Mental health experts flag lack of national and district mental health programme in Budget

KOLKATA: Mental health experts, while appreciating the Budget proposal to set up a National Institute of Mental Health and Neurosciences (NIMHANS) in North India and the upgradation of infrastructure in Tezpur and Ranchi, flagged concerns about the lack of a national and district-level mental health programme to deal with problems at the micro level.

Clinical psychologist and mental health activist Ratnaboli Ray said that while the announcements on expanding advanced mental healthcare, training, and research capacity addressed long-standing shortages in specialist infrastructure, she warned that these institutions risk becoming isolated centres of excellence, disconnected from everyday mental health needs, in the absence of a standalone allocation for the National Mental Health Programme (NMHP), the primary vehicle for delivering community and district-level mental healthcare across the country.




NMHP and its district components are responsible for outreach, continuity of care, availability of medicines, follow-up, and crisis support. “For most Indians, mental healthcare does not begin at national institutes. It begins, if at all, at primary health centres, district hospitals, and community services,” she pointed out.

Psychiatrist Aniruddha Deb said that while a country as populated as India needs many more NIMHANS, there is also a need for a countrywide programme that enables grassroots intervention to help people with mental health issues. “One needs a fine balance between developing centres of excellence and setting up district-level clinics for people suffering from mental health issues,” he said.

From an employment perspective, untreated mental health conditions are a major driver of job loss, absenteeism, informalization of work, and early exit from the labour force, particularly among young people, women, and gig workers.

Institute of Psychiatry assistant professor Prasanta Roy pointed out that since the loss to the economy due to mental health was never quantified, we tend to ignore its implications. “If we study how many productive years are lost due to mental health in India, it will rank higher than most other ailments. For severe mental illness, the productivity loss is long-term. There is scope to prevent mental illness, but most of the stress is on treatment post-illness,” he said.

Mental health experts also pointed out that weak community mental healthcare shifts the burden onto families, especially women, increasing unpaid care work and reducing labour force participation.

There is also a governance dimension. Capital expenditure is visible and finite; programme expenditure is ongoing, less visible, and more accountable. “Prioritising institutions over programmes shifts responsibility to states and families, while limiting the Centre’s exposure to rights-based scrutiny under existing laws,” added Ratnaboli Ray of mental health rights organisation Anjali.



WHAT IS THERE IN THE BUDGET

• Upgradation of premier mental health institutions in Ranchi and Tezpur
• Establishment of a second National Institute of Mental Health and Neurosciences (NIMHANS) in North India; some believe Delhi-based Institute of Human Behaviour and Allied Sciences (IBHAS) will be rechristened NIMHANS

WHAT ISN'T THERE IN BUDGET

• No clarity on programme funding: there is no clearly stated, standalone allocation for the National Mental Health Programme (NMHP), the primary vehicle for delivering community and district-level mental healthcare across the country
• Without strengthened programme funding, new institutions risk becoming isolated centres of excellence, disconnected from everyday mental health needs.

“After three decades in the mental health sector, I learnt that buildings do not deliver care—systems do. Institutions are important, but without sustained investment in community programmes, trained personnel, and rights enforcement, mental healthcare remains out of reach for most people. A budget that recognises mental health must fund not just visibility, but responsibility.” -- Ratnaboli Ray, mental health activist