Strengthening Minds, Securing Futures: India’s Evolving Mental Health Strategy

Why in the News ?

The Economic Survey recently highlighted a sharp rise in digital addiction and screen-related mental health problems, especially among children and adolescents. Responding to these concerns, the Union Budget presented on February 1 announced major steps to strengthen India’s mental health infrastructure, including the establishment of a second National Institute of Mental Health and Neuro Sciences (NIMHANS) in north India and upgrades to premier institutions in Ranchi and Tezpur.

These initiatives aim to improve regional access, reduce the burden on existing facilities, and expand specialised mental healthcare services nationwide.

Background: Mental Health in India’s Public Health Landscape

Mental health has historically received limited attention in India’s public health policy, despite its deep social, economic, and demographic implications.

For decades, mental healthcare remained concentrated in a few urban, tertiary institutions, while community-based services remained underdeveloped. Social stigma, lack of awareness, and severe shortages of trained professionals further constrained access.

The enactment of the Mental Healthcare Act, 2017, marked a rights-based shift by recognising mental healthcare as a legal entitlement. However, implementation gaps, underfunding, and institutional capacity constraints have continued to limit its transformative impact.

The COVID-19 pandemic and the rapid expansion of digital lifestyles have further intensified psychological stress, anxiety, depression, and behavioural disorders, especially among youth, women, and the working population—forcing policymakers to reassess India’s mental health strategy.

India’s Mental Health Burden: Scale and Severity

India is currently facing a profound mental health crisis.

The country accounts for nearly one-third of global cases of suicide, depression, and addiction, making mental illness a major public health and developmental challenge.

High Suicide Burden Among Youth

Data from the National Crime Records Bureau (NCRB) and the Sample Registration System (SRS) reveal that:

• Suicide is among the leading causes of death for Indians aged 15–29 years.
• Adolescents and young adults face heightened vulnerability due to academic pressure, unemployment, social stress, relationship issues, and digital addiction.

Economic Cost of Mental Illness

According to the World Health Organization (WHO):

• India is projected to lose $1.03 trillion between 2012 and 2030 due to mental health conditions.
• Losses stem from reduced productivity, rising healthcare costs, absenteeism, and premature mortality.

Large Treatment Gap

A critical concern is the treatment gap, estimated at 70%–92% for most mental disorders.

This gap is driven by:

• Low mental health literacy
• Deep-rooted social stigma
• Acute shortages of trained professionals
• Inadequate infrastructure at the primary and community levels

Shortage of Mental Health Professionals

As per the Indian Journal of Psychiatry:

• India has only 0.75 psychiatrists per 1,00,000 people
• The WHO recommends at least 3 psychiatrists per 1,00,000

This shortage severely restricts access to diagnosis, counselling, therapy, and follow-up care.

Low Budgetary Priority

Despite an overall rise in health expenditure since FY2014–15, mental health receives only about 1% of the total health budget, limiting investment in infrastructure, manpower, outreach, and innovation.

Mental Health Infrastructure in India: Expanding Access Beyond Hospitals

Recognising the need to decentralise mental healthcare, the government has increasingly integrated mental health services into primary healthcare systems.

Integration under Ayushman Bharat

Mental health services are now part of the Comprehensive Primary Health Care package delivered through Ayushman Arogya Mandirs (Health and Wellness Centres).

• Over 1.73 lakh sub-health centres and primary health centres have been upgraded.
• These centres offer basic mental health screening, counselling, referral services, and follow-up care.
• This approach reduces reliance on specialised hospitals and improves early detection and intervention.

Strengthening Specialist Capacity

To address manpower shortages, the government has expanded education and training capacity:

• Over 20 Centres of Excellence sanctioned for postgraduate training in mental health.
• 47 postgraduate departments in psychiatry and allied disciplines established nationwide.

These efforts aim to increase the availability of psychiatrists, psychologists, psychiatric social workers, and mental health nurses, particularly in underserved regions.

Tele-Mental Health Support: Tele MANAS

India has complemented physical infrastructure with digital outreach through Tele MANAS (Tele Mental Health Assistance and Networking Across States):

• 24×7 toll-free mental health support via 14416 or 1-800-891-4416
• Launched on October 10, 2022
• 53 operational cells across 36 States and Union Territories
• Supported by 23 specialised mentoring institutes

Tele MANAS bridges access gaps, particularly for people in remote areas or those hesitant to seek in-person care, and plays a vital role in crisis intervention and early support.

Where Does India Fall Short on Mental Health Funding ?

India’s mental health budget has increased from ₹683 crore in 2020–21 to approximately ₹1,898 crore in 2024–25.

However, experts argue that this apparent rise conceals a deeper problem of chronic underinvestment.

The allocation remains below 2% of the total health budget, which itself is only around 2% of India’s GDP—far below what the magnitude of the mental health burden demands.

Mismatch Between Spending and Need

The underinvestment becomes stark when weighed against:

• India’s high suicide and depression burden
• Massive treatment gaps
• Substantial economic losses due to untreated mental illness

Despite these realities, mental health continues to receive low fiscal priority within health and social sector planning.

Overemphasis on Tertiary Institutions

A major concern is the skewed allocation pattern:

• A significant portion of funds is directed toward tertiary institutions such as NIMHANS and newly established centres of excellence.
• While these institutions are vital for research and advanced care, they:
  • Serve a limited population
  • Are concentrated in urban centres
  • Cannot mainstream mental healthcare in a country of India’s size and diversity

Experts stress the need for greater funding toward:

• Community-based services
• School and adolescent mental health programmes
• Workplace mental health interventions
• Early intervention and preventive care models

These approaches are more cost-effective and better suited to reaching underserved and vulnerable populations.

Utilisation Gap Compounds the Problem

Beyond low allocations, fund utilisation remains a serious challenge:

• Mental health funds are often underutilised at both national and state levels.
• Administrative bottlenecks, lack of trained local staff, and weak decentralised planning hinder effective spending.

Health experts argue that improved outcomes require decentralised, community-led planning, alongside capacity building at the district and block levels—not merely higher budget allocations.

The Way Ahead: Shifting to Preventive and Community-Based Mental Healthcare

India urgently needs to ensure affordable access, continuity of care, and timely treatment to prevent avoidable deaths, disability, and long-term social harm from mental illness.

Experts highlight:

• An over-reliance on specialist-led, tertiary care
• Severe shortages of trained professionals
• A treatment access gap approaching 95% for certain disorders

Encouragingly, the government is now pivoting toward a whole-of-community approach, integrating mental well-being into:

• School education systems
• Workplace policies
• Public health campaigns
• Digital health platforms

This signals a strategic shift from a predominantly curative, hospital-based model to a preventive, promotive, and community-based mental healthcare framework, aligned with global best practices and Sustainable Development Goals.

Significance and Way Forward

India’s evolving mental health strategy marks a critical step toward recognising mental health as a central pillar of public health, social justice, and human development.

By expanding infrastructure, integrating mental health into primary care, leveraging digital platforms, and strengthening training capacity, the government is addressing long-standing structural gaps.

However, for lasting impact:

• Mental health must receive sustained and proportionate fiscal priority.
• Community-level services and preventive interventions must be scaled up.
• Social stigma must be addressed through education, advocacy, and cultural change.
• Monitoring, evaluation, and accountability mechanisms must be strengthened.

A mentally healthy population is essential for demographic dividend, economic productivity, social cohesion, and national well-being.