India’s mental health crisis is a political crisis

By Zulekha Shakoor Rajani

"A psychology of liberation," Ignacio Martín-Baró wrote, "requires a prior liberation of psychology." Martín-Baró was a Spanish-born Jesuit priest and social psychologist who worked in El Salvador through its civil war, until Salvadoran soldiers killed him, five fellow Jesuits and two women at the Central American University in 1989. His question was not only how psychology could help people cope with suffering, but what it failed to see when it treated suffering as a purely individual problem, stripped of the history and power that shaped it. More than three decades later, that question feels urgent in India.

In May, India cancelled NEET-UG, the national entrance exam for medical colleges, over a reported paper leak. In the weeks that followed, several aspirants died by suicide. From late June, thousands of young people gathered at Jantar Mantar in New Delhi. What stayed with me was that they refused to treat those deaths as private grief. They mourned them publicly and demanded accountability for them. On July 25, Education Minister Dharmendra Pradhan resigned. Even then, in his resignation letter, he warned against "anti-national forces" exploiting the protests.

In naming those deaths, the students made an argument that India's mental health conversation usually avoids. These were not only private tragedies. They were the outcome of a system that failed the people who trusted it. India's Supreme Court reached a similar conclusion last year. In a July 2025 judgment concerning the death of a 17-year-old NEET aspirant in Visakhapatnam, the court said that patterns of student distress pointed to a "systemic failure" to address students' emotional and mental health needs, and affirmed mental health as part of the constitutional right to life.

I am a counselling psychologist and clinical director at a counselling and de-addiction centre in Bengaluru. Every year on October 10, India talks about mental health in the language of the individual: reach out, break the stigma, practise self-care. None of that is wrong. But much of the distress I meet in the counselling room does not begin inside the person alone. It is caused, deepened or sustained by the conditions they live in. We are asking people to heal inside the very circumstances that are making them unwell.

Start with work. According to the government's Periodic Labour Force Survey, unemployment among Indians aged 15 to 29 reached 15.9 percent between April and June this year, the highest since the survey was revamped in 2025.

Joblessness is not only lost income. It is the loss of a daily structure, a reason to leave the house and a sense of purpose. In the counselling room, it rarely arrives labelled as unemployment. It arrives as sleeplessness, irritability, conflict at home, fractured self-esteem, a crisis of meaning and the feeling of being a burden. Addiction can cost people their jobs, and the road runs both ways. But in de-addiction work, when I trace a drinking or drug problem back to where it began, I find again and again that the rejections came first: years of applications, interviews and silence. We treat the substance. The waiting that came before it is rarely named. Deaths recorded under the National Crime Records Bureau's drug overdose category rose by about half in a single year, to 978 in 2024. Of the more than 170,000 Indians who died by suicide that year, about 95 percent were recorded as having annual incomes below 500,000 rupees. Those figures do not prove that poverty caused each death, but they show plainly who is dying.

The pressure starts earlier. The number of student deaths by suicide reached 14,488 in 2024, the highest in a decade, according to the National Crime Records Bureau, up from 8,068 a decade earlier. Many families stretch their finances to send teenagers to coaching towns such as Kota, where they study far from home for a handful of seats. A single exam is expected to decide a young person's future. When that exam is compromised, what collapses is not only a timetable. It is the belief that effort is rewarded and that the rules are fair.

That belief matters clinically. People can endure enormous hardship if they believe it leads somewhere. What breaks them is discovering that the ground beneath them was never solid. No breathing exercise can, by itself, restore a seventeen-year-old's faith in a system that has just shown itself to be unreliable.

For women, the strain is heavier still. Last month, a 17-year-old girl was allegedly gang-raped in a park in south Delhi by men posing as police officers. Students across Delhi University marched in protest, and one placard captured their anger: "It's not a women's safety issue, it's a male violence issue." India registered 441,534 crimes against women in 2024, about 1,200 every day. The largest category was cruelty by a husband or his relatives. These are only the cases that reached a police station. Many women never report, because the person harming them is the person they depend on. The same year, 22,113 homemakers died by suicide, far more than students, and with far less public attention.

The mental health cost of this violence is not limited to those who are attacked. After the Delhi assault, one 17-year-old Miranda House student told reporters that her parents now call her several times a day and ask her to share her location whenever she leaves college. Every woman who plans her route home around which streets are lit, or stays in a harmful marriage because leaving would cost her children or her home, carries some of the same weight. Clinically, heightened vigilance can be a symptom of anxiety or trauma. But for many Indian women, a degree of vigilance is also a rational response to their surroundings, and treating it only as a symptom misses the point. A counsellor can help a woman manage her anxiety. A counsellor cannot make the street safe or the police responsive.

For many Muslims, and for some other religious minorities, there is another layer: the experience of being made to feel that their place in the country is conditional. In 2025, the Center for the Study of Organized Hate recorded 1,318 hate speech events, 98 percent of them targeting Muslims, alone or alongside Christians. In 276, speakers called for mosques, shrines or churches to be removed or destroyed.

Alongside the rhetoric there has been another practice: punitive demolitions. In November 2024, India's Supreme Court ruled that demolishing homes as punishment for alleged crimes is unconstitutional, saying the sight of a bulldozer razing a building without due process "reminds one of a lawless state of affairs, where might was right". Critics say the practice has been used mainly against Muslims, a charge the ruling Bharatiya Janata Party denies. Demolitions have continued since, and in July the court declined to hear contempt petitions directly, sending petitioners to the high courts instead. Mob violence has not stopped either. In January, a Muslim man working as a helper on a cattle van in Odisha's Balasore district died after the van overturned while being chased by alleged cow vigilantes, who then beat him. A purported video of the attack appeared to show him being forced to chant religious slogans.

Millions of citizens have also been required to produce documents to stay on the electoral rolls. During the revision of rolls in West Bengal, more than nine million names were removed. Anthropologist Adil Hossain, who holds a passport and family land records from the 1950s, was struck off weeks before the state election. "I felt a sense of alienation," he told Scroll. The Election Commission told the Supreme Court in December 2025 that claims of mass disenfranchisement were exaggerated. Dalit Indians know their own version of this exclusion. In 2024, police registered 4,262 rape cases involving Dalit women.

Psychologists use the term minority stress for the additional burden that comes with stigma, discrimination and marginalisation. For some people it shows up as persistent vigilance, disrupted sleep, withdrawal from public life and a shrinking sense of belonging. Individual resilience matters, but it cannot remove a threat that comes from the street and, at times, from the state.

Prolonged conflict deepens all of this. In Manipur, ethnic violence that began in May 2023 displaced about 60,000 people. In September, the chief minister told the state assembly that about 24,000 are still living in relief camps. Two weeks later, the Supreme Court ordered the state's chief secretary to explain, on affidavit, unnatural deaths in those camps, including 25 flagged by a court-appointed committee, and asked why bereaved families had received only 20,000 to 30,000 rupees in compensation.

Prolonged exposure to violence, displacement and the absence of safety raises the risk of trauma-related conditions, including complex post-traumatic stress disorder, or CPTSD. The World Health Organization's classification describes CPTSD as a condition that can develop after prolonged or repeated trauma from which escape is difficult or impossible, marked by difficulties with emotional regulation, self-worth and relationships. Exposure to trauma is not itself a diagnosis, and many people in the camps will not develop the disorder. But three years without a home or a date to leave creates exactly the conditions in which the risk grows. Trauma treatment begins with safety, and therapy struggles to take hold while the threat remains.

The government does acknowledge the crisis. This year's Economic Survey flagged mental health, including youth mental health and digital addiction, as a serious challenge. But the money has not followed. According to the Centre for Mental Health Law and Policy, direct mental health spending in the 2026–27 Union health budget is about 1,038 crore rupees, roughly 1 percent of the health ministry's budget, and about 88 percent of that goes to a single institution, NIMHANS in Bengaluru. Tele-MANAS, the national mental health helpline, was budgeted 51 crore rupees for 2026–27, against 80 crore the year before, and its 2025–26 allocation was revised down to 45 crore during the year. The last national mental health survey, conducted in 2015–16, found that 70 to 92 percent of people with a mental disorder received no treatment, depending on the disorder.

None of this makes therapy unnecessary. People need treatment even when the conditions around them are unjust, and it often helps. India urgently needs more of it. But treatment and prevention are not the same thing. When distress is framed only as an illness inside the individual, the solution becomes individual too: a helpline number, a wellness app, a campus counsellor. A student is offered a helpline while the exam that failed him goes unreformed. A woman is offered therapy while the police station that turned her away goes unquestioned. Care that stops at the individual can leave the systems producing that distress untouched.

A serious mental health strategy would recognise exam reform, decent and secure work, women's safety, the protection of minority rights, equal citizenship, a less corrupt and more accountable bureaucracy, and peace-building as part of the conditions that shape a nation's mental health. It would ask, before any major decision on examinations, demolitions or electoral rolls, what that decision will do to the minds of the people it affects. And it would fund counselling in relief camps, district hospitals and colleges, not only in one flagship institute.

In 1967, Martin Luther King Jr addressed the American Psychological Association and challenged the profession on one of its favourite words: maladjusted. Psychologists were right to help people overcome destructive maladjustment, he said, but there were some things to which no person of good will should ever adjust. "We must never adjust ourselves to religious bigotry," he told them. For a psychologist in India today, that line reads less like history than instruction.

The theme for this year's World Mental Health Day is "Lived Experiences Heard: Real Voices, Real Change". India has heard many real voices this year: students at Jantar Mantar, young women marching in Delhi, families in Manipur's relief camps, citizens queuing to prove they still exist on a voter list.

They were not asking for a better helpline. They were asking for a fairer country.

As a clinician, I will keep sitting with people one at a time, because that work matters. But I no longer believe it is enough to help people cope with conditions that should never have been normal. If India wants a healthier population, it must stop asking its citizens to adjust to injustice, and start changing the conditions that make them unwell.

Zulekha Shakoor Rajani is a counselling psychologist and clinical director at Ummeed Counselling Centre in Bengaluru, where she heads the Department of Islamic Psychology.

The views expressed in this article are the author’s own and do not necessarily reflect the position of Nous.