When Someone Else Decides...

Lack of freedom of choice and agency- mental health fallouts for the rural youth

- By Kamala Easwaran

"KISKE sapne hai didi... jab kuch kehne ka haq hi nahin hai...” (Who gets to dream didi? ...when you don't have the right to say anything...?)

what you wear,
who you meet,
who you speak to,
when you eat,
whether you can own a phone,
who you marry,
when you have children,
how many children you have...
when you can't choose what you want your life to look like, when someone else decides...

mann kaise acchha ho sakta hai...? (how can you be mentally well?)

These questions were posed by Meeta, a participant I met at a capacity building programme that trains nonspecialist health workers to offer peer support and counselling as early intervention services for young people in rural Uttar Pradesh. Meeta is in her 20s, with an infant by her side. During sessions, she breastfeeds her daughter, makes notes, participates in role plays and arts engagements, and oversees her daughter's naps. Meeta is multitasking and has three more daughters at home. She is speaking about an individual's freedom of choice and agency from her lived experience of being regularly denied this.

The examples Meeta used are those many take for granted. It is a snapshot of a single story, but reflects a larger reality facing young people, particularly women, and those from vulnerable and marginalised groups.

Freedom of choice and agency are often used interchangeably but remain distinct. Freedom of choice is the ability to select from available options, while agency is the ability to act on goals and intentions. Agency is limited by having (a) options and (b) the opportunity to choose. Agency is core to philosopher Martha Nussbaum's capability approach, which prioritises individual dignity and recognises that shaping one's life is integral to achieving wellbeing. The lack of agency affects mental health and wellbeing of both individuals and communities.

Through training, I asked myself the same question...