Beyond survival: examining mental health outcomes and structural determinants among women domestic workers

Abstract

While urbanization has enhanced healthcare accessibility, it has simultaneously created vulnerable urban slum environments that contribute to escalating mental health disorders, particularly among women in low-income settings. This study examines the mental health status of women domestic workers in Jawahar Nagar Kacchi Basti, an urban slum in Jaipur, India, where women experience compounded vulnerabilities due to precarious employment conditions, inadequate wages, and substandard living environments3. Employing a mixed-methods approach, this research surveyed 250 women domestic workers using validated instruments including the Beck Depression Inventory (BDI-II) and Generalized Anxiety Disorder Assessment (GAD-7), complemented by thematic analysis of in-depth narrative interviews with 20 participants43. The investigation reveals alarming prevalence rates of psychological distress, with 72% of participants experiencing clinically significant depression and 68% reporting moderate to severe anxiety symptoms. The findings demonstrate that women domestic workers face multiple, interconnected stressors including economic vulnerability (mean monthly income ₹3,200), occupational insecurity, social invisibility, and systematic devaluation of their labor contributions. The qualitative analysis identifies four primary domains of psychological distress: economic precarity characterized by inadequate wages and job insecurity, physical exhaustion resulting from extended working hours, social isolation stemming from migration and community disconnection, and healthcare inaccessibility due to financial constraints. The intersectional analysis reveals how gender-based inequalities, including restricted healthcare access and limited social support systems, exacerbate the emotional burden experienced by participants. The research contributes to understanding the complex intersection of urbanization, gender, and mental health in informal labor markets, providing evidence for the urgent need for holistic policy measures addressing both socioeconomic and psychological challenges faced by domestic workers in urban slums. Policy implications include comprehensive social protection schemes, mental health service integration within primary healthcare systems, labor rights enforcement, and gender-sensitive interventions recognizing the dual burden of paid employment and unpaid caregiving responsibilities.