Work is a necessary part of life. More than simply a means to a paycheck, work gives individuals a sense of dignity and accomplishment. Feeling as though one is participating in meaningful work, whether it is contributing to a massive project or an individual artistic pursuit, allows one to feel as though they have a purpose.

While this urge to create or work appears to be a universal human trait, the conditions in which individuals work are constantly changing. This is particularly the case during or following major technological “revolutions.” Neolithic revolutions throughout the world transformed hunter and gatherer societies into sedentary farming communities. Meanwhile, industrial revolutions that began in Europe during the eighteenth century have become increasingly common as more advanced technologies have ushered in sweeping changes to the ways in which societies and economies are organized.

Some (most notably Klaus Schwab) posit that there have been three such industrial revolutions, and that we are now entering into a fourth, which will be characterized by rapid technological developments, particularly in the fields of artificial intelligence and robotics, and that these advances will once again radically change society for the better. The same technology has the potential to fundamentally alter the concept of the “job” by making work scarcer and more precarious for all but a privileged minority, and this may lead to negative effects on mental health.

The rise of the precariat

All technological revolutions have made certain jobs, skills, and previous technologies obsolete. This is known as technological unemployment. For futurists and tech CEOs, this kind of disruption is considered good because it allows for more innovative solutions to problems and to replace existing markets. For less educated and older workers, it can mean the effective disappearance of their professions.

Throughout the twentieth and early twenty-first centuries, this has primarily affected manual workers who lack specialized training or experience. In regions like the Rust Belt, for example, millions have been forced to take refuge in the service economy or, more recently, by participating in what is known as the gig economy. Many theorists have taken to calling this new group the precariat (a portmanteau combining the words “precarious” and “proletariat”) because these jobs are oftentimes tentative or part-time.

If the fourth industrial revolution does produce advances in AI and robotics, this will likely mean more automation in these sectors of the economy and even fewer jobs for the precariat class. Combined with population growth, these advances threaten to make it impossible to provide employment to everyone who wants a job, which begs a very blunt question: What is everyone going to do?

The impact on mental health

While this is no doubt a fecund discussion on a variety of levels, these potential changes present dozens of significant problems from the perspective of public health, especially mental health. Two seem particularly germane to this discussion.

As work becomes scarcer, competition for available positions will become more aggressive. Those who manage to keep their positions may increasingly seek to prove themselves to be indispensable to their superiors, which could lead to an acceleration of the existing culture of instant accessibility wherein workers are always available via email or phone—even if compensation is still modeled on a 40-hour workweek. In an organization with leadership willing to exploit this vulnerability, they could tacitly demand workers perform duties beyond their contractual tasks, a phenomenon that has been described as compulsory citizenship behavior.

Even today, there is already worry that the erosion of the distinction between work and leisure times due to social media, work emails, and other duties is leaving individuals in a near-perpetual state of stress that can have a wide array of negative health outcomes. The proverbial “giving 110 percent” here takes on a sinister meaning, as it implies that one is expected to give more than what is possible to their job and that anything less is a shortcoming that is grounds for their termination. Apart from being an oppressive practice that seems ethically dubious, evidence suggests that such a demanding environment negatively impacts worker engagement and performance (known as burnout), and that organization-wide productivity may suffer as a consequence if such attitudes are made endemic due to toxic leadership.

Conversely, many may experience another form of anxiety should they continue to find it difficult to find steady work. Worse, some may fall into despair if they lack certain resources or abilities, making them attractive to employers. Even if there is the implementation of a universal basic income to prevent the worst aspects of long-term unemployment or underemployment, there will likely be continued expectations and social pressure to have a job. Those who cannot meet those expectations will likely feel deeply humiliated, lonely, and resentful, and will likely experience many of the well-documented physical and mental health problems currently associated with “worklessness” (hypertension, diabetes, stroke, heart attack, anxiety, and depression).

The role of mental health professionals

Such a paradigm shift has already begun and will likely accelerate during and following the coronavirus-related recession. One can be hopeful that these are temporary problems that will eventually be resolved by intensive reforms, but they are clear and present challenges that will not go away on their own for the foreseeable future. We need to acknowledge that these changes are happening and that the resultant stressors are having an impact on people from virtually all walks of life.

For those of us who work as mental health professionals, we will have to become more attuned to these global phenomena to better understand our patients and their struggles. We will need to better empathize with the anxieties of those who feel they are subject to the whim of their employers, as well as the anger of those who feel adrift or unwanted. We must recognize the material circumstances that are shaping our patients’ conditions if we are to properly treat them.

Samoon Ahmad is a psychiatrist.

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