Work, Family and Neighbourhood Relationships and their Impact on Mental Health: A Cross-sectional Assessment in Coimbatore

Background: Globally, interpersonal relationships shape mental health trajectories, with disruptions in work–family balance and community ties contributing to 13% of years lived with disability. In low- and middle-income countries like India, where informal economies amplify these strains, semi-urban locales demand targeted, context-specific strategies to foster resilience and equity. Methods: A cross-sectional survey was conducted from January to June 2023 amongst 300 adults aged 25–60 years in Othakalmandapam. Tools included the work-family conflict scale (WFCS), family assessment device, Neighbourhood Cohesion Instrument (NCI), World Health Organization (WHO-5) Well-Being Index and a semi-structured free association protocol. Data were analysed using descriptive statistics, Chi-square tests and thematic analysis. Results: Mean WFCS score was 3.2 ± 1.1, indicating moderate conflict; 58% reported poor family functioning and neighbourhood cohesion was low (mean NCI 2.8 ± 0.9). Poor mental health (WHO-5 <50) was prevalent in 42% of participants. Significant associations were found between high work-family conflict (WFC) (odds ratio 2.4, 95% confidence interval 1.5–3.8) and poor mental health. Free associations revealed themes of ‘overwhelm’ from work spilling into family and ‘isolation’ from neighbourhood discord, correlating with depressive ideation. Conclusion: This study measured moderate-high WFC, borderline family dysfunction and low neighbourhood cohesion, demonstrating significant associations with poor mental health and uncovering psychosocial themes of spillover and isolation via free association. These insights advocate for relational-focused primary care strategies to enhance well-being in the similar semi-urban settings.