The Value of Communication for Mental Health
Mental health disorders account for a significant share of the overall global disease burden. The economic losses from such disorders are staggeringly large, particularly in low-income countries, where people are faced with several unexpected shocks. We test whether improved communication can mitigate such mental health disorders. Partnering with a major telecommunications company, we implement low-cost communication interventions that provide mobile calling credits to a nationally representative set of low-income adults in Ghana during the COVID-19 pandemic. Individuals’ inability to make unexpected calls, need to borrow SOS airtime, and to seek digital loans decreased significantly relative to a control group. As a result, the programs led to a significant decrease in mental distress (-9.8%), the likelihood of severe mental distress by -2.3 percentage points (a quarter of the mean prevalence), and domestic violence, with null impact on consumption expenditure. The effects are stronger for monthly mobile credits than a lump-sum. We present evidence that improvements in both business-related services and social inclusion and/or protection are relevant explanations. Simple cost-benefit analysis shows that providing communication credit to low-income adults is a cost-effective policy for improving mental health. Communication – the ability to stay connected – meaningfully improves mental well-being and interventions about communication are particularly valuable when implemented as many installments.
Field support from Samuel Adotevi, Kwamena Arkafra and Felix Debrah (Ghana Statistical Service) and all field officers is acknowledged. Jessica Moreira provided excellent research assistance. We thank Nathaniel Hendren, Erzo F.P. Luttmer, Albert Ortega, David Cutler, Carol Graham, AEA/ASSA 2021, Brookings, and NBER COVID-19 and Health Outcomes meeting participants for comments on a draft of this paper. We are grateful to three anonymous referees and the editor for their insightful comments. We are grateful to the Columbia University CPRC and Earth Institute for funding. The CPRC and Earth Institute had no involvement in any substantive aspect of the research project. Institutional Review Board (IRB) approvals for research data collection were obtained from Georgia State University and Barnard College, Columbia University. The project was registered in the AEA RCT Registry, AEARCTR-0006104. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.