Mental Health

and Well
Being in India
Key Abbreviations
+ MNS - Mental, Neurological and Substance Use
+ HWCs - Health and Wellness Centers
+ MoHFW - Ministry of Health and Family Welfare
+ DMHP - District Mental Health Programme
+ NMHP – National Mental Health Programme
+ NMHS - National Mental Health Survey
+ NIMHANS - National Institute of Mental Health and Neuro
Sciences
 Social Stigmas relating to mental
health in India
+ Lack of awareness and education among people regarding
mental health, neurological, and substance use disorders.
+ Such conditions are often viewed as punishment for sinful
actions or curses by evil spirits.
+ Stigma associated with mental health and substance use
disorders further discourages people from seeking help.
+ Reluctance to seek professional help due to fear of being
labeled as "mad" or "crazy".
+ Societal pressure to conform to traditional gender roles,
and discrimination against certain castes and religious
minorities.
+ Mental health conditions are more prevalent among
males (13.9%) than females (7.5%), but mood
disorders are higher among women.
+ Males in the age group of 30-49 years are the most
affected by mental illnesses.
+ Urban residents have a greater prevalence of mental
disorders, and those from lower income quintiles have
a greater prevalence of one or more mental disorders.
+ 0.9% of those over 18 years are at high risk and 0.7%
at moderate risk of suicide. The highest-risk groups
are females (1.14%), those living in urban metros
(1.71%), and those between the ages of 40-49 years.
+ The prevalence of mental health disorders in the age
group of 13-17 years is 7.3%, and depressive disorders
are the commonest conditions. Nearly 9.8 million
young Indians aged between 13 and 17 years need
active interventions. The prevalence is significantly
higher (13.5%) in urban metros compared to rural
areas (6.9%) in this age group.

Source: National Mental Health Survey of India, 2015-16: Prevalence, Pattern and Outcomes. National Institute of
Mental Health and
Neuro Sciences 2016
Concerns that
need
immediate action
 + The National Mental Health Survey showed that 150 million people in India needed intervention
for mental disorders, but less than 30 million are seeking care at present.
+ All mental disorders, except for epilepsy, had a treatment gap of more than 60%, with the highest
treatment gap being for alcohol use disorders (86%).
+ One in 20 persons in the country suffers from depression, out of which 39% suffer from severe
depression. Three out of four persons with severe mental disorders have disabilities affecting
their work, family, education, and other aspects of life.
+ 0.9% of the population over 18 years is at high risk of suicide.
+ About 14.6% of people (approximately 160 million) were current alcohol users, and about 5.2%
of Indians are estimated to be affected by harmful or dependent alcohol use.
+ About 2.8% of Indians (31 million) reported using cannabis products within the previous year,
and about 0.66% (approximately 7.2 million individuals) need help for their cannabis use
problems.
+ 2.1% of the country's population (22.6 million) uses opioids, including opium, heroin, and
different pharmaceutical opioids. About 0.55% of Indians are estimated to need help for their
opioid use problems. The most common opioid used at the national level is heroin, followed by
pharmaceutical opioids and opium. The overall prevalence of current use of opioids is 2.06%.
National Mental health Survey of India, 2015–16. Bengaluru: NIMHANS; 2016 (http://www.indianmhs.nimhans.ac.in/Docs/Summary. pdf, accessed 20 August 2022)
 Magnitude of substance use in India. New Delhi: Ministry of Social Justice and Empowerment, Government of India,
NDDTC,AIIMS;2019(https://www.aiims.edu/images/pdf/Departments_Centers/NDDTC/Magnitude_Substance_Use_India_ REPORT.pdf, accessed 20 August 2022)
 Type of mental health Treatment gap (%)
problem
Common mental disorders 85.2%
Psychoses 75.5%
Bipolar affective disorders 70.4%

Alcohol use disorder 86.3%

Median duration for seeking

care (months)
Depressive disorder 2.5
Epilepsy 12
Common source of care Government facility

Source: National Mental Health Survey of India, 2015-16: Prevalence, Pattern and Outcomes. National Institute of
Mental Health and Neuro Sciences 2016.
 Indian
Government
Policies,
Programmes and
Legal Initiatives

This Photo by Unknown author is licensed under CC BY-SA.

Source: Rashtriya Bal Swasthya Karyakram (RBSK). In: Ministry of Health and Family Welfare,
Government of India [website] (https://rbsk. gov.in/RBSKLive/, accessed 20 August 2022). 
 + The National Mental Health Policy (NMHP) 2014
emphasizes universal access to quality services,
community participation, and a holistic approach to
mental health.
+ The principles of NMHP have been incorporated into
the National and District Mental Health Programmes
and Mental, Neurological and Substance Use package
at health and wellness centers.
+ The Mental Healthcare Act 2017 has provisions for
mental health care and services, protecting the rights
of persons with mental illnesses, decriminalizing
suicide, and regulating electroconvulsive therapy.
+ National rules for implementing the Act have been
endorsed, and states are developing their own rules
based on the national rules.

This Photo by Unknown author is licensed under CC BY.

Organization and Scope of Prevention and Promotion Measures 
Initiative Description

Calls for universal access to quality services,

equitable distribution, community
participation, a rights-based approach,
intersectoral coordination, use of appropriate
National Mental Health Policy (NMHP) technology, and a holistic approach to mental
health. Fully implemented, and its principles
have been incorporated in the NMHP/DMHP
and  Use MNS use package at  (HWCs)
operating at the primary care level.
Initiative Description
Has provisions for mental health care and
services for persons with mental illness and for
protecting, promoting and fulfilling the rights
of such persons during delivery of mental
health care and services. The national rules for
implementation of the Act have been
Mental Healthcare Act 2017 endorsed. Further, states are in the process of
developing their own rules, drawing from the
national rules. It safeguards the rights of
persons with mental illnesses, decriminalizes
suicide and regulates electroconvulsive
therapy. Elements of mental health promotion
can be included as appropriate.
Initiative Description

The MoHFW releases posters and videos on its

website and social media handles to raise
awareness of mental health. Districts receive
funds up to INR 400,000 annually for
community-based IEC activities under the
Information, Education and Communication DMHP. States/UTs undertake various
awareness-generation activities like
newspaper ads, radio messages, street plays,
wall paintings, etc. under the DMHP. Specific
activity details can be obtained from states as
public health is a state subject.
Initiative Description
Screens children from birth to 18 years of age
for 4 D’s – Defects at birth, Diseases,
Deficiencies and Development delays,
spanning 32 common health conditions for
early detection and free treatment and
Rashtriya Bal Swasthya Karyakram (RBSK) management. These include surgeries at the
tertiary level. Mental health and neurological
conditions are identified. Children diagnosed
with identified selected health conditions are
provided early intervention services and
follow-up care at the district level.

Under Ayushman Bharat – a joint initiative of

the MoHFW and Ministry of Human Resource
School Health Programme and Development – the School Health
Programme takes care of aspects like
prevention of bullying, school health
promotion activities, etc.
 Arrangement
and Extent of
Mental Health
Services

This Photo by Unknown author is licensed under CC BY-SA.

Operational guidelines on school health programme under Ayushman Bharat. New Delhi:
MoHFW and Ministry of Human Resource and Development; 2018
(https://nhm.gov.in/New_Updates_2018/NHM_Components/RMNCHA/AH/guidelines/
Operational_guidelines_ on_School_Health_Programme_under_Ayushman_Bharat.pdf, accessed
20 August 2022).​
+ Mental health services are governed by the Mental Health Division of
the MoHFW at the national level, Mental Health Division of the
MoHFWs of state governments at the state level and the DMHP.
+ The DMHP component of the NMHP has been sanctioned for
implementation in 704 out of 750 districts.
+ DMHP provides outpatient services, assessment,
counselling/psychosocial interventions, awareness generation,
continuing care, support to persons with severe mental disorders,
drugs, outreach services at the community health center and primary
health center levels, ambulance services, and provision for a 10-
bedded inpatient mental health treatment facility at the district level.
+ Tailor-made courses have been initiated through a digital academy to
increase the availability of adequately trained mental health workforce
at all healthcare levels.
+ Operational guidelines on mental, neurological and substance use
disorders (MNS) at HWCs have been released under Ayushman Bharat.
+ Primary health-care workers are being trained to provide mental health
services to all sections of society at the primary level.
+ DMHP guidelines make provisions for medications to be made available
at the CHC level, where they are dispensed by the Medical Officer.
+ Half-way homes and community rehabilitation centers have been
established by certain states in collaboration with NGOs.
+ The Drug De-Addiction Program under the MoHFW provides
treatment facilities in selected Central Government
hospitals/institutions.
+ A 24 x 7 toll-free helpline has been established to provide
psychosocial support and mental health services during
emergencies.
+ Human resources are a major challenge, and the government
provides grants to education and training institutions to
produce qualified mental health professionals.
 Mental Health Services Undertaken by different Ministries
+ The National Trust, a statutory body of the Ministry of Social Justice and Empowerment,
was set up under the “National Trust for the Welfare of Persons with Autism, Cerebral
Palsy, Mental Retardation and Multiple Disabilities” Act (Act 44 of 1999), based on the
principles of the United Nations Convention on the Rights of Persons with Disabilities
(UNCRPD). It works to provide opportunities for capacity development of persons with
disability and their families. Under the Disha scheme (early intervention and school
readiness scheme), early interventions, including therapies to affected persons, and
training and support to family members are carried out .
+ The Ministry of Social Justice and Empowerment has schemes to address alcohol and
other psychotropic substance addiction.
+ The Ministry of Education is implementing the Ayushman Bharat School Health
and Wellness Programme in collaboration with the MoHFW.

Source: https://www.thenationaltrust.gov.in/content/innerpage/introduction.php
Areas that
need growth
and Support
+ The NMHP is being implemented in all states and UTs in India, with the
objective of ensuring the availability and accessibility of minimum
mental health care for all, with a special focus on the most vulnerable
and underprivileged sections of the population.
+ The DMHP is currently being implemented in 704 of the 750 districts in
the country to facilitate early detection and treatment and to generate
public awareness.
+ To ensure the availability of health-care services at the community
level, the Government of India, under its Ayushman Bharat initiative,
included the MNS package at HWCs. The government has a target of
operationalizing    
    150 000 HWCs by the end of 2022.
+ These initiatives are ensuring the availability of trained human
resources by building the capacities of non-specialist cadres with
a capsule of in-service training, which is in line with the WHO
mental health Global Action Programme (mhGAP). Priority is
also given to ensure the availability of medicines and other
essential equipment for diagnosis and treatment of mental health
conditions.
+ Recently, the government has announced the launch of
telemedicine services to be implemented through NIMHANS as
the nodal center. Preparations are ongoing.
 Government Agencies Responsible for Mental Health Care in India
Agency Name Type Services provided Impact

Development of mental health policies and programs;

National Institute of Mental Health Clinical care, research, and
Government telepsychiatry services to increase access to mental
and Neuro-Sciences (NIMHANS) training
health care in remote areas

Central Institute of Psychiatry Mental health care, research, and Research in the field of schizophrenia; contributions to
Government
(CIP) training the development of mental health policies and programs

Funding for the establishment of mental health services

National Mental Health Program Mental health services and
Government at the district level; creating awareness about mental
(NMHP) training
health issues and reducing stigma
Agency Name Type Services provided Impact

Outpatient services,
counseling, and Improving access to
District Mental Health Government outreach services at mental health care in
Program (DMHP)
the community and rural areas
primary care levels

Promoting mental Creating awareness

Indian Psychiatric Professional health and advancing about mental health
Society (IPS) organization the science of issues and reducing
psychiatry stigma

Improving the lives of

Mental health care to
thousands of
homeless and
The Banyan Non-profit organization marginalized individuals through its
community-based
communities
interventions
Agency Name Type Services provided Impact

Launching campaigns to
create awareness about
Reducing the stigma mental health and
The Live Love Laugh around mental health
Foundation providing support to
Non-profit organization issues and providing
support to those who thousands of
(Founder: Deepika Padukone) individuals through its
are struggling
helpline and online
resources

Developing evidence-
based interventions for
Community-based mental health and
Sangath Non-profit organization
mental health services improving access to
mental health care in
low-resource settings
 Strong central Comprehensive
and district-level mental health
organizations for policy, law, and
mental health guidelines in
services. place.

Strength
Established
community and
State-level
primary care
prevalence data
system for
available.
mental health
services.
Weakness

Human resource
Administrators handle Addressing these
constraints exist in
other programs constraints is
clinical, primary care,
besides mental health. necessary.
and field staff.
 Mental health was given a priority
during the pandemic.

MNS package will be

Opportunities implemented at 150,000 HWCs by
end of 2022.

High-quality technical expertise is

available in the country.
Threats

Unattractive conditions Substance use disorder is

Stigma and low mental
for mental health High treatment gap could a significant risk factor
health literacy are
professionals in the worsen. for developing mental
prevalent.
government sector. health disorders.