This article was published on KevinMD and Psychology Today.
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, the Industrial Revolution that began in Europe during the eighteenth century saw the rise of steam power, the precursors to modern factories, and technologies that led to the widespread decline of cottage industries, guilds, and artisanal labor in general.
This was just the first of many such revolutions. It was followed by the Second Industrial Revolution of the nineteenth and early twentieth centuries, which saw the introduction of electricity, the modern assembly line, and the use of interchangeable parts—particularly in North America and Europe. The Third Industrial Revolution, which began in the middle of the twentieth century, was characterized by the rise of digitalization, computing, information technologies, and the globalization of supply chains. The latter process has led to the deindustrialization of many regions within the Global North (such as the Rust Belt in the Great Lakes region) and the accelerated industrialization of parts of the Global South, especially provincial cities in the Far East, which have become magnets for previously rural migrant workers (nongmingong or min-gong) who have been displaced by industrialized and automated farming systems.
Some (most notably Klaus Schwab) now posit that we are entering into a Fourth Industrial Revolution, which will be characterized by rapid technological developments in the fields of artificial intelligence, digital networking, quantum computing, robotics, materials science, and genetics, and that these advances will once again radically change society. Some of these changes will undoubtably be good. Novel medicines will likely be developed that can prevent or cure a host of diseases. Advances in renewable energy technology, building science, and other fields may ensure humanity averts a climate disaster. The growth of decentralized distribution networks could allow us to eliminate a great deal of food waste. The list goes on.
While all these changes have the capacity to eliminate suffering and to use resources more efficiently, 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.
The Rise of the Precariat
All technological revolutions have made certain jobs, skills, and previous technologies obsolete. This is known as technological unemployment. For workers who are affected by these changes, they can either fight against the process or look for opportunity elsewhere. (Those in the former group are often called Luddites, a term which refers to a group of highly skilled textile workers in eighteenth-century England who destroyed the mechanical looms and weavers that threatened their livelihood.) The fight against change, however, is not easy, as new technologies make products cheaper to produce and cheaper to purchase. This leaves them at odds not only with owners, but consumers, too. As adoption becomes more widespread, the fight becomes increasingly quixotic.
This phenomenon is not rare, nor is it a relic of the past. If anything, it is becoming more common as computers have become smaller and more powerful (see Moore’s Law), and the rate at which broader technological advances occur has accelerated (see Kurzweil’s Law). 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.
This has already happened to many manual workers who lack specialized training or experience. Millions have been displaced by globalization or automation that has occurred in the last fifty years—in regions like the Rust Belt, for example—and they 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 follows this trend of accelerating the process of displacement, these industries that have served as a refuge for the precariat will also see increased automation via AI and robotics, which will mean even fewer jobs. Combined with the rise in the number of people entering the workforce due to population growth, automation threatens to make it impossible to provide employment to everyone who wants a job.
While technological advances have historically impacted workers who work primarily with their hands or do not require a great deal of specialized knowledge to enter into their industry, new technologies may affect even highly skilled and specialized workers whose work is solely intellectual. Even certain healthcare professionals, like therapists, may share a similar fate due to advances in AI. If a therapy “bot” can offer services that are indistinguishable from a human therapist at a fraction of the cost and without the need to travel to an office or schedule an appointment, how long can this remain a viable profession for thousands of people?
This begs the very blunt question: If these new technologies eliminate the need for tens of millions of jobs and there is no new industry to serve as a refuge, what is everyone going to do?
The Impact on Mental Health
While this is no doubt a fecund discussion, as this process will demand a restructuring and rethinking of how current economic, management, and political systems are organized, these potential changes present dozens of significant problems from the perspective of public health, especially mental health.
Many of them have already materialized.
I will focus only on two for now, as they both stem from the high likelihood that traditional employment will continue to be thought of as a necessary part of adulthood, even if traditional jobs may not be available to all adults.
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 near perpetual state of stress that can have a wide array of negative health outcomes. The proverbial “giving 110%” 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, 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. 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 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 and changes in policy, 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 as though they are only as secure as the caprices of their employers, as well as the anger of those who feel as though they have been cast by the wayside or lack a purpose. We must recognize the material circumstances that are shaping our patients’ conditions if we are to properly treat them.
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