Bengaluru: When Dr Prabha S Chandra took over as director of the National Institute of Mental Health and Neurosciences (Nimhans) a few weeks ago, she stepped into a system grappling with a stark imbalance: a rapidly rising burden of mental health patients and an overstretched care infrastructure.
In a conversation with TOI, Dr Chandra spoke of the urgent need to bridge this gap—through a tiered, community-driven model of care. She also drew attention to the growing mental health issues among young people. Excerpts:
Is the availability of mental health resources keeping up with the help that people need?
Reliable, trained resources are still limited. Institutions like Nimhans cannot handle everything and are meant to deal with more difficult and complex cases. The number of psychiatrists is increasing with more medical colleges starting programmes, but the quality and training is still not adequate. There is limited clinical, hands-on exposure, and the quality varies widely across institutions.
What is being done by Nimhans to bridge this gap?
Some key steps are being taken. One is strengthening district mental health programmes. Another is transitioning to a more clinically focused master's programme (M Clin Psy) under the National Education Policy. Importantly, there is the Nimhans Digital Academy, where teachers, counsellors and community workers are trained through online methods. The idea is that not everyone needs intensive therapy—many problems of living, such as exam stress or relationship issues, can be managed with basic counselling, support and handholding. So, a tiered approach is being developed: community-level support for milder issues, trained professionals for moderate concerns, and specialised institutions for severe cases.
As a national referral centre, Nimhans is often overburdened. What steps are being taken to develop infrastructure?
A new neurotrauma centre is being planned in north Bengaluru, with government approval already in place. It will not be limited to neurotrauma but equipped to handle multiple injuries such as head, limb and abdominal trauma. Given the lack of dedicated trauma centres in India—apart from AIIMS Delhi—this facility is expected to significantly strengthen trauma care in Karnataka. At the same time, there are plans to increase ventilator capacity, with clear recognition that equipment alone is not enough. Each ventilator requires trained personnel, including critical care specialists and nurses, with roughly three nurses needed per patient. So, the focus is also on strengthening human resources.
What are the emerging mental health challenges, especially among young people?
Anxiety is a major concern, driven by safety issues, climate and geopolitical factors, and intense academic pressure. At the same time, play and sports—which help manage mental health—are reduced. With fewer buffers in society and limited opportunities for free play, children are not developing the skills needed to regulate their emotions. As a result, stress levels are high. This distress often manifests as anxiety, social avoidance and difficulty regulating emotions. Social media adds to the problem. At the same time, social circles are shrinking, and interactions are increasingly happening in closed spaces or through phones.
Given these challenges, what are the collaborative research projects Nimhans is undertaking with state and central governments?
There is extensive research underway in suicide prevention. For example, in Ramanagara, cases of suicide attempts are being tracked through a registry, with regular phone follow-ups to prevent repeat attempts—an approach that is already showing positive results. Cohort studies on pregnancy and early childhood have also shown that the home environment in the first three years significantly influences later emotional and physical development. Based on this, there is close collaboration with the Government of Karnataka to refine crèche policy and strengthen early childhood care systems. At the national level, efforts are ongoing with the Government of India to develop Nimhans 2.0. In parallel, research is exploring technologies, including robotics, brain tumours and post-stroke rehabilitation.
