose the benefit of all the people who could contribute to the growth of the economy and improve the quality of life for everyone.
We therefore need to rethink the approach. I would say that, unless there is a paradigm shift to different cultural norms, where we emphasise community cohesion, reduce income inequality, and invest in more social infrastructure and personalised education for students in challenging social and economic circumstances, then we are destined to grapple with rising rates of mental illness.
Any new approach needs to start from the tenet that a healthy and just society is run for the economic benefit of all. It is one that cares.
Frans Camilleri is an economist. He studied at Oxford and University of East Anglia, is a former corporate head at Air Malta, and has served on various public and private boards.