Policy Update
Arjya Shree Pande
Background
The National Mental Health Policy (NMHP) of India was unveiled on 10 October 2014 by the Union Minister of Health and Family Welfare as the country’s first dedicated policy framework for mental health (Press Information Bureau, 2014). It emerged from the recognition that earlier legal instruments, such as the Indian Lunacy Act, 1912, and the Mental Health Act, 1987, focused primarily on custodial arrangements and failed to adequately address human rights, community-based care, or the scale of need. A policy group constituted by the Government of India worked to formulate recommendations that aligned mental health with a participatory, rights based approach and prepared the ground for subsequent legislative reform (Press Information Bureau, 2014).
The policy was introduced to address a large and growing burden of mental health problems, severe shortages of specialised human resources, wide treatment gaps, and the bi-directional link between poverty and mental ill-health. Official statements noted that only about 3,500 psychiatrists were available in the country at the time and that a substantial proportion of persons with mental illness had no access to care, with predictions that a significant share of the population could experience some form of mental illness in the coming years (Press Information Bureau, 2014). Stigma, exclusion, and limited services, especially in rural and underprivileged settings, further compounded the problem, necessitating a pro-poor orientation and integration of mental health into general health systems.
The goals of the National Mental Health Policy, 2014 include reducing distress, disability, exclusion, morbidity and premature mortality associated with mental health problems across the lifespan of a person; enhancing understanding of mental health in the country; and strengthening leadership in the mental health sector at the national, state and district levels (Press Information Bureau, 2016).
The objectives of NMHP, 2014 are to provide universal access to mental health care; increase access to and utilisation of comprehensive mental health services by persons with mental health problems, including those belonging to vulnerable groups; reduce the risk and incidence of suicide and attempted suicide; ensure respect for the rights of persons with mental health problems and reduce associated stigma; and enhance the availability and distribution of skilled human resources for mental health. The policy is grounded in the values of equity, justice, integrated and evidence-based care, quality, and a participatory and holistic approach (Press Information Bureau, 2016).
Implementation is supported by the Mental Health Action Plan 365, which delineates roles for the Central Government, State Governments, local bodies and civil society organisations (Press Information Bureau, 2014). Target beneficiaries encompass the entire population, with particular emphasis on vulnerable groups such as those living in extreme poverty, the homeless, persons in custodial institutions, and others at heightened risk, consistent with its pro-poor focus (Press Information Bureau, 2014).
Key provisions centre on promotion of mental health, prevention of illness, destigmatisation, socio-economic inclusion, accessible and affordable quality care throughout the life span within a rights-based framework, and strengthening of leadership and services at national, state and district levels through programmes such as the National Mental Health Programme and District Mental Health Programme.
The National Mental Health Policy, 2014 has not been formally amended since its launch.
Subsequent developments that build upon its principles include the Mental Healthcare Act, 2017 (which operationalises rights-based care and decriminalises attempted suicide), progressive expansion of the District Mental Health Programme, integration of mental health services into primary care under the National Health Mission and Ayushman Arogya Mandirs, and the launch of the National Tele Mental Health Programme (Tele MANAS) in 2022 to improve access through tele-counselling (Press Information Bureau and Ministry of Health and Family Welfare parliamentary responses, 2016 onwards; Lok Sabha, 2024).
These measures continue to advance the policy’s vision of universal, equitable and rights based mental health care.
Functioning
The National Mental Health Policy, 2014, operates as a guiding framework rather than a standalone programme. It is operationalised primarily through the pre-existing National Mental Health Programme (NMHP, launched 1982) and its District Mental Health Programme (DMHP) component, integrated into the National Health Mission (NHM). The policy emphasises universal access, rights-based care, promotion, prevention, and community participation, with services delivered across primary, secondary, and tertiary levels, including outpatient care, counselling, psychosocial interventions, medication, outreach, and limited inpatient facilities (Press Information Bureau, 2016; Ministry of Health and Family Welfare).
Institutionally, the Ministry of Health and Family Welfare provides overall leadership and technical guidance. Implementation occurs through State Health Societies and District Health Societies under the NHM architecture. Central institutions such as the National Institute of Mental Health and Neuro Sciences (NIMHANS), Central Institute of Psychiatry, and Lokopriya Gopinath Bordoloi Regional Institute of Mental Health support tertiary care, training, and research. The Mental Healthcare Act, 2017, established Central and State Mental Health Authorities and Mental Health Review Boards to oversee rights protection and service standards (Ministry of Health and Family Welfare parliamentary responses).
The implementation mechanism relies on State Project Implementation Plans under NHM. DMHP teams at the district level deliver services at Community Health Centres and Primary Health Centres, with activities extending to schools, workplaces, and community awareness. Integration with Ayushman Arogya Mandirs further embeds mental health screening and basic management at the primary care level. The National Tele Mental Health Programme (Tele MANAS), launched in 2022, functions as a digital extension providing 24×7 tele-counselling (Ministry of Health and Family Welfare).
Funding is channelled mainly through the NHM Flexible Pool as a Centrally Sponsored Scheme, with typical centre–state sharing ratios. Earlier support under DMHP was enhanced to approximately ₹83 lakh per district per year. Tertiary components include grants for Centres of Excellence and postgraduate departments (Press Information Bureau, 2016; Ministry of Health and Family Welfare).
Progress includes expansion of DMHP to 767 districts, sanction of 25 Centres of Excellence, strengthening of postgraduate training capacity, and Tele MANAS handling millions of calls across multiple languages and states (Ministry of Health and Family Welfare; Press Information Bureau).
Government data indicate continued infrastructure and human resource development. Secondary evaluations, however, highlight persistent concerns such as uneven fund utilisation by states, shortages of specialised personnel at peripheral levels, variable quality of community services, and challenges in translating policy intent into consistent last mile delivery, underscoring the need for stronger monitoring, capacity building, and state level absorption (based on parliamentary data reported by the Ministry of Health and Family Welfare).
Performance
Over the last 5 years, the National Mental Health Policy, 2014, has shown measurable expansion in service coverage and digital outreach, though implementation gaps persist in fund utilisation and equitable delivery (Press Information Bureau; Ministry of Health and Family Welfare parliamentary replies).
Programme progress is reflected in the scaling of the District Mental Health Programme (DMHP) under the National Mental Health Programme (NMHP). Facilities include outpatient services, counselling, psychosocial interventions, drugs, outreach, and 10-bedded inpatient units at the district level. (Press Information Bureau, 2025; Ministry of Health and Family Welfare).
Tele MANAS, launched on 10 October 2022 as the digital arm of DMHP, represents a major performance milestone. As of early 2026, 36 States/UTs had established 53 Tele MANAS Cells offering 24×7 services in 20 languages, improving entry points especially for remote and underserved populations (Press Information Bureau, 2025–2026; Ministry of Health and Family Welfare). More than 34 lakh calls have been handled since inception, with significant referrals to in-person care, District Mental Health Programme units, specialists, and emergency services. A dedicated mobile application was launched in October 2024 (Press Information Bureau, 2025–2026).
Budgetary trends indicate rising allocations for mental health overall. Total Ministry allocations covering NMHP, DMHP, and key institutions rose from approximately ₹683 crore in 2020–21 to over ₹1,100 crore in recent years. For DMHP specifically, approved funds under NHM increased from ₹84.13 crore in 2020–21 to peaks near ₹157.62 crore in 2024–25, with expenditure rising but remaining substantially below approvals (approximately 40–55 per cent utilisation in most years).
State-wise data reveal marked variation: higher absorption in some states (e.g., Andhra Pradesh, Karnataka, Tamil Nadu in certain years) contrasted with persistently low utilisation in others (Parliamentary replies, Ministry of Health and Family Welfare, 2025).
Economic Survey references acknowledge the National Mental Health Policy, 2014, and the Mental Healthcare Act, 2017, as foundational frameworks, while noting broader mental-well-being challenges and government efforts to expand access (Economic Survey, recent years). Parliamentary data and Ministry updates confirm expanded geographic reach and digital volume, yet highlight incomplete fund absorption and uneven state-level performance as continuing constraints on realising policy objectives of universal and equitable care.
Impact
The National Mental Health Policy, 2014, aimed to provide universal access to mental health care, reduce distress, disability and premature mortality, enhance understanding and human resources, increase access for vulnerable groups, reduce suicide risk, and uphold rights while reducing stigma (Press Information Bureau, 2016). Evaluation against these objectives, drawing on official reports and parliamentary assessments, indicates partial progress with significant unfinished agenda.
On access and coverage, expansion of the District Mental Health Programme to 767 districts and integration of mental health services into over 1.75 lakh Ayushman Arogya Mandirs have broadened geographic reach and also has extended basic screening and care at the primary level (Press Information Bureau, 2025; Ministry of Health and Family Welfare).
Human resource objectives have advanced through 25 Centres of Excellence, 47 postgraduate departments in mental health specialties have been supported, increasing postgraduate seats and training output (Ministry of Health and Family Welfare) and also increases in undergraduate and postgraduate medical seats since 2014 (Ministry of Health and Family Welfare parliamentary replies).
However, the National Mental Health Survey 2015–16, conducted by the Government through NIMHANS, reported a prevalence of about 10.6 per cent for mental disorders in adults and treatment gaps ranging from 70 to 92 per cent across disorders (Lok Sabha, 2024). A Parliamentary Committee examining implementation noted that, nearly a decade after launch, strategic objectives of the policy had yet to be fully translated into action, with limited state-level uptake and incomplete realisation of governance, prevention, and community participation goals (Rajya Sabha Committee Report, 2023). Suicide reduction and stigma elimination remain areas where measurable national impact is less clearly established in official data.
Overall, while the policy has catalysed institutional expansion, digital outreach, and rights-based legislation (Mental Healthcare Act, 2017), high residual treatment gaps and uneven implementation indicate that core objectives of universal, equitable, and rights-protected care have been only partially achieved. Continued strengthening of primary level services, fund absorption, and intersectoral action is required to close the remaining gaps (Ministry of Health and Family Welfare; Parliamentary Committee assessments).
Emerging Issues
- Financing and Fund Utilisation
Approved allocations for the District Mental Health Programme under the National Health Mission have increased in recent years, yet actual expenditure by States/UTs has consistently remained substantially lower, often around half of approved amounts across 2020–25 (Ministry of Health and Family Welfare parliamentary replies). This underutilisation limits the scale and quality of community-level services and indicates weak absorption capacity at the state and district levels.
- Human Resource Shortages and Distribution
Despite expansion of medical seats and Centres of Excellence, availability of psychiatrists and other mental health professionals remains highly uneven. National Mental Health Survey data and subsequent parliamentary responses show densities as low as 0.05 per lakh population in some states, far below recommended norms, constraining last-mile delivery especially in rural and underserved areas (Ministry of Health and Family Welfare; National Mental Health Survey references in official replies).
- Implementation and Institutional Coordination
A Parliamentary Committee observed that, nearly a decade after the policy’s launch, its strategic objectives had not been fully translated into action, with limited state-level adoption and incomplete intersectoral coordination (Rajya Sabha Committee Report, 2023). Health being a state subject creates variation in priority-setting, monitoring, and integration of mental health into broader primary care systems.
- Persistent Treatment Gaps and Inclusion
Official data continue to highlight treatment gaps of 70–92 per cent for different mental disorders (Lok Sabha, 2024, citing National Mental Health Survey 2015–16). Vulnerable groups, including rural populations, the homeless, and those in custodial settings still face barriers related to awareness, stigma, and physical access, despite pro-poor policy intent and digital initiatives.
- Technology and Continuity of Care
Tele MANAS has expanded reach (over 34 lakh calls handled), yet conversion of tele-contacts into sustained, local, in-person follow-up through District Mental Health Programme units remains limited in volume relative to demand (Press Information Bureau, 2025–2026). Strengthening referral linkages, data systems, and accountability mechanisms for quality and outcomes is an emerging priority.
These issues underscore the need for stronger state-level ownership, improved fund absorption, workforce planning, and robust monitoring frameworks to fully realise the policy’s rights-based and universal-access objectives.
Way Forward
- Strengthening Primary and Community-Level Delivery
Full operationalisation of mental health services within Ayushman Arogya Mandirs and District Mental Health Programme units across all sanctioned districts should be prioritised. Expanding training of medical officers, nurses, and community health workers in detection, counselling, and referral will improve early intervention and reduce the treatment gap (Ministry of Health and Family Welfare).
- Enhancing Fund Absorption and State Ownership
States and Union Territories should improve utilisation of National Health Mission allocations for the District Mental Health Programme through timely planning, streamlined procurement, and regular review of Project Implementation Plans. Central technical support and performance-linked incentives can encourage better absorption while respecting the concurrent nature of health (Ministry of Health and Family Welfare parliamentary replies).
- Accelerating Human Resource Development
Continued expansion of postgraduate seats in psychiatry, clinical psychology, psychiatric social work, and psychiatric nursing through Centres of Excellence and medical colleges is essential. Short-term skill-building programmes for non-specialist cadres and deployment incentives for underserved areas will help address geographic imbalances (Press Information Bureau; Ministry of Health and Family Welfare).
- Deepening Digital Physical Integration
Tele MANAS should be further strengthened as a gateway by improving referral pathways to District Mental Health Programme teams, primary care facilities, and tertiary centres. Integration of the Tele MANAS mobile application with local service records and follow-up mechanisms will enhance continuity of care (Press Information Bureau, 2025–2026).
- Strengthening Monitoring, Accountability, and Intersectoral Action
Regular outcome-based monitoring using standardised indicators, periodic independent reviews, and stronger coordination among health, education, social justice, and women’s development departments will support rights-based implementation. Alignment with the National Health Policy and broader development goals of inclusive growth and human capital will maximise long term impact (Ministry of Health and Family Welfare; National Health Policy framework references).
References
Press Information Bureau. (2014, October 10). Country’s first ever Mental Health Policy unveiled. Ministry of Health and Family Welfare, Government of India.
https://pib.gov.in/newsite/PrintRelease.aspx?relid=110417
Press Information Bureau. (2016, March 11). Mental Health Policy. Ministry of Health and Family Welfare, Government of India.
https://pib.gov.in/newsite/PrintRelease.aspx?relid=137749
Ministry of Health and Family Welfare. (n.d.). National Mental Health Programme (NMHP).
https://dghs.mohfw.gov.in/national-mental-health-programme.php
Tele MANAS Official Portal & Dashboard. (n.d.). Ministry of Health and Family Welfare.
https://telemanas.mohfw.gov.in
https://telemanas.mohfw.gov.in/telemanas-dashboard
Rajya Sabha Committee. (2023). Report on mental health care and related matters (Committee on Health and Family Welfare).
National Institute of Mental Health and Neuro Sciences. (2016). National Mental Health Survey of India, 2015-16: Prevalence, patterns and outcomes (Commissioned by Ministry of Health and Family Welfare).
https://indianmhs.nimhans.ac.in
https://indianmhs.nimhans.ac.in/phase1/Docs/Report2.pdf
National Health Mission (NHM). (n.d.). Framework and related documents on integration of mental health services.
Government of India, Ministry of Finance. (2025). Economic Survey 2024-25 (Chapter 11: Education and Health).
https://www.indiabudget.gov.in/budget2025-26/economicsurvey/doc/eschapter/echap11.pdf
About the contributor
Arjya Shree Pande is a Research and Editorial Intern at IMPRI. She is currently pursuing a Masters in Sociology and Advanced Post Graduate Diplomas in Communication for Social Behaviour Change, technical support (UNICEF) and Global Politics. She is seeking analytical, policy, or programme oriented roles in international, governmental, or development settings where she wants her experience in research, behavioural insights, and governance expertise can be applied to evidence based decision making, public service delivery, and technology enabled social impact.
Acknowledgments
The author sincerely expresses gratitude to the reviewers ( Sneha Kohli & Mannat Abbot ), IMPRI India and the editorial team for their valuable comments, constructive suggestions, and continuous guidance throughout the preparation of this article.
Disclaimer
All views expressed in the article belong solely to the author and not necessarily to the organisation.
Read more at IMPRI:
