“I am in that temper that if I were under water I would, scarcely kick to come to the top.” This quote by John Keats in his letter to Benjamin Bailey amplifies how conflicted thoughts engulf the mind, causing individuals to descend into an existential crisis and lose the will to fight back. This reflects the innumerable experiences of people sinking deep into mental suffering, demanding widespread attention. While healthcare organizations focus on improving overall well-being, mental health is often overlooked in favor of physical health concerns.
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity,” thereby positioning mental health as integral to public health discourse. According to a study titled The Burden of Mental Disorders Across the States of India: The Global Burden of Disease Study 1990–2017, India reported 197.3 million individuals affected by mental health disorders, including 45.7 million experiencing depressive disorders and 44.9 million suffering from anxiety disorders in 2017.
Suicide, often stemming from suppressed emotions, unresolved pain, and unspoken grief, is one of the gravest consequences of inadequately managed mental health conditions. In 2021, Assam recorded 3,262 suicides, driven by factors such as mental health disorders, emotional struggles, financial pressures, and substance abuse. Social stigma and self-stigma surrounding mental illness, along with barriers like shame, financial constraints, and confidentiality concerns, further hinder access to essential psychiatric care and recovery opportunities.
The Government of India has introduced initiatives like the National Mental Health Policy (2014) and the Mental HealthCare Act (2017) to support vulnerable populations. The District Mental Health Programme (DMHP), under the National Mental Health Programme (NMHP), operates in 767 districts, training healthcare professionals to meet mental health needs. Online training through institutions like NIMHANS Bengaluru, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, and Central Institute of Psychiatry, Ranchi has been available since 2018. In October 2022, the National Tele Mental Health Programme was launched, and by November 2024, 53 Tele-MANAS (Tele-Mental Health Assistance and Networking Across States) Cells were established across 36 States and Union Territories.
Despite these initiatives, efforts for lasting mental health improvements lack sufficient preparation. Out of a ₹90,659 crore health budget for 2024-25, only 1% is allocated to mental health. Poor fund utilization by states results in consistently low allocations, revealing a gap between strong policies and inadequate implementation due to limited governance focus and investment.
The DMHP faces challenges like inconsistent funding, underutilized resources, administrative delays, and poor state-level coordination. Contractual jobs, frequent staff transfers, and challenges in retaining trained professionals, especially in rural areas, further hinder its effectiveness. A lack of data on personnel deployment and limited mental health professionals in regions like Assam exacerbate the problem.
On a brighter note, some government initiatives tackle these challenges. A 2020 survey by Assam Police, in collaboration with the Department of Psychiatry at Gauhati Medical College Hospital (GMCH), revealed alarming statistics: 46% of respondents experienced anxiety, 14% reported depressive symptoms, 8.3% had depressive disorders, and 5.4% had suicidal thoughts. In response, the Assam government launched ‘Monon,’ a telepsychology helpline, in partnership with Piramal Swasthya Management and Research Institute (PSMRI) and GMCH’s Mental Health Department. Similarly, tele-counseling services initiated by Assam Police and GMCH offer support to those in need.
Improving Mental Health Literacy (MHL) is vital to preventing mental health issues. Financial barriers remain a major challenge to accessing and affording mental health care. High treatment costs, combined with income loss during treatment, create a vicious cycle where poverty worsens mental health conditions. Additional expenses like medication and travel further strain individuals, limiting their ability to seek or continue adequate care.
To address these challenges, healthcare institutions must enhance the quality and accessibility of psychiatric interventions, especially for vulnerable populations. Nongovernmental organizations can play a critical role in mental hygiene and trauma recovery initiatives, as demonstrated by the Action Northeast Trust (Ant), which organized a mental health camp in Kuklung village in 2024, focusing on awareness, therapy, and community engagement.
Promoting mental health awareness in workplaces is also vital for supporting at-risk employees. Employers can ensure access to tools and understanding needed to cope with mental health difficulties, fostering a healthy work-life balance and overall well-being.
Including mental illness in health insurance packages can ease the financial burden of mental disorders. Incorporating a mental health curriculum in education systems can promote early detection and awareness, addressing related issues like substance abuse. Media campaigns can also play a transformative role in shaping public perceptions, fostering a supportive and informed society that prioritizes mental health.
Urgent efforts are needed to develop forward-thinking policy measures supported by strong political commitment and adequate funding. These measures should aim to reach the broader population, remove existing barriers, and effectively address mental health challenges.
Finally, addressing mental health issues like depression is a collective responsibility. Individuals often confide in close ones before seeking professional help, making it crucial to create an environment where people feel safe to express themselves without fear of judgment. By fostering a culture of compassion and acceptance, society can treat mental health with the importance it truly deserves.
The author is a PhD Scholar at the North Eastern Hill University, Shillong. Views expressed are personal.
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