Are We Really Listening? India’s Changing Mental Health Landscape - Neerja Birla

Mental health advocate Neerja Birla, Founder and Chairperson of the Aditya Birla Education Trust, has been working to raise awareness, challenge stigma and improve access to mental health support in India. In this conversation, she discusses the country’s changing mental health landscape, the stigma that continues to surround help-seeking, the growing mental health concerns among young people, and why early intervention and accessible, compassionate care are essential to building a more supportive society.

1. World Mental Health Day is an opportunity to take stock of where we are. What, in your view, has genuinely changed in India’s mental-health landscape, and where are we still falling short?

India’s mental-health conversation has evolved considerably. There is greater awareness today, and more people are beginning to recognise that emotional well-being is just as important as physical health. Conversations that were once considered uncomfortable are now taking place more openly. This is an important shift because acknowledging that we need help is often the first step towards seeking it.

However, awareness alone is not enough. WHO’s World Mental Health Today report, published in 2025, estimates that over one billion people worldwide are living with a mental health condition, with most not receiving adequate care. This reminds us that the challenge extends beyond recognising mental health as a priority. We must ensure that people can access the right support when they need it.

In India, initiatives such as the National Tele Mental Health Programme are helping expand access to support. Tele-MANAS has handled approximately 34.34 lakh calls, with 53 cells operational across 36 States and Union Territories. This is an important step towards making mental-health support more accessible. However, reaching out must be followed by timely intervention, appropriate care and continued support.

I believe our priority now must be to bridge the gap between awareness and access. We need to make mental-health services more accessible, encourage early intervention and create environments where people feel comfortable speaking about their struggles without fear of judgement. This calls for a collective effort across families, schools, workplaces, communities and the healthcare system.

For me, progress will be meaningful when seeking mental-health support becomes as natural as seeking help for a physical health concern, and when every individual has the opportunity to receive the care they need with dignity and compassion.

2. Mental health conversations have become more visible, but has the stigma actually reduced, or have we simply become better at talking about it?

Mental health is increasingly discussed in public, but speaking open about personal struggles remains difficult for many of us. Fear of judgement, social expectations and the misconception that seeking help is a sign of weakness can prevent people from reaching out. Stigma, though reduced in some spaces, has certainly not disappeared. We are becoming more comfortable discussing mental health as a social issue, yet acknowledging our own struggles and seeking professional help can still feel difficult. There is a difference between talking about mental health and creating an environment in which people feel safe enough to ask for support.

Mpower’s 2026 survey, Unpack Your Emotional Baggage, found that 49.5% of young adults surveyed aged 18–25 across 10 Indian cities hide difficult emotions and try to cope alone, while only 9.2% reported seeking professional help. These findings point to a gap between awareness and help-seeking.

The scale of engagement with Tele-MANAS, which had received more than two million calls by April 2025, also demonstrates the importance of having accessible avenues for support. However, calls alone are not justifiable measurements of whether stigma has reduced or whether people have received sustained care. We need to look at whether individuals feel safe disclosing distress, can access professional support and are able to continue treatment without the fear of being judged.

The real test of acceptance is whether someone can say, “I am not okay,” and be met with empathy, understanding and practical support.

3. India has a particularly young population. What concerns you most about the mental health of young people today, and what do you believe needs to change urgently?

Young people today navigate multiple pressures, from academic expectations and career uncertainty to relationships, social comparison and the need to meet external expectations. These challenges can leave emotional distress unspoken or dismissed as a passing phase.

Mpower’s 2026 youth survey found that 67.3% of respondents had felt hopeless at some point, and for most of them, academic pressure and examinations were the commonly cited reasons. These findings relate to the survey respondents and should not be extrapolated to every young Indian, but they underline why we need to listen more carefully to young people’s experiences.

The most concerning number, however, is of young people who feel they must navigate emotional distress on their own. hey are growing up amid academic expectations, uncertainty about the future, social comparison, and relationship pressures, often with the feeling that they must always appear capable and successful. We must not mistake outward achievement or constant connectivity for emotional well-being.

India also needs stronger, more accessible systems for identifying distress early. Schools and colleges should have clear protocols for recognising warning signs, offering initial support and referring students to qualified professionals. Teachers should not be expected to become therapists, but they should be equipped to recognise when a student may be struggling and know where to seek help.

We must also equip young people with emotional literacy—the ability to recognise, articulate, and respond to their feelings. Asking for help should be seen as a sign of self-awareness and our responsibility is to ensure that when they speak up, there is a meaningful support system ready to respond.

4. Mental healthcare remains inaccessible to many Indians because of cost, geography, and a shortage of professionals. What would a truly equitable mental health system in India look like?

I believe a truly equitable mental-health system is one where no one is denied care because of their financial circumstances, where they live or the resources available to them. Mental health is an integral part of our overall well-being, and access to support should never be a privilege. It requires greater efforts for mental health to be treated as an essential part of healthcare, rather than a separate or secondary concern.

In India, this means strengthening public mental-health services, addressing the shortage of trained professionals and taking care closer to communities, particularly in areas where specialist support is limited. It also means building a system where primary healthcare facilities, helplines, digital platforms and clinical services work together, so that people have different ways to access care. Equally important is ensuring that treatment is affordable and that support continues beyond the first consultation.

At Mpower, our experience with the mental-health helpline has reinforced the importance of making professional support more accessible. In 2025–26, the helpline received 43,315 calls from 17,827 unique callers. Such services can help bridge gaps in access, but they must be part of a wider, well-supported mental-health system.

We must also recognise that equity is not simply about making services available. It is about ensuring that people feel able to seek help, are treated with dignity and can access care that responds to their needs, without stigma or financial barriers.

The true measure of an equitable system is whether someone living in a remote community has the same opportunity to receive appropriate support as someone in a major city, and whether a person’s economic status determines the care they receive. That is the standard we must work towards: mental healthcare that is accessible, compassionate and within reach of every Indian.

5. How important is early intervention? Are we still waiting for people to reach a crisis point before offering meaningful support?

Early intervention is one of the most important aspects of mental healthcare. Yet, we often find ourselves responding only when distress begins to interfere with a person's everyday life. We tend to recognise the need for help when someone reaches a point where coping becomes difficult, rather than paying attention to the early signs that something may not be right.

I believe we need to change the way we look at mental health support. Seeking help should not be seen as a last resort, nor should a person have to reach a crisis point for their concerns to be taken seriously. Sometimes, a timely conversation, a safe space to express oneself or access to professional support can make a meaningful difference.

At Mpower, we have seen how important it is to bridge the gap between recognising distress and actually seeking help. Through our public-private partnerships, individuals identified as at risk through screenings were referred to the District Mental Health Programme and encouraged to seek help. These remind us that identifying someone who may be struggling is only the beginning. We must also ensure that the support they need is accessible and that they feel encouraged to take that step.

Through our public-private partnerships, individuals identified as at risk through screenings were referred to the District Mental Health Programme and encouraged to seek help. These remind us that identifying someone who may be struggling is only the beginning.

This becomes particularly important when we consider children and young people. The adults around them, including parents, teachers and caregivers, play a crucial role in recognising changes in behaviour or emotional well-being. Equally vital is the role of peer support, as demonstrated through the Mpower COPE initiative in colleges. By equipping students with the awareness and skills to listen, recognize early signs of distress, and support one another, the initiative creates an approachable, stigma-free network on campuses. When we create environments where young people feel safe to speak about what they are experiencing, we give them the opportunity to seek support before their difficulties become more overwhelming.

Ultimately, early intervention is about creating a culture where mental health is treated with the same care and attention as physical health. It requires us to listen without judgement, recognise distress without stigma and make support available when it is needed, not only when it becomes unavoidable.

We should not have to wait for someone to reach a breaking point before we reach out. The real measure of progress is whether people feel supported enough to seek help early.

6. There is still a tendency to treat mental health as an individual problem—something a person must “fix” within themselves. How important is it to address the environments people live and work in?

Mental health is deeply personal, but it is not shaped by personal factors alone. Our emotional well-being is influenced by the environments we grow up in, the relationships we build and the spaces in which we learn and work. Whether we feel safe, supported and heard can have a significant bearing on how we experience and respond to life's challenges.

When we look at mental health only through the lens of individual resilience, we risk placing the entire responsibility on the person who is struggling. We encourage people to cope better or manage their stress, without always asking whether the circumstances around them also need to change. Resilience is important, but it cannot be a substitute for supportive environments.

This is particularly relevant in workplaces, where leadership behaviour, workload and organisational culture can influence an individual's well-being. Similarly, in schools, children need to feel safe expressing their emotions without fear of being judged or dismissed. In both settings, it is important to create environments where people feel comfortable speaking about their concerns and seeking help when they need it.

Addressing mental health, therefore, requires us to look beyond the individual and recognise the role that families, institutions and communities play. While individuals must be encouraged to seek support and care for their well-being, organisations and institutions must also take responsibility for creating environments that are sensitive to people's emotional needs.

We cannot ask people to become more resilient while overlooking the circumstances that may be contributing to their distress. Mental health must be a shared responsibility, one that calls not only for stronger individuals, but also for more understanding, supportive and inclusive environments.

7. If you could change one policy or institutional practice in India tomorrow to improve mental-health outcomes, what would it be?

If there is one institutional change that can make a meaningful difference to mental health outcomes in India, it is ensuring that emotional well-being becomes an integral part of our education system.

The Education Minister's review of the draft National Mental Health and Well-Being Policy for Schools is an important step in this direction. With its focus on creating supportive and inclusive school environments, the policy recognises that emotional well-being must be at the centre of a child's development, alongside academic learning.

The priority now is to translate this intent into meaningful action across schools. This means equipping teachers to recognise and respond to emotional concerns, ensuring access to trained counsellors, establishing clear referral mechanisms, and engaging parents and caregivers in the process. Schools must also have the necessary resources and guidance to implement these measures effectively.

A policy can provide the framework, but its impact will depend on how consistently it is put into practice. Mental health cannot remain a separate initiative or an additional responsibility for schools; it must be woven into the way children learn, grow and experience their formative years.

Every child deserves an education system that recognises their emotional well-being alongside their academic progress. The real measure of this policy will be its ability to translate intent into everyday practice, ensuring that children feel safe, understood and supported as they learn and grow.