The Union Budget for FY 2023-24 was released by the Government of India in Parliament this month. We at the Keshav Desiraju India Mental Health Observatory, are greatly interested in, and attuned to budgetary allocations towards mental health. Such allocations are symbolic of the Central Government’s policy priorities and plan to improve access to quality, equitable, affordable and rights-based mental health services in the country.
In our latest brief, Union Budget for Mental Health 2023-24, we focus on the budget for mental health primarily under the Ministry of Health and Family Welfare (MoHFW) and the Ministry of Social Justice and Empowerment (MoSJE)
Snapshot of Budgetary Allocations
Allocations under the Ministry of Health and Family Welfare
Mental health services are typically under the purview of the MoHFW. In the budget, the Central Government funds two mental health institutions: National Institute of Mental Health and Neuro-Sciences, (NIMHANS), Bengaluru (₹721 crore) and Lokpriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur (₹64 crore).
This year, the flagship initiative of the MoHFW, the National Tele-Mental Health Programme (T-MANAS), has received a substantial sum of ₹134 crores. This represents the Government’s focus on scaling digital mental health. While T-MANAS was announced during last year’s budget, the programme was formally launched on World Mental Health Day, 10 October 2022.
T-MANAS: a renewed focus on digital mental health
Our previous analyses of the Union Budget in 2021-22 and 2022-23 point to similar trends in budgetary allocations. Mental health institutions categorically receive over 85% of the total funding for mental health. This year, T-MANAS which has been introduced as a new line-item in the budget, received 15% of the mental health funds.
We believe, T-MANAS has the potential to improve access to mental health services in remote parts of the country and plug the shortfall in mental health human resources to some extent. But larger concerns do remain on the effectiveness of digital mental health services and the resultant data privacy and security challenges. Moreover, commensurate investment is required from the government to develop community-based models of care.
Uncertainty on the budget for the National Mental Health Programme
In previous years, funds were earmarked for the tertiary activities component of the National Mental Health Programme (NMHP). The activities under this component included enhancing capacities of mental health human resources and developing Centres of Excellence for mental health in different states. However, in this year’s budget, the programme has been subsumed under the umbrella of Tertiary Care Programme. This restructuring makes it difficult to ascertain the funds allocated for NMHP – tertiary activities.
Another very integral component of the NMHP is the District Mental Health Programme (DMHP). The objective of the DMHP is to deliver and integrate mental health services at the community and primary healthcare level. Although, the Central Government does allocate funds to the DMHP, it does not feature as a separate line-item. Thus, it is not possible to determine how much is spent by the Government on the programme.
Allocations to the Ministry of Social Justice and Empowerment
The MoSJE sets aside funding for rehabilitation of persons with psychosocial disabilities through the Deendayal Disabled Rehabilitation Scheme (₹130 crore). Another important allocation is for the Scheme for Implementation of the Rights of Persons with Disabilities Act, 2016 (₹150 crore). However, since these schemes encompass services for persons with different disabilities, and not just psychosocial disabilities, the exact proportion of funds ringfenced for mental health is unknown.
Noteworthy omissions in this year’s budget
Overall, while the mental health budget this year has increased by 16%, there are some notable absences. In November 2022, along with T-MANAS, the MoHFW also released the National Suicide Prevention Strategy (NSPS) addressing a crisis of rising suicide rates in the country. While T-MANAS has received significant financial backing, the NSPS does not have funds explicitly earmarked for its implementation, nor did it find a mention in the Budget Speech.
Finally, mental health and well-being are impacted by several factors that include food security, access to livelihoods and quality education. While certain Government schemes have received a higher allocation this year, others like the Mahatma Gandhi National Rural Employment Guarantee Scheme (MNREGS) saw their funding slashed. In 2021, the National Crimes Record Bureau (NCRB) reported that 26% of the people who died by suicide were daily wage earners. In such a case, programmes such as MNREGS that guarantee employment and income, may lead to reduced suicide rates and improve mental health outcomes. Therefore, we strongly believe that development and rights-based schemes like MNREGS should be strengthened and improved with adequate funding support from the Government.
Read and download our detailed budget brief, here.
To know more about the Keshav Desiraju India Mental Health Observatory and our publications, please visit our website.
Keshav Desiraju India Mental Health Observatory is an open-access repository of data and information on mental health laws, policies and services.
Sayali Mahashur and Tanya Fernandes are Research Associates at the Centre for Mental Health Law & Policy, Indian Law Society, Pune.