Mental Health Experts Applaud New NIMHANS But Flag Critical Gap in National Programme
Mental health professionals across India have expressed mixed reactions to the recent Budget announcements concerning mental healthcare infrastructure. While appreciating the proposal to establish a second National Institute of Mental Health and Neurosciences (NIMHANS) in North India and upgrade facilities in Tezpur and Ranchi, experts have raised significant concerns about the absence of dedicated funding for the National Mental Health Programme (NMHP).
Infrastructure vs. Systemic Care: A Critical Disconnect
Clinical psychologist and mental health activist Ratnaboli Ray acknowledged that the expansion of advanced mental healthcare, training, and research capacity addresses long-standing shortages in specialist infrastructure. However, she issued a stark warning: "These new institutions risk becoming isolated centres of excellence, completely disconnected from the everyday mental health needs of the population, without a standalone allocation for the NMHP."
The NMHP and its district-level components are the primary vehicles for delivering community-based care, including outreach, continuity of treatment, medicine availability, follow-up support, and crisis intervention. "For the vast majority of Indians, mental healthcare does not begin at prestigious national institutes. It begins, if it begins at all, at local primary health centres, district hospitals, and community services," Ray emphasized.
The Need for a Balanced, Grassroots Approach
Echoing this sentiment, psychiatrist Aniruddha Deb stated that while a country as populous as India undoubtedly requires more institutions like NIMHANS, there is an equally urgent need for a robust, countrywide programme enabling grassroots intervention. "We must strike a fine balance between developing centres of excellence and establishing accessible district-level clinics for people suffering from mental health issues," he explained.
From an economic and employment perspective, the consequences of untreated mental health conditions are severe. They are a major driver of job loss, increased absenteeism, the informalization of work, and early exit from the labour force, disproportionately affecting young people, women, and gig economy workers.
Quantifying the Economic and Social Cost
Institute of Psychiatry assistant professor Prasanta Roy highlighted a critical oversight: the economic loss due to mental health issues is rarely quantified, leading society to ignore its profound implications. "If we study how many productive years are lost due to mental health in India, it would rank higher than most other ailments. For severe mental illness, the productivity loss is long-term. There is significant scope to prevent mental illness, but the current emphasis remains overwhelmingly on treatment post-illness," he pointed out.
Experts further noted that weak community mental healthcare infrastructure shifts an enormous burden onto families, particularly women. This increases unpaid care work and reduces female labour force participation, creating a ripple effect on household economies and gender equality.
The Governance and Accountability Dimension
There is also a crucial governance aspect to this funding disparity. Capital expenditure for new buildings is highly visible and finite, whereas programme expenditure is ongoing, less visible, and demands greater accountability. Ratnaboli Ray of the mental health rights organisation Anjali added, "Prioritising institutions over programmes effectively shifts responsibility to state governments and families, while limiting the central government's exposure to rights-based scrutiny under existing mental healthcare laws."
Budget Highlights: What's Included and What's Missing
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. Speculation suggests the Delhi-based Institute of Human Behaviour and Allied Sciences (IBHAS) may be rechristened as NIMHANS.
WHAT ISN'T THERE IN THE BUDGET
- No clarity on programme funding: There is no clearly stated, standalone allocation for the National Mental Health Programme (NMHP), the primary framework for delivering community and district-level mental healthcare nationwide.
- Without strengthened programme funding, new institutions risk becoming isolated, failing to integrate with the broader healthcare ecosystem needed for everyday mental health needs.
Reflecting on decades of experience, Ratnaboli Ray concluded, "I have learned 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 genuinely recognises mental health must fund not just visibility, but responsibility."
