Context

Mental health has emerged as one of the most urgent public health concerns in India. The statistics are stark and sobering. In 2022 alone, the country lost over 1.7 lakh lives to suicide, a figure that reflects not just psychological distress but also deep-seated social and economic vulnerabilities. With 18% of the global population residing in India, the World Health Organization (WHO) estimates that the country carries a mental health burden of 2,443 disability-adjusted life years (DALYs) per 10,000 population, while the age-adjusted suicide rate stands at 21.1 per 100,000 people. Beyond human suffering, the economic loss linked to mental health conditions between 2012 and 2030 has been projected at an enormous USD 1.03 trillion.

Against this background, mental health helplines, particularly the Centre’s Tele-MANAS initiative launched in 2022, have been invaluable lifelines. They provide immediate support to people in distress, logging over 24 lakh calls since inception. State governments and NGOs also run their own helplines. However, experts caution that helplines, while critical, are not sufficient by themselves. They must be integrated into a broader, systemic approach that addresses the multiple layers of mental health challenges.

In this context, The Government of India has  launched the ‘Never Alone’ Mental Health App on the ocassion of World Suicide Prevention Day on 10 September, 2025. It is a web-based platform designed to make mental health services more accessible, particularly for students

The Current State of Mental Health in India

Prevalence

·         National Mental Health Survey (2015–16): 10.6% of adults suffer from mental disorders.

·         Lifetime prevalence: 13.7%.

·         Adults requiring intervention: 15% of the adult population.

·         Urban vs Rural: Prevalence is higher in urban areas (13.5%) compared to rural (6.9%).

Treatment Gap

·         70–92% of people with mental disorders do not receive proper treatment.

·         Causes: lack of awareness, stigma, shortage of professionals, and high costs.

·         Human resource shortage: India has 0.75 psychiatrists per 1,00,000 people, against WHO’s recommendation of 3. Similarly, there are severe shortages of clinical psychologists and psychiatric nurses.

Factors Influencing Mental Health

1.    Biological Factors: Family history of mental disorders, neurological conditions, and chronic physical illnesses increase vulnerability.

2.    Psychological Factors: Traumatic childhood experiences such as abuse or neglect and certain personality traits can predispose individuals to mental distress.

3.    Environmental and Socioeconomic Factors: Poverty, unemployment, and financial instability create stress, while exposure to disasters, violence, or accidents can exacerbate problems. Limited access to healthcare services further deepens the crisis.

4.    Lifestyle Factors: Substance abuse, poor diet, irregular sleep, and chronic stress are strong contributors.

5.    Cultural and Societal Factors: Deep-rooted stigma, social discrimination, and cultural beliefs that downplay psychological distress continue to discourage help-seeking behaviour.

Key Challenges in India’s Mental Health Landscape

Patient-Centric Challenges

·         Stigmatization: Fear of social judgment deters patients from seeking help.

·         Treatment discontinuation: Long-term counselling and therapy remain prohibitively expensive.

Resource Constraints

·         Hospital beds: Only 1.43 psychiatric beds per 1,00,000 population.

·         Shortage of professionals: Just 0.15 psychologists per lakh people against the recommended 3.

·         Irregular medication supply: Especially at the Primary Health Centre (PHC) level.

·         Rehabilitation facilities: Very few exist, leaving survivors without long-term care.

Administrative and Structural Issues

·         Lack of coordination: Overlap between health and social welfare ministries reduces efficiency.

·         Underutilisation of funds: Less than 40% of funds allocated to states under the District Mental Health Programme (2015–2020) were spent.

·         Regional disparities: Rural areas remain neglected due to lack of incentives for professionals.

Government Initiatives

National Mental Health Programme (NMHP), 1982

The NMHP was a pioneering initiative aimed at ensuring accessible and affordable mental health care, especially for vulnerable populations. It sought to integrate mental health knowledge into general healthcare and encourage community participation.

District Mental Health Programme (DMHP), 1996

Launched under the NMHP, the DMHP was modelled on the Bellary Model. It focused on early detection and treatment, training general physicians, public awareness campaigns, and effective record-keeping and monitoring.

Mental Health Care Act, 2017

This landmark legislation guaranteed the right to mental healthcare. Its provisions included:

• • • Decriminalisation of suicide, treating it as a health issue rather than a crime.

    • Advance directives allowing individuals to specify treatment preferences.

    • Establishment of Mental Health Review Boards.

    • Mandatory insurance coverage for mental health care.

    • Prohibition of inhuman practices like chaining or seclusion.

Tele-MANAS Initiative, 2022

Launched by the Ministry of Health, Tele-MANAS provides 24x7 free tele-mental health services across the country, with special emphasis on underserved and remote regions. It has become one of the largest digital mental health lifelines, handling over 24 lakh calls since its inception.

State and Community-Level Interventions

Karnataka

• • • N-SPRITE (Suicide Prevention Centre at NIMHANS): A hub for research, training, and suicide prevention strategies.

    • SURAKSHA Project: A community-based suicide prevention model in Ramanagara district.

    • USHAS Project (Urban Self-Harm Study, 2022): Counselled and saved the lives of more than 15,623 individuals who had attempted suicide, across 19 hospitals in 11 districts.

Kerala

• • • Jeevanraksha Programme: Trains “community gatekeepers” to identify warning signs, provide psychological first aid, and connect people to professionals.

    • Other programmes include interventions for post-partum depression and refresher training for volunteers.

Tamil Nadu

• • • Integration of Tele-MANAS with helplines of the School Education and Social Welfare Departments.

    • Special outreach to students distressed by exam failures, especially after Class X, Class XII, and NEET results.

    • Tele-MANAS also functions as the digital arm of the District Mental Health Programme, improving accessibility and reducing stigma.

Insights from the Economic Survey 2024–25

The Economic Survey underlined that mental wellbeing is as crucial as physical health in sustaining India’s demographic dividend. It described mental health as encompassing emotional, cognitive, social, and physical capabilities and called for a whole-of-community approach.

1.    Enhancing school education: Early detection of anxiety, stress, and behavioural issues among students.

2.    Improving workplace mental health policies: Addressing stress, long hours, and burnout.

3.    Expanding digital services: Strengthening Tele-MANAS and exploring AI-based mental health tools.

The Way Forward

• • • Closing the Treatment Gap: India must expand training for psychiatrists, psychologists, and psychiatric nurses, while incentivising rural placements.

    • Expanding Infrastructure: More hospital beds, rehabilitation centres, outpatient services, and regular medicine supply are critical.

    • Administrative Reforms: Better inter-ministerial coordination, full utilisation of funds, and bottom-up approaches beginning at village level are essential.

    • Addressing Stigma: Large-scale awareness campaigns, integration of mental health literacy in schools, and community gatekeeper models can normalise help-seeking.

    • Making Care Affordable: Regulating counselling costs and mandating comprehensive insurance coverage for outpatient care is urgently required.

Conclusion

India’s mental health crisis is not a matter of individual distress alone but a reflection of systemic, social, and cultural challenges. The rise in suicide numbers and untreated disorders demonstrates that the issue cannot be solved through helplines or hospitals alone. It requires a multi-dimensional approach—from community interventions and robust legislation to awareness campaigns and better resource allocation.