India has approximately 0.3 psychiatrists for every 100,000 people, a stark contrast to the roughly 13 per 100,000 found in high-income countries, highlighting a critical gap in mental healthcare access.
Yesterday, an informal mental wellness gathering took place in India—no stages, no panels, no recordings. Just founders, startup employees, investors, and individuals, many grappling with mental health challenges in their own lives. I attended as an observer, mostly listening.
What resonated wasn’t the sophistication of proposed solutions, but the overwhelming depth and persistence of the problem. It felt larger, more ingrained, and less resolved than I had anticipated.
When Lived Experience Outpaces Theory
My own experience with health issues has been primarily physical—a slipped disc, for example—which certainly had mental consequences, but didn’t necessitate professional mental health support. That distance is precisely why the conversations I overheard were so unsettling.
People openly discussed:
- Years spent in therapy
- Decades-long battles with chronic insomnia
- Burnout cycles that seemed inescapable
- High-functioning lives masking internal struggles
An entrepreneur casually mentioned living with long-standing insomnia, not with drama or exaggeration, but with a quiet acceptance. That acceptance, to me, was the most alarming revelation. It prompted a fundamental question: how many people are simply coping, rather than truly healing?
A Question That Lingered
A participant posed a question that stayed with me long after the gathering:
“Why do we intervene only after someone has an episode—burnout, depression, breakdown? Why can’t we spot the signs earlier?”
I don’t have a definitive answer. As clinicians, we’re trained to observe visible symptoms. Even in medicine, mental health is often inferred, not directly measured. I recall noticing teeth grinding—nocturnal bruxism—in dental patients as a potential stress indicator, but that’s merely scratching the surface.
Stress, anxiety, and emotional fatigue rarely announce themselves clearly. And in India, there isn’t even universal agreement on what constitutes “needing help.”
The Scale of the Unspoken Challenge
India’s mental health crisis isn’t abstract; it’s a structural issue. Consider these figures:
- The country has approximately 0.3 psychiatrists per 100,000 people, compared to around 13 per 100,000 in wealthier nations.
- The Tele-MANAS helpline, serving a population of 1.4 billion, receives roughly 3,000 calls daily.
Is that number reassuring—or deeply concerning? Does it suggest only 3,000 people require help each day? Or does it indicate that millions don’t recognize their distress, lack trust in available systems, or simply don’t know where to turn?
I genuinely don’t know.
What troubles me further is the prevalence of mental health “advice” consumed on social media—often well-intentioned, but rarely clinically validated. This raises a critical question: do we have enough qualified professionals to adequately support a country of this size?
Pressure, Performance, and the Absence of Villains
An interesting side conversation revolved around pressure. One investor suggested mandating mental wellness check-ins in startup term sheets. Another, in a quieter exchange, questioned whether pressure truly originates with limited partners and flows down to funds and startups—or if we’ve simply normalized pressure without examining its root causes.
There was no finger-pointing, no identification of villains—just uncertainty. It highlighted how easy it is to discuss “systems” and how difficult it is to pinpoint the origins of stress and how it accumulates.
A Personal Reflection
I play golf to relax, and it usually helps. But recently, as I began focusing on improving my handicap, stress crept back in.
It wasn’t dramatic or clinically significant.
It was a reminder that even our coping mechanisms can subtly transform into performance metrics. I’m not a professional golfer; I don’t need that pressure. Yet, it intrudes.
If that’s true for someone reasonably self-aware and resourced, what does it look like for everyone else?
Not Solutions, But a Starting Point
I’m writing this not because I’ve solved the puzzle of mental health.
I haven’t.
I’m writing because I’ve realized how little we collectively understand it—and how much of it we carry in silence.
Perhaps the first step isn’t about finding solutions, policies, or frameworks. Maybe it’s about asking questions, sharing stories, and fostering safe conversations.
I don’t know what the right interventions are. I don’t know how early is “early enough.” I don’t know how to scale empathy or self-awareness.
But I do know this: the problem is far larger than we acknowledge, and pretending otherwise isn’t helping anyone.
If you’re working in this field, struggling with it, researching it, funding it—or simply trying to make sense of it—I’d genuinely like to hear from you. Not to fix anything, but to understand it better.
