India’s public health conversation has long been dominated by visible crises—infectious diseases, malnutrition, maternal mortality and outbreaks that demand urgent policy responses. Yet running parallel to these well-recognised challenges is a quieter but equally consequential crisis: the rising burden of mental illness. Today, the scale of the problem is impossible to ignore. Experts estimate that one in seven Indians lives with some form of mental health disorder, a staggering number that cuts across age groups, regions and socio-economic groups. Even more troubling is the enormous treatment gap. In several states, between 70 and 90 per cent of those suffering from mental health conditions receive little or no professional care, either because services are unavailable, specialists are scarce, or stigma discourages people from seeking help. In such a context, the Union Budget’s announcement to establish a second National Institute of Mental Health and Neuro Sciences (NIMHANS) in North India is an important policy signal. It reflects a growing recognition that India’s mental health infrastructure must expand if it is to address the scale of the challenge. The original NIMHANS in Bengaluru has, over the decades, evolved into one of the country’s most respected centres for neuroscience, psychiatry and mental health research. Its influence extends far beyond patient care, shaping specialist training, clinical standards and national policy discussions. Replicating such an institution is therefore not merely a bureaucratic expansion of infrastructure. It represents an acknowledgement that mental health is no longer a peripheral concern within the healthcare system but a central public health priority that demands sustained attention and investment.
The importance of strengthening mental healthcare becomes even clearer when seen in the broader context of India’s evolving disease burden. Non-communicable diseases now account for more than 60 per cent of deaths in the country, and mental and neurological disorders contribute significantly to disability-adjusted life years (DALYs). Depression, anxiety, substance dependence and stress-related conditions are increasingly intertwined with chronic illnesses such as diabetes, hypertension and cardiovascular disease. When mental health conditions remain untreated, they worsen the outcomes of these physical illnesses and impose high economic costs through lost productivity, family distress and long-term disability. Yet despite the growing burden, mental health services remain unevenly distributed across the country. While a handful of institutions provide high-quality care and research, vast regions still lack access to advanced neuro-psychiatric facilities. North India in particular faces a shortage of tertiary-level services, especially in specialised areas such as neuroimaging, neurocritical care and advanced neurological treatment. For millions of patients, accessing such services often requires travelling to distant cities, incurring financial strain and delaying treatment that could prevent further deterioration. Establishing NIMHANS-2, therefore, has the potential to correct a long-standing regional imbalance. More importantly, it could expand the country’s capacity to train psychiatrists, neurologists, psychologists and other mental health professionals—an area where India faces an acute shortage. However, infrastructure alone will not close the treatment gap. The deeper challenge lies in ensuring that knowledge and expertise generated in premier institutions reach district hospitals and primary healthcare systems. Experts have therefore emphasised the need for a hub-and-spoke model, where centres of excellence provide specialist guidance, tele-consultation support and training to smaller hospitals and community-level facilities. If implemented effectively, such a system could extend specialised mental health care to rural and underserved regions without forcing patients to travel long distances.
Equally significant is the proposal to establish a National Brain-Mind Cloud Network under the National Health Mission, linking institutions such as AIIMS, state medical colleges and primary healthcare centres through digital platforms. In an era where technology increasingly shapes healthcare delivery, such integration could transform the reach of mental health services. Unified digital health records, AI-based screening tools and tele-neuro-psychiatric hubs could enable early diagnosis and specialist consultations even in districts that lack trained professionals. India’s Tele-MANAS programme, which offers tele-mental health support through call centres and digital platforms, has already demonstrated the potential of technology to bridge geographical barriers. Integrating such initiatives with major neuroscience institutions could create a nationwide network capable of providing counselling, diagnosis and follow-up care to millions of people who currently remain outside the formal healthcare system. This is particularly important for underserved regions such as the northeastern states and remote rural districts, where specialist manpower and infrastructure remain limited. Yet technology and institutional expansion alone cannot address the deeper challenge. For decades, mental illness in India has remained hidden behind stigma, social silence and fragmented policy attention. Many families still hesitate to seek professional help, treating psychological distress as a private or moral issue rather than a medical condition. Addressing this barrier will require sustained public awareness, community-level engagement and the integration of mental health services within primary healthcare systems. Initiatives aligned with the Ayushman Bharat Digital Mission and the ABHA ID ecosystem can strengthen coordination within the healthcare system, but the ultimate test of success will be whether these reforms reduce the treatment gap and encourage people to seek help without fear or shame. India’s aspirations for economic growth, social stability and demographic advantage cannot be realised if the psychological well-being of its citizens remains neglected. Recognising mental health as a national priority must therefore evolve into a sustained commitment that expands care systems, strengthens institutions and ensures that no individual is left to struggle with mental illness in silence.