When someone you love is struggling: mental health warning signs, how to help, and where to get support in India

If you or someone near you is in danger right now, call 112 or go to the nearest hospital emergency department. To talk to a trained mental health counsellor at any hour, call Tele-MANAS on 14416 or 1-800-891-4416. The call is free.

On 10 October, India marked World Mental Health Day. This year’s global theme, which the Union Health Ministry adopted for its observance, is “Lived experiences heard: real voices, real change”: a reminder that the people who know most about mental illness are the people who have lived through it.

The ministry’s figures show how many people are now reaching out. Tele-MANAS, the national tele-mental health helpline launched on 10 October 2022, had received 47,75,644 calls by October 2026, through 53 cells across all 36 states and union territories. Of the 13,35,275 callers whose profile was recorded, 73.2% were between 18 and 45 years old: students, young workers, new parents, people in the busiest years of their lives.

That is encouraging. It also means that, in many Indian homes, someone is quietly struggling and the people around them are not sure what to do. This guide is for them: the parent, the spouse, the friend, the room-mate.

How common is this, really?

Far more common than most families assume.

The National Mental Health Survey, run by NIMHANS across 12 states in 2015–16, found that about 10.6% of adults had a mental health condition at the time of the survey, and 13.7% had had one at some point in their lives. A national analysis published in The Lancet Psychiatry estimated that 197.3 million people in India were living with a mental disorder in 2017, including 45.7 million with depression and 44.9 million with anxiety disorders.

Most of them were not getting care. The same survey found that, depending on the condition, between 70% and 92% of people who needed treatment were not receiving it. Stigma, distance, cost and simply not recognising the signs all play a part.

The good news is that these are treatable conditions. The World Health Organization is clear that there are effective treatments for mild, moderate and severe depression, including talking therapies and, where needed, medicines.

Signs that someone may need support

Everyone has bad days, bad weeks, sad moods after a loss. What matters is a change that lasts and that gets in the way of ordinary life. WHO describes a depressive episode as a low, irritable or empty mood, or a loss of interest and pleasure, lasting most of the day, nearly every day, for at least two weeks. Other signs include:

• poor concentration, or falling behind at studies or work;
• strong feelings of guilt or worthlessness;
• hopelessness about the future;
• sleeping far more or far less than usual;
• changes in appetite or weight;
• feeling very tired or low in energy all the time;
• thoughts about dying or suicide.

In everyday life this often looks like someone withdrawing from friends, skipping classes or work, not answering calls, giving up things they used to enjoy, or becoming unusually irritable. Some people simply go quiet.

Depression is also common around childbirth. WHO notes that more than 10% of pregnant women and new mothers worldwide experience it. Under the National Health Mission, ASHAs and ANMs screen new mothers for postpartum depression during their postnatal home visits, so a mother who is struggling can ask her ASHA for help.

Warning signs that need you to act today

Some signs mean the person may be at risk of harming themselves. Take them seriously, every time:

• talking or writing about dying, suicide or not wanting to live;
• deep hopelessness about the future;
• a previous suicide attempt, which WHO identifies as an important risk factor;
• a recent crisis such as financial trouble, a relationship breaking down, a loss, or long-term pain or illness, especially in someone already struggling;
• growing isolation, which WHO notes is strongly associated with suicidal behaviour.

WHO also notes that many suicides happen impulsively, in a moment of crisis. That is exactly why the people nearby matter so much.

How to help someone you are worried about

You do not need to be an expert. You need to be present, calm and willing to listen.

1. Choose a quiet moment and ask. “You haven’t seemed yourself lately. I’m worried about you. How are you really doing?” Then let them talk.

2. If you are worried about suicide, ask directly. “Are you thinking about ending your life?” Many people fear this question will put the idea in someone’s head. The evidence says it does not: a review of published studies in Psychological Medicine found none that showed a significant increase in suicidal thoughts after people were asked, and suggested that talking about it may reduce them. Asking tells the person it is safe to be honest.

3. Listen more than you speak. Avoid “think positive”, “others have it worse” or “just pray more”. You do not have to fix anything in the first conversation. “Thank you for telling me” is often enough.

4. Do not keep a serious risk secret. If someone tells you they plan to harm themselves, you cannot promise to keep that to yourself. Tell them you care too much to do that, and bring in help.

5. Help them take the next step. Offer to sit with them while they call Tele-MANAS, or to go with them to a doctor. A practical offer (“I’ll come with you on Saturday”) works better than “you should see someone”.

6. Stay close if the risk is high. Do not leave the person alone. Keep them away from anything they could use to harm themselves, such as stored medicines or pesticides. WHO lists limiting access to such means among the most effective ways to prevent suicide.

7. Keep checking in. Recovery takes time. A message a few days later (“Thinking of you, want to meet for chai?”) tells someone they have not been forgotten.

8. Look after yourself too. Supporting someone is tiring. Share the load with others you trust, and seek support for yourself if you need it.

Where to get help in India

Tele-MANAS: 14416 or 1-800-891-4416. Free, 24 hours a day, every day. Calls are answered first by trained counsellors and can be escalated to psychiatrists, clinical psychologists, psychiatric social workers and psychiatric nurses, with referral to in-person care through the District Mental Health Programme. The service runs in 20 languages, depending on the languages each state has chosen. There is also a Tele-MANAS mobile app, now available in English, Hindi and 10 regional languages, with a design that supports visually impaired users, and a video consultation facility.

Your nearest government hospital or health centre. The District Mental Health Programme has been sanctioned in 767 districts, with outpatient care, counselling, medicines and a 10-bed inpatient facility at district level. Mental health services have also been added to the primary care package at the Ayushman Arogya Mandirs (upgraded sub-health and primary health centres). There are 47 government-run mental hospitals, and mental health services are available at all AIIMS.

Manodarpan, for students and teachers: 8448440632. The Ministry of Education’s psychosocial support helpline offers tele-counselling by trained psychologists.

In an emergency: 112. India’s single emergency number connects you to police, fire and medical help.

Cost should not be a barrier. Under Ayushman Bharat PM-JAY, cashless treatment is available for 22 specified mental health procedures. And under the Mental Healthcare Act, people living below the poverty line, or who are destitute or homeless, are entitled to free mental health treatment at government-run or government-funded facilities.

Your rights under the Mental Healthcare Act, 2017

India’s mental health law is built around the dignity and choices of the person receiving care. Some of the rights it gives are worth knowing before you need them:

• Right to access care (section 18). Every person has the right to affordable, good-quality mental health care from government-run or funded services, without discrimination on grounds including gender, sexual orientation, religion, caste, class or disability. Medicines on the essential drug list are to be free at government facilities from community health centres upwards.
• Right to confidentiality (section 23). Information about a person’s mental health and treatment must be kept confidential, with limited exceptions such as sharing with the treating team or preventing harm. This applies to digital records too. No photograph or information about a person in treatment may be released to the media without their consent (section 24).
• Advance directive (section 5). Any adult can write down in advance how they wish, and do not wish, to be cared for if they become unwell.
• Nominated representative (section 14). Any adult can name, in writing on plain paper, a person to support them in decisions about their care.
• Right to live in the community and with dignity (sections 19 and 20). No one should remain in a mental health facility merely because their family will not take them home, and everyone in care is protected from cruel, inhuman or degrading treatment.
• Equal insurance cover (section 21). Insurers must provide medical insurance for mental illness on the same basis as for physical illness.
• Free legal aid (section 27). A person with mental illness is entitled to free legal services to exercise these rights.

And one provision every family should know: attempting suicide is not treated as a crime. Section 115 says a person who attempts suicide is presumed to have been under severe stress and shall not be tried and punished. Instead, the government has a duty to provide care, treatment and rehabilitation. No one should be afraid to bring a loved one to hospital after a self-harm attempt.

When to seek help, and when to go to hospital

Talk to a doctor or call Tele-MANAS soon if:

• low mood, worry, irritability or loss of interest has lasted two weeks or more;
• sleep, appetite, studies, work or relationships are clearly suffering;
• someone is using alcohol or other substances to cope;
• a new mother seems persistently low, anxious or unable to bond with her baby;
• an older relative has become withdrawn, confused or stopped eating well.

Go to a hospital emergency department, or call 112, at once if someone:

• has harmed themselves, or has taken an overdose of any medicine or a poison, even if they seem well now;
• talks about a plan to end their life, or you believe they may act on it;
• is hearing voices telling them to harm themselves or others;
• is extremely agitated, confused or out of touch with reality and cannot be kept safe at home.

Stay with them, keep them away from anything they could use to harm themselves, and let the hospital team know what you have seen.

The bottom line

Mental health conditions are common in India, treatable, and still too often hidden. The steps that help most are simple: notice the change, ask honestly, listen without judging, and help the person take the next step towards care. Recovery is possible, and many people who have been through a crisis go on to live full lives.

If this article has stirred something difficult for you, you do not have to carry it alone. Call Tele-MANAS on 14416 at any hour.

This article is general health information, not medical advice. In an emergency, call 112 or go to the nearest hospital.

Frequently asked questions

What is Tele-MANAS and how do I reach it?

Tele-MANAS is the Government of India's free, 24x7 tele-mental health service, launched on 10 October 2022. You can call 14416 or 1-800-891-4416. Trained counsellors answer first, and calls can be escalated to psychiatrists, clinical psychologists, psychiatric social workers and psychiatric nurses, with referral to in-person care through the District Mental Health Programme.

Will asking someone whether they are thinking about suicide put the idea in their head?

No. A review of the published research in Psychological Medicine found no study showing a significant increase in suicidal thoughts among people who were asked about them, and suggested that talking about it may reduce such thoughts. Asking directly and calmly is one of the most helpful things you can do.

Is attempting suicide a crime in India?

Under section 115 of the Mental Healthcare Act, 2017, a person who attempts suicide is presumed, unless proved otherwise, to have severe stress and is not to be tried and punished. The government has a duty to provide that person with care, treatment and rehabilitation.