The World Health Organization (WHO) defines mental health as a state of well-being that enables people to cope with the normal stresses of life, realise their capabilities, work productively, and contribute to their community.

In an inter-connected world, the following factors affect the mental well-being of a person:

• Migration: Migrants have to delink their physical and emotional ties, and deal with a situation of anonymity, loneliness, socio-cultural changes, racism, etc.,
• Economic factors: Low socio-economic status is associated with a high level of psychiatric morbidity. Also, materialistic success is being valued more leading to cut-throat competitions at academic and professional levels, which adds to mental stress.
• New patterns of relationships: The safety net of a joint family has weakened over time, adding to the stress of married couples and straining their relationship. The amount of interaction among family members has also decreased, and people are finding it tough to establish close inter- personal relationships outside their nuclear family.
• Rise in use of social media: More young adults and teenagers are getting addicted to the virtual world, and at the same time, the culture of comparison and affirmation by others is on rise, impacting sleep cycle, behaviour and mental health.

Though India launched a National Mental Health Program in 1982 itself, as per the National Mental Health Survey, 2016, close to 14% of India’s population requires active mental health interventions and about 2% suffers from severe mental disorders.

The various challenges in achieving sound mental healthcare include:

• Stigma: Because of the associated stigma, mental health patients do not seek any medical help. This has a deep and isolating psychological impact.
• Costly and long treatment: Sometimes treatment including counselling for mental health patients can take over a year. Also, these sessions are prohibitively costly, forcing patients to withdraw.
• Shortage of doctors: India has around 9,000 psychiatrists i.e. only 0.75 psychiatrists for one lakh people, while the requirement is three psychiatrists per lakh. Further, estimates from the WHO in 2017 show that India has only 0.15 psychologists per lakh.
• Inadequate training of doctors: There is a range of mental illnesses that need to be identified and treated, however, the training of doctors is currently not commensurate with the demand of the job.
• Resources at the Primary Health Centres (PHCS): The supply of medication at the PHCs are irregular and inadequate, given the wide range of mental health illnesses.
• Rehabilitation facilities: Rehabilitation facilities are either missing or inadequate in India, especially in rural areas.
• Lack of coordination: Given that mental health involves both medical treatment and social welfare, there is an overlap between the Ministries of Health and Social Justice, however, inter-sectoral coordination is missing.
• Underutilisation of funds: Less than 40% of funds allocated to states from 2015 to 2020 under the District Mental Health Programme were utilised.
• Regional disparity: Due to inadequate resources in rural and remote areas, many mental health professionals are reluctant to work in rural areas.

In this context, the government has taken several steps passing of the Mental Healthcare Act, 2017, implementation of the National Mental Health Programme, Tele-Mental Health Assistance and Nationally Actionable Plan through states. In addition, careful mapping and research is required to produce quality data and understand the size of the problem. Policies must recognize the diverse mental health needs of the population and move away from a one-size-fits-all approach. Also, mental health services should be planned keeping the socio-economic, cultural and structural determinants of mental health issues in mind.