India’s Mental Health Crisis

Syllabus: GS2/Issues Related To Health

Context

• Every year, October 10 marks World Mental Health Day — a reminder of the global burden of mental illness affecting over a billion people.
• India, with a 13.7% lifetime prevalence of mental disorders, needs to address mental health challenges through legal, institutional, and policy frameworks.

About the Mental Health

• According to the World Health Organization (WHO), mental health is a state of well-being where individuals can cope with life’s stresses, work productively, and contribute to their communities.
• It is shaped by a mix of individual, social, and structural factors—poverty, violence, inequality, and trauma all increase vulnerability.

Global Scenario

• According to the Mental Health Atlas 2024 of WHO, nearly one in eight people worldwide live with a mental disorder.
  • Depression and anxiety are the most common mental health conditions, affecting over 300 million people.
  • Suicide remains a leading cause of death among young people aged 15–29.
  • Over 40% of countries have fewer than one psychiatrist per 100,000 people.

Status in India

• According to the NCRB’s Accidental Deaths & Suicides in India (ADSI) 2023 report, India recorded 1,71,418 suicides.
  • Top Suicide Rate States: Andaman & Nicobar Islands, Sikkim, Kerala;
  • Highest Absolute Deaths: Maharashtra, Tamil Nadu, Madhya Pradesh, Karnataka, West Bengal;
  • Demographic Trends: Men formed 72.8% of victims, revealing deep economic and social stress.
  • Primary Causes: Family issues (31.9%), illness (19%), substance abuse (7%), relationship and marriage problems (10%).
  • Men account for nearly 73% of all suicides, often driven by economic and social stress.
• Agrarian Distress: In 2023 alone, 10,786 farmers — 6.3% of total suicides — took their lives, largely in Maharashtra and Karnataka.
  • Since 2014, over 1,00,000 farmers have died by suicide, driven by debt, crop failure, and market instability.
• The National Mental Health Survey (2015-16) conducted by NIMHANS revealed that 10.6% of adults suffer from mental disorders, excluding tobacco-related conditions.
• WHO estimates India’s suicide rate at 16.3 per 1,00,000.

Persistent Challenges: Key Reasons For Mental Health Crisis

• Severe Treatment Gaps: Over 80% of people with severe conditions receive no professional care out of nearly 230 million Indians who live with some form of mental disorder.
  • The National Mental Health Survey (2015–16) revealed treatment gaps ranging between 70% and 92%, with 85% for common conditions like depression and anxiety.
• Workforce Shortage: India has 0.75 psychiatrists and 0.12 psychologists per 100,000 population against WHO’s minimum recommendation of 3 psychiatrists per 100,000.
• Operational Inefficiencies: DMHP’s uneven performance across states due to inadequate resources;
  • Frequent shortages of essential psychotropic drugs at primary health centres;
  • Rehabilitation coverage meeting only 15% of national needs.
  • Enduring Stigma: More than 50% of Indians still attribute mental illness to weakness or shame — perpetuating silence, dropout from care, and lost productivity worth over $1 trillion by 2030.
• Systemic Gaps and Policy Failures: Despite statutory (Mental Healthcare Act, 2017) and regulatory (National Suicide Prevention Strategy, 2022) provisions in India, suicides have continued to rise.
• Programs such as Manodarpan, intended to support students, remain under-implemented.
• Rise of Digital Solace — and Its Risks: OpenAI CEO Sam Altman acknowledged that  people turn to AI tools like ChatGPT for emotional support, in the absence of accessible human care.
  • It underscores a profound social failure.
• Cost of Inaction: Suicide is now the leading cause of death among Indians aged 15–29.
  • Untreated mental illness could cost India over $1 trillion in lost GDP by 2030, with employers already losing ₹1.1 lakh crore annually due to burnout and absenteeism.

Global Comparisons

• Countries like Australia, Canada, and the UK report:
  • Treatment gaps of 40–55% (far lower than India’s);
  • 8–10% of health budgets devoted to mental health (India: only 1.05%);
  • Mid-level mental health providers delivering 50% of counselling services;
  • Universal insurance coverage for 80%+ of citizens;
  • Robust mental health surveillance systems for real-time data and response;
• India’s policies lag behind in adopting WHO’s International Classification of Diseases (ICD)-11 standards, which include emerging disorders such as complex PTSD, prolonged grief disorder, and gaming disorder.

India’s Legislative and Policy Response

• The Mental Healthcare Act, 2017: It remains a milestone in ensuring the right to mental health care. It decriminalises suicide, mandates insurance coverage for mental illnesses, and protects patient dignity and autonomy;
  • It has positioned mental health as a fundamental right under Article 21 — reaffirmed by the Supreme Court of India in Sukdeb Saha vs State of Andhra Pradesh.
• Expanding Access through National Initiatives:
  • District Mental Health Programme (DMHP): Operates in 767 districts, offering outpatient services, counselling, and suicide prevention.
  • Tele MANAS (24×7 Helpline): Over 20 lakh tele-counselling sessions have extended mental health support to underserved populations.
  • Manodarpan: A school-based programme that has reached 11 crore students, promoting psychological well-being among youth.

Way Forward

• Prioritise Mental Health as a National Emergency: Establish a cross-ministerial task force spanning health, education, agriculture, and women’s welfare.
  • Ensure independent funding and accountability for all mental health initiatives.
• Strengthen Human Infrastructure: Increase the number of mental health professionals to 3–5 per 1,00,000 people within five years.
  • Expand psychiatry and psychology training with rural placement incentives.
• Institutionalise Counselling as Public Infrastructure: Mandate full-time counsellors in schools, colleges, and hospitals.
  • Fund mental health services through central and state budgets, not NGOs alone.
• Target High-Risk Groups:
  • Farmers: Combine counselling with debt relief and livelihood support.
  • Homemakers: Create community-based therapy networks.
  • Students: Build continuous, preventive mental health systems in coaching hubs and universities.
• Regulate Digital Mental Health Tools: Enforce privacy disclosures, disclaimers, and crisis-response protocols in all emotional-support apps.
  • Require real-time access to licensed professionals for users in distress.
• Increase Budget Allocation: Raise mental health spending to at least 5% of total health expenditure to strengthen infrastructure, recruit workforce, and ensure medicine supply.
• Integrate Mental Health into Primary Care: Ensure universal health insurance coverage and embed mental health in primary healthcare delivery for equitable access.
• Promote Mental Health Literacy and Anti-Stigma Campaigns: Reach 60% of schools and workplaces by 2027 through awareness campaigns fostering early help-seeking and social inclusion.
• Foster Inter-Ministerial Coordination: Align efforts across health, education, social justice, and labour ministries to create a unified national mental health framework.

Conclusion

• World Mental Health Day 2025 calls for renewed commitment and systemic change. India’s progress — from constitutional guarantees to nationwide programmes — is commendable, yet incomplete.
• Only by increasing investment, decentralising services, updating policies, and dismantling stigma can India move closer to ensuring that mental health is truly a right, not a privilege.

Source: TH