On October 10, every year, World Mental Health Day highlights the extent of mental illness in the world — over one billion people (13% of global population) suffering from mental illnesses. India is a part of this, with a 13.7% lifetime prevalence of mental disorders in the country.
India has legally prioritised mental health through the landmark Mental Healthcare Act, 2017, which guarantees the right to mental health care, decriminalises suicide, mandates insurance coverage and enshrines patient dignity and autonomy. This legislation covers nearly 200 million Indians affected by mental illness. In Sukdeb Saha vs State of Andhra Pradesh, the Supreme Court of India reinforced mental health as a fundamental right under Article 21, thereby legally binding the government to ensure accessible, affordable and quality mental health care. The government’s District Mental Health Programme (DMHP) covers around 767 districts, expanding access to counselling, outpatient services, and suicide prevention and also signalling a significant attempt to decentralise mental health services.
The launch of Tele MANAS, a 24X7 mental health helpline number has enabled over 20,05,000 tele-counselling sessions, improving reach in underserved areas. Additionally, school-based government programmes such as Manodarpan have reached 11 crore students nationwide.
The hurdles in India
But challenges persist. The National Mental Health Survey (NMHS) 2015-16 revealed treatment gaps of 70%-92% across disorders, with an 85% gap in common disorders such as depression and anxiety. India’s mental health workforce remains scarce; with only 0.75 psychiatrists and 0.12 psychologists for a 1,00,000 population, India falls short of World Health Organization (WHO) guidelines requiring at least three psychiatrists for 1,00,000 people.
Even though the DMHP has expanded its coverage, various studies report that DMHP’s function poorly in various states across the country. Shortcomings extend to medicine availability as well, where often primary health centres report stockouts of essential psychotropic drugs. Rehabilitation services, vital for recovery and social integration, meet less than 15% of identified needs nationwide. Deep-seated stigma continues to exist as recent studies indicate over 50% of Indians attribute mental illness to personal weakness or shame. These failures result in millions dropping out of care pathways before treatment begins or completing them only partially, thus perpetuating disability and economic loss estimated at over $1 trillion annually by 2030.
The global prevalence of mental disorders is about 13.6%, but Australia, Canada and the United Kingdom report mental health treatment gaps of 40%-55%. Though significant, it is far lower than India’s 70%-92%. These countries also allocate 8%-10% of their annual budget to mental health; in India it is only 1.05%. WHO’s International Classification of Diseases (ICD)-11 diagnostic manual includes emerging conditions such as complex post-traumatic stress disorder (PTSD), prolonged grief disorder and gaming disorder — all of which are absent in India’s mental health policies and guidelines, therefore, limiting tailored care models.
These countries have adopted mid-level mental health providers who deliver nearly 50% of counselling services; in India, the workforce remains centered around urban specialist doctors. Mental health services are universal and insurance coverage exceeds 80%, compared to under 15% in India. Digital and school-based mental health programmes reach 20%-30% populations in advanced countries, while India’s Tele MANAS, although promising, with 53 Tele MANAS in the country, needs deeper penetration across all regions. These countries also maintain robust mental health surveillance systems for real-time cascade monitoring, which India lacks largely due to fragmented data collection practices and inadequate funding.
The deep-seated problems
Sociopolitical stigma in India remains high, limiting political prioritisation and innovative policy momentum. Coordination between the Ministries responsible for health, education, social welfare and labour remains variable, causing fragmented mental health initiatives. Research funding for mental health is also much less than total health research budgets, restricting evidence-based decision making. Despite an increasing budgetary allocation for mental health, the 1.05% share of total health spending remains insufficient compared to the WHO-recommended minimum of 5%. Workforce shortages are worsened by resistance to mid-level provider roles, given the dominance of specialist-centric models.
Moreover, rural populations, which constitute 70% of India’s demographic, face severe scarcity of mental health professionals.
Steps to take
To address this profoundly unmet need, India must undertake comprehensive policy reforms. The government should increase the mental health budget to at least 5% of total health expenditure, facilitating infrastructure, workforce recruitment and medicine supply. Scaling mid-level provider training and deployment would ease urban-rural disparities and surpass the WHO minimum workforce density. Full integration of mental health into primary health care and universal health insurance schemes should guarantee accessible, affordable care nationwide. Updating national diagnostic manuals and policies to include WHO’s ICD-11 disorders would enable focused interventions for emerging mental health conditions.
Establishing a rigorous cascade-based monitoring and evaluation system at the district and State levels with linked budgets could improve accountability, track treatment dropouts and guide targeted resource allocation. Expanding anti-stigma campaigns, particularly within schools and workplaces, and ensuring that mental health literacy reaches over 60% of educational institutions by 2027 will encourage early help-seeking. Finally, stronger inter-ministerial coordination aligning health, education, social justice and labour policies can create a unified mental health response, maximising synergies and outcomes.
Samayeta Bal is an advocate, a former Legislative Assistants to Members of Parliament (LAMP) Fellow (2024-25), and currently a Parliamentary, Legislative and Policy Researcher
Published – October 10, 2025 12:08 am IST
