Introduction
Though suicide has been decriminalized in India, the service delivery of mental healthcare has long been neglected. Also, the Mental Healthcare Act 2017[1] attempts to address the issue of mental health in its entirety, including treatment, and proactively identify, protect, and promote the rights of mentally ill people. But here arises an important question: Are the guidelines for the implementation of the Act, which are required for ensuring comprehensive mental healthcare facilities, being adhered to? As far as mental health is concerned, with approximate 18% share of the total global population, [2] it displays an excessive burden of mental illness, which is unprecedented. According to the report provided by the World Health Organization, the total mental health burden of this country displays 2,443 disability-adjusted life years for every 10,000 people, and its age-adjusted suicide rate displays an astonishing ratio of 21.1 for every 100,000 of its population. [3] This crisis indicates how this country’s own ‘coaching capital,’ namely Kota, displays one of the highest rates of suicides among its students. Is it ironical that the place where young minds flock with dreams of Doctors and Engineers gets turned into such an ‘important’ hotspot of psychologists’ and doctors’ visits? The blog delves the features of legislation pertaining to mental health and the implementation hurdles faced for effective implementation.
Why Mental Health Law Is Important: Understanding Mental Health Laws In India
The report by the Union Minister of Finance and Corporate Affairs, titled “Mental Health of Youth Will Drive the Future Economy: Economic Survey 2024-25,” throws light on the fact that lifestyle, work culture, and home environment are essential for one’s overall well-being. According to it, if India wants to achieve its economic goals, it is a fact that lifestyle, more specifically lifestyles during early teenage, need to be properly monitored and regulated because it has a major influence on one’s mental health and productivity. [4]
The Mental Health Act was introduced in 1987,[5] aiming for the integration of mental health care services with primary health care. However, this law was later repealed, with the Mental Healthcare Act 2017[6] being passed, focusing on the right to mental health care services, with suicide being decriminalized, moving away from a legal framework to a rights-based approach for people with mental ill-health.
Key Provisions Under The Act
Advance directive and nominated representative: the law allows the advance directive to be made in writing setting out how he should be treated in the event of mental suffering. The law permits revocation, amendment or cancellation of advanced directive. It determines the liability of, medical health professional in relation to advance directive.
Creation of Mental health authorities: The legislation requires the creation of Central and State mental health authorities to ensure compliance with the legal requirements and for protection of persons with mental illness.
Insurance Coverage: The law requires insurance companies to provide mental illness insurance coverage on an equality basis with general illness. Establishment of mental health review board: These quasi-judicial bodies review complaints, admissions, and advance directives to ensure the protection of patients’ rights.
Community-based care: The Act gives patients the right to be in the community and not to be isolated from the rest of the community. This is to promote the aspect of social inclusion in the sense that all persons with mental health problems should be valued and respected as part of the community where every individual Matters.
Equality and Freedom from Discrimination: Thus, this article treats a person with mental illness on par with any physically ill patient. The article forbids discrimination of any kind based on one’s gender, sex, sexual orientation, religion, culture, caste, ideological or social standing, or disability.
Right to confidentiality: This provides that all the information gathered from the process of mental health treatment, whether concerning mental health care or illnesses, will remain confidential. This avoids compromising the privacy of the person and the integrity of the mental health care services.
Right to legal aid: The act mandates providing free legal aid under the Legal Services Authorities Act, 1987 (39 of 1987)[7] in case of any complaint about deficiency of services, violation of stipulated requirement under the act.
Decriminalised suicide: The Mental Healthcare Act 2017 [8]decriminalised suicide, which had earlier been treated as an offence under the law. The traditional or previous approach, that is based on the principle of deterrent because of criminalization, did not yield any realistic outcome. Decriminalization realizes the need to provide care and treatment to people who attempt to take their lives. The earlier approach, premised on deterrence through criminalisation, proved ineffective. Decriminalisation recognises that individuals who attempt suicide require care and rehabilitation, not punishment.
Psychiatrist-To-Patient Ratio
Where India has Failed to Meet the WHO Standard, the current psychiatrist-to-patient ratio in the country is 0.75 psychiatrists per 100,000 population, [9] which itself indicates a large gap in the existing mental healthcare apparatus. On the other hand, the World Health Organisation suggests at least 3 psychiatrists per 100,000 population. [10]
This sharp contrast gives a clear view that the internal shortcoming of the present regime is that the lack of trained mental health professionals themselves has been a major barrier to the proper execution of policies in relation to mental healthcare.
Inadequate Budgetary Allocation For Mental Healthcare And Review Boards
The budget allocation for the financial year 2025-26 allocated ₹ 99858.86 crore to the Ministry of Health and Family Welfare, [11] which accounts for 2% of the budget. and the total support to mental healthcare accounts for approximately 1% of the budget, which is much less than what the sector demands. [12] The budget constraints in the mental health sector are a significant hurdle that prevents major reforms in the sector from being implemented. The present infrastructure demands expenditure in trained mental healthcare professionals, trained nursing staff and infrastructure to support mental health services.
Where the Mental Health Act, 2017, [13] mandates setting up a mental health review board in each state, setting up this board faces significant institutional and financial gaps. According to statutory norms, Mental Health Review Boards are required to be established across all States. However, no consolidated public data is presently available regarding their operational status, composition, or effectiveness. The norms proposed that the board will have a strength of 6 members. The board’s big strength is a barrier to effective decision-making and implementation. The board faces barriers related to effective decision-making and financial constraints. The budget should outline a specific outlay for this sector for effective management of the body. The union budget with less than 1% allocation to the mental health sector should be increased, and a specific allocation should be made to address the problem.
Tele Mental Health Initiatives Within India’s Federal Health Framework
Public Health and sanitation are a state subject listed under Entry 6 of the state list. [14] The states have the authority to issue regulations in the area. The states lack uniformity in infrastructure and regulations that deter the implementation of national health programmes.
The union budget for FY 25-26 increased funding for the National Tele Mental Health Programme to improve health care coverage across India. [15]
According to the latest press release from the Ministry of Health and Family Welfare, 53 telehealth cells have been established in the 36 States and Union Territories to provide mental health services around the clock. [16] However, the limited coverage is evident, as having only 53 cells nationwide makes it difficult to serve the majority of the population.
Coverage Of Mental Illness: Requirement Under The Law And Compliance
Section 21(4) of the Mental Healthcare Act, 2017[17] requires every health insurance company to ensure coverage for mental illness under the same terms and conditions as physical illness. This requirement aims to create equality in medical care for both types of conditions.
To meet this legal obligation, the Insurance Regulatory and Development Authority of India (IRDAI) mandated in an official notification issued in 2020 that all health insurance companies provide coverage for mental health services in accordance with the Mental Healthcare Act of 2017. [18]
Currently, 59 insurance companies are registered with the IRDAI, including 26 life insurance companies and 33 non-life insurance companies. [19]
Despite these legal protections, the use of mental health insurance coverage remains extremely low. According to The Times of India, less than 1% of health insurance claims in India relate to mental health treatment. This figure is disproportionately low considering the prevalence of mental health disorders in the population. [20]
One major reason for this gap is the social stigma surrounding mental illness, especially major depression. This stigma discourages people from disclosing their mental health issues and seeking insurance coverage, effectively undermining their legal right to equal treatment in insurance.
Conclusion
Despite the good intentions behind the legislation, India’s mental health system suffers from poor implementation, inadequate funding, and ongoing social stigma. The Mental Healthcare Act, 2017 recognizes mental health as a right, but weaknesses in infrastructure, a lack of professionals, insufficient review boards, and low insurance usage contradict this goal. Budget cuts, differences between urban and rural services, and inconsistent state-level implementation weaken the Act’s effectiveness.
Author(s) Name: Ananya Gupta (Jamia Millia Islamia)
[1] Mental Healthcare Act 2017.
[2] Tarannum Ahmed, Neha Dumka, Erin Hannah, Vishal Chauhan and Atul Kotwal, ‘Understanding India’s Response to Mental Health Care: A Systematic Review of the Literature and Overview of the National Mental Health Programme’(2022) Journal of Global Health Neurology and Psychiatry e2022010 <https://joghnp.scholasticahq.com/article/36128-understanding-india-s-response-to-mental-health-care-a-systematic-review-of-the-literature-and-overview-of-the-national-mental-health-programme> accessed17 January 2026.
[3] World Health Organization, Mental Health – India (WHO Country Profile) <https://www.who.int/india/health-topics/mental-health?> accessed 17 January 2026.
[4] Press Information Bureau, Economic Survey 2024-25: Mental Health of Youth Will Drive Future Economy (Government of India, 31 January 2025) < https://www.pib.gov.in/newsite/economicsurvey2025.aspx> accessed 17 jan. 2026.
[5] Mental Health Act 1987.
[6] Mental Healthcare Act 2017 (1).
[7] Legal Services Authorities Act 1987.
[8] Mental Healthcare Act 2017 (1).
[9] Vijay Niranjan et al, Mapping of geographic inequality in mental health care facilities and psychiatrists’ distribution across seven districts of Indore division: A geospatial analysis from central India (2025)
[10] India’s Growing Mental Healthcare Costs (mental health analysis) <https://www.mhfaindia.com/indias-growing-mental-healthcare-costs > accessed 17 January 2026.
[11] Ministry of Health and Family Welfare, Union Budget 2025-26 Allocations: Health Sector (budget report) (FY 2025-26), ~2 % of total budget <https://outlive.in/node/171> accessed 17 January 2026.
[12] Government of India, Rajya Sabha Unstarred Question Reply on Mental Health Budget Allocations 2025-26 (Ministry of Health and Family Welfare response, 9 December 2025) <https://sansad.in/getFile/annex/269/AU1082_DKF0WV.pdf> accessed 17 January 2026.
[13] Mental Healthcare Act 2017 (1).
[14] Constitution of India 1950, Seventh Schedule, List II, Entry 6.
[15] Union Budget 2025-26: Allocation for National Tele Mental Health Programme (Tele-MANAS) increased to ₹79.60 crore <https://www.theweek.in/wire-updates/national/2025/02/01/del117-bud-health-allocation.html> accessed 17 January 2026.
[16] Press Information Bureau, Mental Wellness Health Interventions — Tele-MANAS Mental Health Support (Ministry of Health and Family Welfare press release, 20 December 2024) <https://www.mohfw.gov.in/press-info/8677 > accessed 17 January 2026.
[17] Mental Healthcare Act 2017, s 21(4).
[18] Insurance Regulatory and Development Authority of India, Disclosure on Mental Illness in Health Insurance Policies (IRDAI circular, Ref No IRDAI/HLT/REG/CIR/162/10/2020, 16 October 2020)
[19] Insurance Regulatory and Development Authority of India, Annual Report 2024–25
[20] Neil Ghai, ‘India’s mental health insurance gap: Less than 1% of health insurance claims pertain to mental wellbeing’ EconomicTimes (26 March 2025) <https://economictimes.indiatimes.com/industry/banking/finance/insure/indias-mental-health-insurance-gap-less-than-1-of-health-claims-pertain-to-mental-wellbeing/articleshow/119528230.cms> accessed 17 January 2026.