“Integrate mental health into primary healthcare support to keep it in communities” : Neerja Birla

With over 450 suicides every day, how do you suggest that prevention can be built into the national health agenda?

As we work towards becoming a developed nation by 2047 – we must recognize that mental health is a central pillar of public health policy. A mentally healthy population leads to higher productivity, reduced social strife and stronger family systems and wellbeing. India has made important strides through the Mental Healthcare Act, the National Suicide Prevention Strategy, and TeleMANAS, but policies alone are not enough.

Real change comes when families, communities, and workplaces foster openness and connection, so individuals feel safe to seek help. If prevention, coupled with strong systemic and institutional support, is prioritized we can save lives and safeguard the future strength of our society.

On the helplines that Mpower runs – who calls in the most? Young people or the elderly?

Our helpline data makes it very clear that young people and those in their early working years are reaching out the most. Between August 2020 and July 2025, nearly 86 percent of all calls came from individuals between 18 and 40 years of age with 41 percent from the 18–25 group and 45 percent from the 26–40 group. In contrast, calls from the elderly, those over 55, accounted for only about 2 percent.

This tells us two important things: that India’s youth are both vulnerable and more willing to seek help; and that while our helplines are open to all, there is a need to encourage elderly populations to also engage more openly with mental health support.

Another interesting pattern is in the nature of concerns. Young callers often reach out for issues such as academic stress, relationship challenges, workplace pressures, and anxiety about the future. Older callers, though fewer in number, tend to highlight isolation, health worries or the burden of caregiving. Recognizing these distinctions allows us to design age-appropriate interventions and outreach strategies.

In short, our helpline data underscores that India’s youth are increasingly reaching out for mental health services, but at the same time, there is an urgent need to bring older generations into the conversation, so that mental health care truly spans across the life cycle.

What are the concerns being raised by the different age groups or socio – economic groups of people?

Our helpline data, combined with on-ground work, shows how distress manifests differently across groups, and why interventions must be contextual, inclusive and stigma-free.

The challenges of children and adolescents (5–18 years) are shaped by academic pressure, peer and relationship difficulties, and the family environment. Bullying, social media exposure, and body image concerns add to this. Globally, WHO estimates 1 in 7 adolescents experiences a mental disorder, a reality mirrored in India.

Young adults (18–25 years) express relationship challenges, academic stress, and identity struggles dominate. Relationship issues alone made up about 6 percent of all helpline calls over five years. Career and independence pressures intensify distress during this transition stage.

Early working years (26–40 years) speak of workplace pressures, financial instability, and balancing family responsibilities. On our helpline, stress accounted for 3 percent of calls and depression for 4 percent. Many in this group juggle multiple roles, often at personal cost.

Older adults (40+ years) express loneliness, isolation, and health worries dominate. Though fewer in number, their concerns highlight the urgent need for community-based support systems.

Women mental health is shaped by domestic violence, sexual harassment, economic insecurity, pre and post-natal experience and societal pressures. These often translate into anxiety, depression, and trauma, but stigma continues to silence many.

And socio-economic groups such as urban, middle-income callers highlight workplace stress and relationship issues, while lower-income communities speak of financial insecurity, job loss and poor access to healthcare. Wider forces like shifts in family structures, climate stress, slum development and social injustice cut across all demographics.

At Mpower, we see mental health literacy as the foundation for change. By running programs nationwide especially in rural belts and community level, we aim to destigmatize conversations and encourage help-seeking. To date, we have reached over 5 million people, driving 26 percent improvement in awareness and coping strategies and 31 percent increase in individuals seeking treatment.

This proves that when awareness meets access, transformation follows. But it also highlights the work ahead: building a culture where mental health is normalized and support is accessible for every individual regardless of age, gender, or background.

Does financial stability and jobs play a critical role in causes driving people to take their life? What has been the findings from your team?

Yes, financial stability and employment do play a role in mental wellbeing and when these are disrupted, they can increase the risk of anxiety and depression.

Our counsellors consistently hear from individuals particularly in the 26–40 age group, who feel overwhelmed by job stress, financial insecurity, and the burden of providing for their families. In fact, this cohort reports relationship concerns, anxiety, and depression most often, and financial uncertainty is a recurring trigger.

The nature of distress, however, varies by age. Young people below 25 are more likely to struggle with academic pressures, relationship challenges, and identity concerns, while adults over 40 often report stress linked to career stagnation, caregiving responsibilities, and health worries.

For the elderly, loneliness and isolation dominate. These patterns tell us that economic pressures are part of a wider ecosystem of stressors but for working-age adults, they are among the most decisive factors driving distress.

Addressing mental health, therefore, also means building environments at work, at home, and in communities, where people feel supported.

Access and affordability to mental health care is a big hurdle – how can this be addressed?

Access and affordability remain two of the biggest hurdles in mental healthcare. Services are often concentrated in urban centres and priced beyond the reach of many.

To address this meaningfully, mental health must be integrated into primary healthcare so that support is available within communities, not only in big cities.

Importantly, after the first consultation, follow-up sessions should be as affordable and routine as visiting a general physician. This will ensure continuity of care, early intervention, and improved outcomes.

To make mental health accessible and affordable we must leverage existing government programs through strong public–private partnerships. For instance, large community mental health literacy programs can complement and strengthen the District Mental Health Programme (DMHP).

By raising awareness and building willingness to seek help, these programs ensure that individuals are guided into government services through clear referral pathways. Since the DMHP already exists across all states, such collaborations can greatly enhance its effectiveness and ensure mental health services are truly accessible and well-utilized at the grassroots level.

We also need stronger insurance coverage and government-backed programs that make mental health care as accessible as physical health care. At the same time, technology can be a gamechanger through tele-counseling and digital solutions, we can scale affordable support to reach underserved populations.

Like a helpline, which triages callers in 11 Indian languages, can be integrated with an AI-powered chatbot to handle initial conversations and guide users—before escalating complex cases to licensed counsellors.

This not only extends care into rural and underserved areas but also helps manage high call volumes efficiently, making the model scalable for integration into public health systems.

The theme on this Suicide Prevention Day, as outlined by WHO, is to Change the Narrative. How do you think India can do that, when it comes to mental health support?

Changing the narrative on suicide prevention begins with recognizing that mental health is foundational to our nation’s social and economic well-being.

India has taken meaningful steps through the Mental Healthcare Act etc, as mentioned earlier., yet the scale of the challenge requires a broader, systemic approach. To change the narrative we must move beyond treating mental health as an isolated issue and instead embed it within schools, workplaces and community systems.

Equally important is to increased spending of health budgets to bridge the treatment gap. Alongside clinical care, peer and community-based networks such as teachers, caregivers, community health workers and trained first responders will be essential to scaling impact sustainably and building resilient systems that safeguard futures.

This is where public-private partnerships become critical. By aligning efforts across government, civil society and multilateral agencies we can expand reach, reduce stigma and institutionalize mental health support as a shared responsibility.

We also need to understand that prevention cannot rest on institutions alone and it depends on how each of us chooses to engage with mental health in our daily lives.

By recognising early warning signs, normalising conversations and fostering environments at home, educational institutions or workplace where people feel empowered to seek help, we can turn awareness into action.