India’s mental health future needs patient capital and collective action

India faces one of the most significant mental health challenges in the world today. We carry nearly one-third of the global burden of depression, suicides and addiction, yet access to care remains deeply uneven. An estimated 95% of people in India who require mental health support do not receive it, with the gap particularly severe among marginalised communities.

The consequences extend far beyond individual suffering. Mental health conditions are estimated to cost India over $1 trillion between 2012 and 2030 through lost productivity, healthcare costs and reduced economic participation. Yet despite the scale of the problem, less than 1% of India’s health budget is allocated to mental health. These numbers illustrate not only a crisis but also a structural challenge: mental health has historically been treated as a purely medical issue rather than a broader development concern.

Mental health is deeply intertwined with the social realities people navigate every day. Education, nutrition, livelihoods, gender inequality, disability, caste hierarchies, climate stress, and social exclusion all shape mental well-being. Across the 17 Sustainable Development Goals, mental health has a complex, bidirectional relationship with nearly every dimension of development. Recognising these intersections is essential. Addressing mental health effectively requires moving beyond isolated programmes and toward a systemic approach that acknowledges the social, economic, and cultural contexts in which people live.

Moving beyond biomedical models

For decades, mental health systems around the world have largely been organised around clinical, expert-driven models focused on diagnosis and treatment. While these services are indispensable, they represent only one component of a much broader ecosystem of care. A purely biomedical approach cannot fully address challenges that are deeply social and structural. What is needed instead is a more holistic framework that integrates psychological, social and cultural dimensions of wellbeing.

This requires a cross-sectoral lens that recognises how mental health is shaped by multiple systems — education that builds emotional resilience, livelihoods that provide economic security, community structures that foster belonging, and social protection systems that reduce vulnerability. Policies and programmes that operate across these domains are far more likely to create environments where mental well-being can thrive.

This shift also calls for recognising a form of expertise that has long been overlooked in policy and programme design: the insights of individuals who have lived through mental health challenges themselves.

Those with lived experience often understand barriers to care, stigma and recovery pathways in ways that traditional systems cannot fully capture. Their voices can help shape services that are more responsive, humane and grounded in real-world needs.

Strengthening the ecosystem for mental health

Addressing a crisis of this scale requires more than expanding clinical services. In recent years, significant private capital has begun flowing into the mental health space through venture capital investors and entrepreneurs building digital platforms, therapy services and new care models. While this has expanded access to certain services, the broader ecosystem that supports mental well-being remains underdeveloped.

Sustainable progress depends on strengthening the networks that connect practitioners, educators, community leaders, civil society organisations and policymakers. Efforts in this direction increasingly focus on curating knowledge, creating spaces for dialogue and strengthening the capacity of individuals and organisations working across the mental health landscape.

Peer communities and learning networks are becoming particularly important in this regard. Such communities also help bridge the gap between academic research and frontline practice, ensuring that field insights inform broader policy and funding decisions. Equally critical is strengthening practitioners' and organisations' capacity to deliver care that is reflective, culturally resonant, and responsive to local contexts. Mental health services that work in one region may not translate easily to another. Effective systems must be grounded in the cultural, linguistic and social realities of the communities they serve.

Knowledge as infrastructure for change

Building a stronger mental health ecosystem also requires investing in knowledge infrastructure — platforms that make credible resources, research and tools accessible to practitioners, educators, policymakers and funders.

For knowledge to truly enable change, it must be open, accessible and inclusive. Resources should not remain locked behind academic paywalls, but be made openly available so that practitioners, educators, community leaders, and organisations across the country can benefit from them. Ensuring that knowledge is available in multiple Indian languages is equally critical to expanding its reach and relevance.

Knowledge-sharing systems play a crucial role in reducing fragmentation within the sector. By curating reliable, context-specific resources and making them widely available, they can support programme design, advocacy, research and community-led initiatives across the country.

The role of patient capital

Transforming mental health systems also requires a fundamental shift in how the sector is funded. Many philanthropic and institutional funding models operate on short-term cycles designed to deliver rapid, measurable outcomes through specific programmatic interventions.

Yet building resilient mental health ecosystems — whether through capacity development, research, community engagement or knowledge creation — requires long-term, flexible and unrestricted capital that allows institutions to build foundational infrastructure for the sector.

This is where patient capital becomes essential. Patient capital recognises that meaningful systems change unfolds gradually and collectively. It allows organisations and alliances to experiment, learn, and adapt while developing solutions that may take years to fully demonstrate their impact.

By investing in ecosystem-building initiatives rather than isolated projects, patient capital can support the development of collaborative platforms, learning networks and research ecosystems that strengthen the sector as a whole.

A collective path forward

The next phase of progress will depend on whether the country can move beyond fragmented interventions and toward a coordinated ecosystem approach. This means centring lived experience, strengthening cross-sector collaboration, investing in knowledge systems and recognising mental health as a fundamental pillar of human development. India’s mental health future will not be built by any single institution. It will emerge through collective action, sustained investment and a long-term commitment to building systems that place human wellbeing at their centre.

(Vasvi Bharat Ram is Founder Chairperson, India Mental Health Alliance)

(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.)