Prescription: Empathy

Mental health policy in India must move beyond treatment to include prevention at every level

- Nachiket Mor and Iti Bhargava

INDIA'S public health successes like polio, maternal mortality and COVID-19 have followed a similar arc—from a visible threat, to a coordinated response, and measurable reduction. Yet, mental health does not fit this trajectory. Unlike other health emergencies, it does not announce itself with a sudden outbreak, but with quiet signals such as dropping out of school, unexplained fatigue, declining productivity, and suicides relegated to the margins of newspapers. And so, for decades, we have under-invested, under-counted and under-responded to it.

India currently loses about 2,433 years per 100,000 people due to mental illness, measured in Disability-Adjusted Life Years (DALYs), which combine years lived with disability and years lost to early death. With only 56,600 psychiatric beds, 9,000 psychiatrists, and a per capita government spend of just Rs 7.46 on mental hospitals, we are fundamentally unprepared. Such a health system, which is activated only after someone falls severely ill, is inadequate and structurally impossible. In our recent paper, 'Mental Health in India: The Pathway to Zero', we used simulation modelling to examine what it would take to meet the population's mental health needs through treatment alone. To meet the current need, we require nearly 800,000 psychiatric beds, 500,000 psychiatrists, and Rs 20,000 per person annually. By 2040, with the mental health burden projected to rise by 30 per cent, the requirements swell up to over 1,100,000 psychiatric beds, 700,000 psychiatrists and Rs 40,000 per person annually.

These gaps are unbridgeable. No health system can be expected to scale over 20 times its infrastructure, 80 times its workforce, and 5000 times its budget in 15 years. To meet the mental health needs of our population, India must shift from a late-stage, treatment-heavy approach to one that prioritises prevention, early intervention and population-level support.