The National Mental Health Programme (NMHP) is India’s landmark public health initiative launched to make mental health accessible, affordable, and inclusive for everyone in the country. It was one of the first national mental health programs in a developing country (Wig & Murthy, 2015).

The programme was launched when the country had fewer than 1000 psychiatrists in alignment with a recommendation by the World Health Organization (WHO) to deliver mental health services to the people under the framework of the general health care system (Gupta & Sagar, 2018; Wig & Murthy, 2015).

Let’s explore the evolution, goals, and impact of this flagship initiative in India.

What is the National Mental Health Programme (NMHP)?

The National Mental Health Programme (NMHP) was launched by the Ministry of Health and Family Welfare in 1982 with an aim to integrate mental health care into general health services at primary level, de-stigmatize mental health issues and ensure the availability of treatment facilities across the country.

As run by the central government under the Ministry of Health and Family Welfare, the programme facilitates the extension of mental healthcare services beyond the specialized hospitals with the use of the existing public health structures such as the primary health center, district hospitals and so on. It works in the following ways:

1. Community / District reach via the District Mental Health Programme (DMHP)
2. Tertiary care through modernization of psychiatric hospitals and upgradation of the psychiatry departments at medical colleges.
3. Training, or Capacity-building through centers of excellence in mental health education.
4. Awareness campaigns to educate the public about mental health and related concerns.
5. The NMHP is also supplemented by newer initiatives (for example, the Tele-MANAS national helpline) to reach people in remote areas.

Vision, Objectives, and Key Goals of the Programme

NMHP aims to improve the mental health of all people in India and reduce the burden of mental illness through an accessible, community-based approach.

• It seeks to guarantee ‘minimum mental healthcare’ for all Indians in the foreseeable future.
• It focuses on underserved and vulnerable groups (rural, poor, displaced, etc.).
• It concentrates on integrating modern mental health knowledge into general healthcare and social services.

Ultimately, it seeks to make prevention, treatment, and promotion services available at the grassroots level, thereby narrowing India’s significant treatment gap for mental disorders.

National Mental Health Programme (NMHP)

Building on its aim, the NMHP has three stated objectives:

1. Accessibility: To ensure the availability and accessibility of minimum mental healthcare for all, especially to the most vulnerable and underprivileged communities in the country.
2. Integration: To integrate mental health care into the general healthcare system of the country, that is, making mental health services a part of routine primary care and public health programs.
3. Community Involvement: To promote community participation in mental health service development and foster self-help. This includes training local community workers, supporting self-help groups for patients and families, and raising public awareness to reduce stigma.

These objectives make mental health a broad societal goal, not just a medical one. By aiming for universal coverage with community-based services, the program explicitly targets India’s huge unmet need for care.

Goals Of National Mental Health Programme (NMHP)

Broadly, the goal of the programme is 'universal mental health coverage’, this would practically mean:

• Shrinking the proportion of untreated people with mental illness by providing basic services everywhere.
• Early detection of common disorders (depression, anxiety, substance use, etc.) through community outreach and screening.
• Ensuring people with chronic mental illness and their families receive long-term support (rehabilitation, vocational training, psychosocial therapy) so they can participate in society.
• Raising public awareness and shifting attitudes to recognize mental illness as a legitimate health issue thereby encouraging early help-seeking and reducing stigma.
• Strengthen the rights and protections of individuals with mental illness by affirming that access to mental health services is a fundamental right. In alignment with legislation like the Mental Healthcare Act, 2017, the program emphasizes humane, dignified treatment and safeguards against discrimination and neglect within the mental healthcare system.

When did the National Mental Health Programme start?

As noted by Math and Murthy (2015), the preparatory work for the programme began in 1980–81. During this time, a series of workshops were held, involving Indian psychiatrists, health officials, and WHO consultants (notably from the Bengaluru and Chandigarh centers) to shape the framework of the programme.

By 1982, a draft plan had been finalized and presented to the Central Council of Health and Family Welfare. The official launch of the NMHP was in August 1982. This marked a significant milestone, making India the first major developing country to implement a national-level mental health initiative.

At the time, the country had only about 1,000 psychiatrists, and the NMHP aimed to bridge this gap by integrating mental health into general healthcare services.

Since its inception, the NMHP has evolved through regular reviews and expansion, such as – the introduction of the District Mental Health Programme (DMHP) in 1996 and tertiary care and manpower development schemes between 2003 and 2009 – to better meet the mental health needs of the population.

Why National Mental Health Programme?

At the time of NMHP's launch in 1982, India was facing a growing mental health crisis.

• It was estimated that around 6–7% of the population had a diagnosis of a mental disorder.
• Nearly one in four families had a member experiencing mental health issues.

Thus, mental health issues were widespread. On the contrary, over 90% of those affected received no treatment.

This huge treatment gap was caused by multiple factors, such as low awareness, social stigma, and a severe shortage of mental health professionals (most of them were based in cities). The rising incidence of psychiatric conditions and the absence of a structured mental health system made it necessary to create a national program.

International developments also played a role. In 1979, the WHO Mental Health Advisory Group urged countries to develop national mental health programs. India had already piloted successful community-based projects in places like Sakalawara (Karnataka) and Raipur Rani (Haryana), where trained non-specialist health workers provided basic psychiatric care.

Supported by WHO guidance and input from Indian experts at institutions like NIMHANS and AIIMS, policymakers designed the NMHP to deliver mental healthcare through the existing public health system. In essence, the NMHP was introduced to address a public health crisis.

Related: Mental Health Programs: How India is Expanding Mental Health Support

Inception and Implementation of the National Mental Health Programme (NMHP)

The NMHP emerged from years of collaboration between Indian mental health experts and the World Health Organization. Following a series of workshops and national consultations, the programme was formally approved by the Central Council of Health and Family Welfare in 1982. Implementation began the following year under the Directorate General of Health Services.

• The NMHP was rolled out in phases, beginning with model projects and later expanded to districts through the District Mental Health Programme (DMHP) in 1996.
• The launch of the District Mental Health Programme (DMHP) in 1996 was a major milestone. DMHP started in four districts based on Karnataka’s Bellary model. Over time, the DMHP expanded steadily reaching over 220 districts by 2012 and nearly 770 by 2025, though not all are fully operational.
• From 2003 onwards, the NMHP also focused on upgrading hospitals and training professionals (Tertiary Care Component). Many state mental hospitals and medical colleges received support.
• From 2009, the Centers of Excellence scheme (or Manpower Development Scheme A) was introduced.
• The Mental Healthcare Act, 2017 further strengthened the NMHP’s legal and rights-based foundation.
• Most recently, the Union Budget of 2022 marked another leap in implementation: it announced the National Tele Mental Health Programme (Tele-MANAS) as part of NMHP. Over 50 state Tele MANAS cells have now been established, making 24/7 tele-counseling available nationwide. This shows how NMHP implementation continues to adapt to modern needs and technology.

Today, the NMHP includes a wide network of district services, improved hospitals, and digital platforms. Backed by policies like the Mental Healthcare Act (2017), it continues to grow with support from central and state health departments and institutions like NIMHANS.

Barriers to implementation of the National Mental Health Program (NMHP)

Despite its strong vision, NMHP has faced many barriers over the years. These include:

• Limited Funding: NMHP’s budget has been relatively small compared to the need. Even when funds are allocated, there have often been delays or underutilization at state levels. This financial weakness constrains the hiring of staff, establishment of new units, and consistent drug supply.
• Shortage of Professionals: India has very few mental health professionals (psychiatrists, psychologists, psychiatric social workers and psychiatric nurses) per capita. Many districts cannot form full DMHP teams, and general health workers often lack proper training or motivation.
• Drug Supply Issues: Many districts struggle to maintain a steady supply of essential psychiatric medications, especially in rural clinics, making treatment irregular.
• Stigma & Low Awareness: Stigma and lack of knowledge about mental illness reduce help-seeking and public demand for services. This also makes mental health a low priority in communities and among policymakers.
• Bureaucratic Hurdles: Poor coordination between departments, slow approvals, and frequent staff transfers disrupt planning and progress.
• Infrastructure Gaps: In remote areas, basic healthcare infrastructure may be missing, making it hard to deliver any kind of mental health service.
• Uneven Implementation Across States: Some states have made strong progress, while others lag due to weaker leadership, limited resources, or poor planning. This results in unequal access to mental health services across the country.

These challenges have slowed down NMHP’s progress. Experts say the problem isn’t with the plan itself, but with weak implementation. Strengthening budgets, training, supervision, and local involvement is key to making the NMHP work better.

Implementation Strategies of the NMHP

The NMHP has endorsed community-based and decentralized approaches to ensure mental health services are accessible and integrated within local settings. The programme employs the following implementation strategies:

Integrating Mental Health Services into the existing Healthcare system in the country:

A core strategy is integration of mental health into primary care. Rather than isolating psychiatric services, NMHP works to make mental health screening and basic management part of routine care at primary health centers (PHCs) and community health centers (CHCs). Simple counselling can be provided locally, while severe cases are referred up the chain (to district or tertiary centers) for specialist care. This integration normalizes mental healthcare and improves case detection.

Equitable resource distribution:

NMHP strives for balanced allocation of funds and personnel across states and regions, to avoid concentrating only on the big cities. To ensure equity, the DMHP has been rolled out in poorer and rural districts.

Making mental health services accessible to everyone:

• To make mental health services accessible to everyone in the country, even at the grass root level, the NMHP programme launched the District Mental Health Programme (DMHP) in 1996. Under the DMHP, each participating district gets a specialist team (psychiatrist, psychologist, social worker, psychiatric nurse) who provide regular outpatient clinics at the district hospital, train general health staff, and conduct outreach clinics at smaller health centers.
• Another strategy for better accessibility is decentralization of mental health care. To decentralize mental health care, the NMHP promotes the diffusion of mental health skills to the periphery through task shifting and role assignment. Task shifting is done by training non-specialist health workers in basic mental health care. This extends support to remote areas. Tasks in mental healthcare (screening, counseling, medication management, rehabilitation) are allocated to appropriate providers at each level, from ASHA workers to district psychiatrists. This ensures that the system operates efficiently.
• A recent step toward improving access to mental health care is the launch of Tele-MANAS in 2022 under NMHP. This 24/7 toll-free helpline offers tele-counseling, video consultations, and referrals from trained professionals. Tele-MANAS is intended to dramatically expand access – especially for people in remote or underserved areas – by leveraging technology and internet-linked clinics (e.g. through e-Sanjeevani). Furthermore, the launch of the Tele-MANAS mobile app on October 10, 2024, expands reach via smartphones.

Building Human Resources:

As new avenues are developed to access mental health services, there is a parallel need to expand the workforce to meet growing demands. The NMHP addresses this through a dedicated human resource development strategy. This involves training more psychiatrists and psychologists and integrating psychiatry into medical and nursing curricula.

• Under Scheme A, the programme has established Centers of Excellence in leading institutions, offering substantial grants to enhance infrastructure and faculty for advanced training in mental health.
• The programme emphasizes on-the-job training by equipping general health workers and community-level volunteers (such as ASHA and Anganwadi workers) with the skills to identify, manage, and refer individuals in need of mental health support.

Public Awareness and IEC (Information, Education & Communication) Campaigns

NMHP integrates mental health with community programs like education and social welfare, building local ecosystems of support through schools, NGOs, and self-help groups. To increase public involvement, it runs awareness campaigns at national and district levels.

Through DMHP, funds are allocated to support local outreach (radio, posters, plays, events) while national campaigns use TV, regional radio, and digital platforms to reduce stigma and promote mental well-being.

These efforts aim to normalize conversations around mental health, encourage early help-seeking, and equip frontline workers to identify signs of distress and guide individuals to appropriate care.

Overall, NMHP’s strategy is to decentralize care, mobilize communities, train personnel (so non-specialists can help), and modernize systems (through upgraded hospitals and telehealth).

Components of National Mental Health Programme (NMHP)

The NMHP is a structured programme, with the following components:

District Mental Health Program (DMHP):

DMHP is the heart of the program at the local level. It includes – outpatient clinics, mobile/satellite clinics in rural areas, staff training, and data monitoring. The DMHP ensures that mental health services are accessible to every individual in the country at the community level. Today, DMHP teams operate in hundreds of districts, linked to every district hospital.

Tertiary Care Component:

In 2003, the NMHP was re-strategized to include the ‘Tertiary Care Component’. The Tertiary Care Component of NMHP focuses on specialized institutions and training. This includes funding for upgrading mental health institutes and general hospitals. Key centers like NIMHANS and LGBRIMH receive support to build infrastructure and offer specialized services and training.

This component includes two schemes:

1. Modernization of State Mental Health Hospitals:

   Under this scheme, older mental hospitals receive grants to improve facilities, add beds, and bring services up to modern standards.

2. Upgradation of the existing Psychiatric Wings of Medical Colleges and General Hospitals

   Under this scheme, psychiatric departments in medical colleges or general hospitals received infrastructure upgrades so they could provide better inpatient/outpatient care.

These schemes aim to strengthen the highest levels of mental health care while also supporting education and training. Under these initiatives, hospital wards are refurbished, new equipment is provided, and additional staff are recruited, thus enhancing the quality of inpatient care and enabling more effective training of future mental health specialists.

Manpower Development (Scheme A & B):

Beyond infrastructure, the NMHP also invests in building the capacity of mental health professionals as a key component of its strategy through the 'Manpower Development Schemes’ which became a part of the programme in 2009. There are two schemes, which are:

1. Scheme A:

   This scheme funds the ‘Centers of Excellence (CoE)’ in Mental Health. Initially 10 institutes were chosen to be CoEs, each receiving large grants (up to ₹337 crore) to expand departments of psychiatry, clinical psychology, social work and psychiatric nursing. Presently, a total of 25 institutes has been funded under this scheme.

2. Scheme B:

   Scheme B provides smaller grants to upgrade the psychiatry departments of general medical colleges. These schemes aim to increase the supply of trained mental health professionals nationwide. Under this scheme, 19 colleges have been upgraded so far.

Tele-Mental Health:

In 2022, the Tele-MANAS initiative was launched, which is formally part of the NMHP. It extends the program’s reach digitally, ensuring tele-counseling and tele-psychiatry are available in every state. Tele-MANAS is a key new component to make the NMHP more accessible and responsive.

Public Education and Community Programs:

Although not a separate scheme line item, public awareness campaigns and NGO partnerships act as components supporting NMHP goals. For example, campaigns by the Live Love Laugh Foundation or The Banyan’s NALAM project work in tandem with NMHP efforts to reduce stigma and provide community support.

The healthcare system under the NMHP is interconnected, that is, each of these components works together, such as:

• district teams link to upgraded hospitals,
• tele-counselors refer to local clinics, and
• centers of excellence supply trained staff back into the system.

Strengths Of National Mental Health Programme (NMHP)

The National Mental Health Programme (NMHP) has evolved into one of the most comprehensive mental health programs in the world. As noted by Math and colleagues (2021), the strengths of NMHP lie in both its design and long-standing implementation across India:

• One of the oldest mental health programmes globally – Launched in 1982, it has decades of continuity and experience behind it.
• Widespread coverage – The District Mental Health Programme (DMHP), the operational arm of NMHP, currently covers over 700 districts across India.
• Dedicated district infrastructure – Each DMHP district has a specific mental health team, budget, and reporting system, ensuring consistent service delivery and accountability at the grassroots level.
• Comprehensive scope – Unlike disease-specific programs, the NMHP covers a wide range of mental disorders, from common issues like depression to severe conditions like schizophrenia, leaving no group excluded.
• Integration with primary care – Mental health services are embedded into general health systems, such as PHCs and CHCs, helping normalize mental health care and improve accessibility.
• Multi-pronged strategy – NMHP addresses mental health through multiple channels: outpatient services, school programs, awareness campaigns, de-addiction camps, and disaster response interventions.
• Community participation – The program actively involves ASHA workers, Anganwadi workers, teachers, and NGOs, expanding reach and building trust.
• Strong government support – Continuous funding and policy updates since 1982 show political will. Recent initiatives like Tele-MANAS and Centers of Excellence indicate renewed commitment.
• Legal backing – The Mental Healthcare Act, 2017 guarantees the right to mental healthcare, adding legal strength to the NMHP’s goals.
• Institutional support – Bodies like NIMHANS and State Mental Health Authorities provide ongoing training, monitoring, and guidance to ensure quality implementation.

In summary, the NMHP’s strengths lie in its broad scope, strong infrastructure, deep community involvement, and lasting government commitment. Together, these features position it as a key pillar in India’s efforts to build a robust, inclusive, and sustainable mental healthcare system.

Limitation of National Mental Health Programme (NMHP)

The NMHP has certain structural and design-related limitations that affect its effectiveness:

• Focus being too Broad: The NMHP covers all mental disorders, unlike disease-specific programs. This makes planning and standardization harder, since mental illnesses vary widely and often need long-term, personalized care.
• High Resource Needs: Effective mental health care needs trained staff, follow-up, and support services. These require ongoing investment, which is often underestimated or underfunded.
• Diagnosis and Stigma: Mental health diagnoses can be complex and change over time. Stigma also pushes people to hide problems or drop out of treatment, limiting the program’s reach.
• Fragmented Governance: NMHP is a central program, but states implement it. Without strong coordination or state-level funding, mental health often stays on the margins of health planning.
• Weak Monitoring: NMHP lacks strong data systems to track outcomes, unlike some other health programs. This makes it harder to measure impact or secure long-term political support.

In short, NMHP’s wide scope is both strength and challenge. Experts suggest dividing it into focused sub-programs for better results. Still, it remains a vital national framework for mental health care.

Need for the National Mental Health Programme

Even decades after its launch, the National Mental Health Programme (NMHP) remains a vital part of India’s healthcare system. Mental health conditions are rising across all age groups, with depression, anxiety, substance use disorders, and suicide becoming increasingly common. The COVID-19 pandemic further exposed the scale of India’s mental health crisis and highlighted how unprepared existing systems still are to meet these challenges.

• National Mental Health Survey shows that nearly 15% of adults in India experience mental health issues that require professional care, yet 70–92% of them receive no treatment.
• The World Health Organization’s factsheets reveal that nearly 720,000 people die by suicide each year, with the highest burden (73%) occurring in low- and middle-income countries. In 2021, suicide was the third leading cause of death among 15–29-year-olds globally, affecting individuals, families, and communities across all regions.
• Mental illnesses like depression and anxiety are also among the top contributors to India’s overall disease burden (Sagar et al., 2019; Public Health Foundation of India, 2019).

These figures reflect not only the personal suffering caused by untreated mental illness but also broader social and economic costs. Several factors contribute to the gap in care, such as:

• Stigma and low awareness prevent people from recognizing symptoms or seeking support;
• Financial and geographical barriers make access difficult;
• Shortage of trained mental health professionals, especially in rural and remote areas (Bawaskar et al., 2024).

In this context, the NMHP offers a practical and scalable solution. It provides a structured, nationwide framework to bring mental healthcare closer to people. It promotes early detection, long-term care, and public awareness while supporting patient rights and linking services with broader development efforts.

Summary Table

Conclusion

The National Mental Health Programme (NMHP) has been a landmark in India’s public health journey, embedding mental health into the general healthcare system. Over 40 years, it has built district services, upgraded hospitals, supported training, and influenced key policies like the Mental Healthcare Act, 2017.

Initiatives like Tele-MANAS show how the program continues to evolve. Yet, challenges such as limited funding, workforce shortages, and persistent stigma remain. As NMHP enters its fifth decade, the focus must now shift to ensuring care is not only available, but also accessible, rights-based, and of good quality. With continued political will, innovation, and integration into wider systems, NMHP can help close India’s mental health treatment gap and bring care to all.