A 25-year-old woman from Hyderabad, an MBBS graduate preparing for an exam, had been struggling with depression and suicidal thoughts for over two years. This was worsened by personal setbacks and a strained relationship with her mother. Although she had tried medications and online therapy, she had discontinued both, finding little benefit. 

She then reached out to Tele-MANAS, the government’s round-the-clock mental health helpline. Here, on a call, she was able to open up to a psychiatrist, who provided a patient ear and coping strategies such as journaling, exercise, meditation, and better sleep practices. She was counselled to communicate with her father and to gradually rebuild her relationship with her mother.

Follow-up calls revealed a marked improvement. She reported feeling significantly better. The helpline also remains open for her to reconnect in future.

Mental health helplines have been an important resource to help those in distress in the country. Multiple helplines operate across States, some run by State governments and others by NGOs, in addition to the Tele-MANAS helpline, which was launched by the Central government in 2022. But while they provide critical and timely help to thousands, this World Suicide Prevention Day, experts say there are some gaps that need plugging and that helplines must be part of a broader, systemic approach to tackling mental health issues and suicide in particular, in order to provide better care for all. 

Gaps in the system

One critical gap is a shortage of trained mental health professionals. Estimates indicate that India has 0.75 psychiatrists per 1,00,000 population, dismally lower than the World Health Organization’s recommended 3. There is also a shortage of clinical psychologists and psychiatric nurses. In Kerala for instance, this shortage is a huge problem in the mental health sector, says P.S. Indu, professor of psychiatry, Government Medical College, Kasaragod. “At present, we are training persons with MSW (masters of social work) or MA psychology degrees to help people with mental health troubles. What we actually need are more clinical psychologists who can be trained to offer therapy, help people manage their thoughts better and improve their general sense of well being,” Dr. Indu says.

Another issue is inadequate resources. V. K. Gupta, founder-director, Silverstreak Multispeciality Hospital, Gurgaon, says that while a compassionate voice and emotional support at the right time can make the difference between life and death, helplines alone cannot be the solution to India’s growing suicide crisis. While helplines provide essential immediate care, they must be part of a wider, systemic approach, he points out. 

Most helplines today struggle with inadequate resources, limited operating hours, and insufficiently trained counsellors, he says, adding: “Mental health does not follow office hours; support systems must reflect that reality.” 

Devdeep Roy Chowdhury, senior clinical psychologist at Monoshij, a platform for mental health services based in Kolkata says that a lack of resources and experts who can volunteer for this work, offering free help, is the problem. “There is a window of crisis when people make the call. At that point, if the helpline does not work, it can feel like the whole society is failing you,” he says. 

What States have tried

Broader, community efforts have been trialled in some States, often linking existing or new services to the Tele MANAS helpline, to stem suicide numbers. 

In Karnataka for instance, where the suicide rate stands at 20.2 per lakh population as of 2022, significantly higher than the national average of 12.4, several initiatives have been tried. 

Anish V. Cherian, additional professor of psychiatric social work at NIMHANS, who is spearheading N-SPRITE, the NIMHANS Suicide Prevention, Research, Implementation, Training, and Engagement Centre, says one such was the SURAKSHA project, a comprehensive community-based suicide prevention model in Ramanagara district. Another project with NIMHANS in collaboration with the Health Department managed to counsel and save the lives of over 15,623 persons who reported repeated suicide attempts or self-harm in 19 government hospitals across 11 districts.

Kerala too, has community-level interventions. Jeevanraksha, a district-level service has community gatekeepers stepping in to prevent suicides. Trained people are given periodic refresher training to recognise warning signs of suicide, give psychological first aid and refer people to mental health  professionals. Kerala also has two other community-level mental health programmes, one of which specifically tackles post-partum depression. 

In Tamil Nadu, TeleMANAS also collaborates with the helplines of the School Education and Social Welfare Departments. “We have been reaching out to students who were unsuccessful in the Class X and XII board examinations, and those who appeared for NEET. We counsel and follow up with students for at least a month.” says V. Venkatesh Mathan Kumar, psychiatrist.

The road ahead

While Vishal Akula, National Direct Council Member of the Indian Psychiatric Society, notes that awareness is growing and many more people are now approaching psychiatrists for timely help, reflecting a positive change in society, more needs to be done.

Suicides are not a one dimensional affair, points out P.S. Kiran, Kerala’s State Nodal Officer for Mental Health. They are multifactorial, and solutions must reflect this. “We must acknowledge that suicide is not only a mental health issue but also deeply rooted in social determinants such as poverty, discrimination, gender inequity, and isolation,” says Dr. Gupta. Addressing systemic drivers of distress must be undertaken, he stresses, adding that suicide prevention must include building an ecosystem of empathy, inclusion, and timely care.

Increasing government funding for awareness and trained human resources, building strong school and college-level mental health programmes, addressing social determinants, and above all, combating stigma are some steps that need to be urgently undertaken, say experts.

The numbers paint a distressing picture:  with over 1.7 lakh lives lost to suicide in 2022 and 1.8 million calls to the Tele-MANAS helpline as of February 2025, it is clear that thousands of Indians are in need of mental health help. The time to act is now.

Those in distress can call the helplines listed here.

(With inputs from C. Maya in Thiruvananthapuram, Afshan Yasmeen in Bengaluru, Bindu Shajan Perappadan in Delhi, Serena Josephine M. in Chennai, Siddharth Kumar Singh in Hyderabad and Shrabana Chatterjee in Kolkata).