What I want from Budget 2020: A Swachh Bharat-type campaign for mental health awareness, more psychiatrists

By Neeja Birla

As we eagerly await the 2020 Union Budget, anticipating sweeping, public-friendly reforms, we can sincerely hope that this time around the traditionally-neglected arena of ‘mental healthcare’ will get the attention it deserves.

The Mental Health Act (MHA) 2017 laid the groundwork for humanising mental healthcare, and regulating and monitoring care services. But studies indicate that a conservative cost of implementing MHA 2017 is pegged at Rs 94,000 crore.

If MHA 2017 is to be actually and successfully implemented, the Government must increase its spending on mental healthcare consciously and imperatively.

Most Western countries spend around 4 per cent of their budget on mental health while we spend only 0.4 per cent. We need to allocate far greater funding for a comprehensive mental healthcare infrastructure that includes research, framework and the development of a trained, mental health fraternity.

As of today, there are major lacunae in regards to both primary and secondary mental healthcare in India. As per the MHA 2017 directive, all government-run hospitals and community healthcare centres must provide basic and emergency mental healthcare services. However, the lack of resources and personnel has prevented this from becoming a reality.


We have 9,000 psychiatrists, 2,000 psychiatric nurses, 1000 clinical psychologists, 1,000 psychiatric social workers and 26,000 hospital beds. Whereas the immediate need is 30,000 psychiatrists, 37,000 psychiatric nurses, 38,000 clinical psychologists and 38,000 social workers. According to the members of the Indian Psychiatrists’ Society, at the current rate of implementation, it will take 150 years to fill this treatment gap.

We need more hospitals, beds, facilities and trained personnel for the timely diagnosis, treatment and prevention of mental illnesses. Modern mental healthcare hospitals with in-patient facilities and facilities that cater specifically to the needs of women are the need of the hour and need to be fast-tracked.

Also, the gap in the number of trained personnel cannot be filled until the educational system gears up to provide the knowledge and training for it. As of now, there is a limited curriculum of mental health or psychiatry stems in medical colleges – only 1.4 per cent lecture hours and a 2-week internship in a medical school.


Mental health studies need to be given more importance in colleges. Online courses can increase the reach substantially. This will help reduce the gap in the number of mental health professionals much, much faster.

When it comes to rural India, there are almost no mental healthcare facilities or trained personnel available to those who are in need. There are no emergency services or a first line of contact either. At the Mpower Foundation, we have seen people from outside Mumbai travel for 2 hours or more for a 45-minute therapy session.

Accredited Social Health Activists or ASHA workers have made a huge difference by acting as an interface between the community and the public health system. Besides developing primary healthcare infrastructure, training of people from the communities themselves in basic mental healthcare hygiene and prevention needs to become a concentrated effort, driven by the allotment of funds and resources. The active promotion of a programme like the Mental Health First Aid (MHFA) across India can train individuals to act as the first line of defence in a mental health crisis.

Allocating funds for the training of school teachers to be the first point of contact and defence in regards to mental health issues and emergencies can prove to be a game-changer as well. It will not only help with early intervention of mental health concerns amongst children, but also help sensitise teachers to students who may be in distress, and prepare them to engage effectively with them.

Last but not the least, funds should also be earmarked for a nation-wide awareness campaign that will help alleviate the stigma associated with mental illnesses. If we can have a Swachh Bharat Abhiyaan to promote cleanliness in India, why can’t we have a powerful campaign to promote mental health and well-being?

In conclusion, we are hopeful that the Union Budget will recognise the immediate need and allocate the requisite funds to bring about a mental health revolution in our country.

*The author is the Founder and Chairperson of Mpower.