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India Needs a Unified Mental Health Response
Oct. 10, 2025

Context:

  • World Mental Health Day, observed on October 10, draws attention to the global mental health crisis affecting over one billion people.
  • In India, where 13.7% of the population experiences mental disorders, the Mental Healthcare Act, 2017 stands as a milestone — guaranteeing the right to mental health care, decriminalising suicide, mandating insurance coverage, and protecting patient dignity.
  • The Supreme Court, in Sukdeb Saha vs State of Andhra Pradesh, affirmed mental health as a fundamental right under Article 21.
  • Government initiatives such as the District Mental Health Programme (covering 767 districts), Tele MANAS (over 20 lakh counselling sessions), and the Manodarpan programme (reaching 11 crore students) reflect India’s expanding, decentralised approach to accessible and inclusive mental health care.

India’s Mental Health Crisis: Persistent Gaps and Global Contrasts

  • Severe Treatment Gaps and Shortage of Professionals
    • Despite progressive laws and programmes, India continues to face major mental health challenges.
    • The National Mental Health Survey (2015–16) reported treatment gaps ranging from 70% to 92%, with an 85% gap even in common disorders like depression and anxiety.
    • The shortage of trained professionals is acute—India has only 0.75 psychiatrists and 0.12 psychologists per 1,00,000 people, far below the WHO’s recommended three psychiatrists per 1,00,000.
  • Weak Implementation and Limited Resources
    • Although the District Mental Health Programme (DMHP) covers 767 districts, its functioning remains weak in many states.
    • Frequent stockouts of essential psychotropic medicines at primary health centres, poor rehabilitation services meeting less than 15% of needs, and deep-rooted stigma—where over half of Indians view mental illness as personal weakness—further undermine care.
    • These factors lead to poor treatment continuity and high economic losses, projected to exceed $1 trillion annually by 2030.
  • India’s Lag Compared to Global Standards
    • Globally, mental disorders affect about 13.6% of people.
    • Countries like Australia, Canada, and the U.K. have lower treatment gaps (40%–55%) and allocate 8%–10% of their health budgets to mental health, compared to India’s meagre 1.05%.
    • They employ mid-level mental health providers who deliver nearly half of counselling services, maintain universal insurance coverage (over 80%), and operate robust digital and school-based programmes reaching up to 30% of their populations.
    • In contrast, India’s Tele MANAS initiative—though a major step forward with 53 centres—requires greater reach and integration.
    • Moreover, unlike these nations, India lacks a strong mental health surveillance system and does not yet incorporate emerging disorders like complex PTSD or gaming disorder into its policy framework.

Systemic Barriers Hindering India’s Mental Health Progress

  • India’s mental health system faces deep-rooted structural and sociopolitical barriers.
  • Persistent stigma continues to limit public discourse, political will, and policy innovation.
  • Coordination among key ministries — health, education, social welfare, and labour — remains weak, leading to fragmented and poorly aligned initiatives.
  • Mental health research receives minimal funding compared to overall health budgets, hindering evidence-based policymaking.
  • Despite rising allocations, mental health still accounts for only 1.05% of total health expenditure, far below the WHO’s recommended 5%.
  • Workforce shortages are further compounded by resistance to integrating mid-level mental health providers, as the system remains dominated by specialist-led models.
  • The rural-urban divide worsens the crisis, with nearly 70% of India’s population in rural areas having minimal or no access to trained professionals, leaving vast sections of the country underserved.

Building a Robust Mental Health Framework for India

  • Expanding Budget and Workforce Capacity
    • To bridge the vast treatment and infrastructure gap, India must raise its mental health budget to at least 5% of total health spending.
    • This will support infrastructure development, ensure uninterrupted medicine supply, and strengthen human resources.
    • Training and deploying mid-level mental health providers can significantly reduce the urban-rural divide and help India meet — and even exceed — the WHO’s recommended workforce density.
  • Integrating Care and Updating Frameworks
    • Mental health should be fully integrated into primary health care and covered under universal health insurance schemes to ensure accessible and affordable services nationwide.
    • National policies and diagnostic manuals must be updated to incorporate WHO’s ICD-11 categories such as complex PTSD and gaming disorder, enabling targeted and contemporary interventions for emerging conditions.
  • Strengthening Accountability and Awareness
    • India needs a strong monitoring and evaluation mechanism at district and State levels, linked to dedicated budgets.
    • Such a system would track treatment dropouts, improve accountability, and guide efficient resource allocation.
    • Simultaneously, nationwide anti-stigma and mental health literacy campaigns — especially in schools and workplaces — should aim to reach over 60% of educational institutions by 2027, promoting early help-seeking and social acceptance.
  • Enhancing Institutional Coordination
    • Finally, stronger collaboration between the Ministries of Health, Education, Social Justice, and Labour is essential.
    • A unified, inter-ministerial approach would harmonise policies, maximise resources, and deliver a cohesive national mental health response.

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