Tele MANAS: India's National Tele Mental Health Programme

Policy Update

Lubina Dua

Background

India carries one of the largest mental health burdens in the world, yet its mental healthcare infrastructure has historically been among the most inadequate. Nearly 11 out of every 100 Indians live with mental health disorders, while 15% of adults may require mental health intervention at some point in their lives. The National Mental Health Survey of 2015-16 found that nearly 150 million Indians needed active mental health interventions, but fewer than 30 million were accessing any care. This treatment gap, the distance between need and access, is driven by three intersecting crises: a severe shortage of psychiatrists and clinical psychologists, widespread stigma around mental illness, and geographic barriers that leave rural and remote populations almost entirely without support.

The COVID-19 pandemic sharpened this crisis drastically. Anxiety, depression, grief, isolation, and economic distress surged across the population, exposing the complete inadequacy of existing in-person mental health infrastructure. The government’s response was the National Tele Mental Health Programme (NTMHP), launched on World Mental Health Day, 10 October 2022, by Prime Minister Narendra Modi. Its flagship service delivery arm is Tele MANAS, which stands for Tele Mental Health Assistance and Networking Across States.

Tele MANAS is implemented under the Ministry of Health and Family Welfare (MoHFW), with the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, as the apex nodal body. It is built on an earlier foundation: the National Psychosocial Support Helpline, which handled over 6 lakh calls during and after the pandemic, demonstrating both the feasibility and the demand for tele-mental health services at scale.

Functioning

Tele MANAS operates through a two-tier service delivery model, designed to ensure that callers receive appropriate levels of care based on the complexity of their needs.

Tier 1 is staffed by trained counsellors and mental health workers who handle the initial call. They provide first-level emotional support, psychosocial counselling, basic mental health information, and, where needed, refer callers to the next tier. The helpline number is 14416, which is also accessible as 1-800-891-4416, and is available 24 hours a day, seven days a week, free of charge.

Tier 2 involves consultation with psychiatrists, clinical psychologists, and specialists available through digital systems, including the eSanjeevani telemedicine platform. Callers who need more intensive assessment or medication management are escalated to Tier 2 from Tier 1. Cases requiring in-person care are referred to District Mental Health Programme (DMHP) clinics, Community Health Centres, and Primary Health Centres.

A key feature of the programme is its callback and follow-up mechanism. Rather than treating each call as a standalone transaction, Tele MANAS workers are expected to follow up with callers, particularly those identified as high-risk. This continuity-of-care approach distinguishes it from a standard helpline model.

Tele MANAS services are available in 20 languages based on the language opted by States, a significant feature given the linguistic diversity of India and the documented link between language barriers and underutilisation of mental health services.

On World Mental Health Day 2024, the government launched the Tele MANAS Mobile Application, a comprehensive digital platform providing support for mental health issues ranging from general well-being to clinical disorders. A video consultation facility was subsequently added as an upgrade to the existing audio-only calling facility, enabling richer clinical interaction between patients and specialists.

A dedicated Tele MANAS Cell has also been established at the Armed Forces Medical College (AFMC) in Pune, specifically to extend tele-mental health support to armed forces personnel and their dependents, a population with distinct and under-addressed mental health needs.

Performance

The growth in call volumes tells the most important performance story. Tele MANAS has climbed from 12,000 calls in December 2022 to 90,000 calls in May 2024, reflecting a nearly eight-fold increase in utilisation over eighteen months. As of November 2025, over 29.82 lakh calls have been handled on the helpline since its inception, with more than 12.33 lakh calls in 2025 alone. This figure crossed 20 lakh by April 2025, indicating accelerating adoption.

As of April 2025, 36 States and Union Territories have set up 53 Tele MANAS Cells across the country. Over Rs. 230 crore has been allocated by the government for NTMHP in the last three years. Specifically, Rs. 120.98 crore was allocated in 2022-23, Rs. 133.73 crore in 2023-24, and Rs. 90 crore in 2024-25.

Nearly 70% of callers fall within the 18 to 45 age group, indicating that working-age adults and students are the primary users of the service. State-level integration is also deepening: in Haryana, the service has been integrated with the “112” emergency response system so that suicide-related emergency calls can be immediately diverted to trained counsellors and mental health professionals for crisis intervention.

The programme connects callers not just to counselling but to the broader mental health system. The District Mental Health Programme (DMHP) is operational in 767 districts across the country, and Tele MANAS serves as a referral gateway into this network for callers who need in-person or long-term care.

Impact

The clearest impact of Tele MANAS is structural: India now has a functioning, free, 24/7 mental health helpline that is accessible in 20 languages across every State and Union Territory. This did not exist before October 2022. For millions of Indians who could not afford private therapy, did not live near a psychiatrist, or were too stigmatised to walk into a clinic, the helpline represents the first point of contact with any mental health support in their lives.

The programme has supported over 28 lakh people across the country. The case examples illustrate the range of needs being served, from a 30-year-old man experiencing suicidal ideation who was guided to a nearby mental health hospital to a 17-year-old student managing exam anxiety who received practical coping support. Both represent meaningful, timely interventions that the existing in-person system would likely not have reached.

The programme’s multilingual feature deserves particular attention. Mental health services in India have historically been concentrated in English and Hindi, effectively excluding large populations in southern, northeastern, and tribal regions. Availability in 20 languages directly addresses this exclusion.

The integration with eSanjeevani has created a pathway from first-contact counselling to clinical consultation without requiring the patient to physically travel anywhere. For rural women, elderly individuals, and those in geographically remote areas, this seamless referral architecture is a significant structural advance.

The programme has also begun normalising conversations about mental health in institutional settings. Outreach activities have been conducted in schools, railway services, and workplaces, gradually shifting the social context within which mental health is discussed.

Emerging Issues

1. Workforce shortage and counsellor burnout. The rapid scale-up of Tele MANAS has outpaced the availability of trained mental health professionals. India has approximately 0.3 psychiatrists per 1 lakh population against the WHO-recommended minimum of 3 per lakh, a tenfold deficit. Frontline counsellors at Tele MANAS Cells are handling large call volumes, often involving crisis cases, with limited clinical supervision and institutional support. This creates real risks of burnout and quality degradation.

Suggestion: Develop a structured Tele MANAS cadre with defined career pathways, clinical supervision protocols, and regular peer support sessions. Expand PG psychiatry seats as directed by the NMC’s (National Medical Commission) PGMSR-2023 (Minimum Standards of Requirements for Post-Graduate Courses, 2023, which lays down the infrastructure, faculty, and bed-strength norms that medical colleges must meet to start or increase postgraduate seats, guidelines, and link new graduates to NTMHP placements.

2. High dropout between Tier 1 and Tier 2. Weak coordination between Tele MANAS and in-person services, such as DMHP clinics, is resulting in high dropout rates between Tier 1 and Tier 2 care. A caller referred from a helpline counsellor to a specialist or to a DMHP clinic often does not follow through, partly due to stigma, partly due to logistical barriers, and partly because there is no robust mechanism to track whether the referral was completed.

Suggestion: Introduce a mandatory referral tracking module within the Tele MANAS platform, requiring Tier 1 counsellors to confirm referral completion within 72 hours and flag non-compliant cases for proactive outreach.

3. Low awareness and uneven state-level utilisation. Uneven public awareness across regions has contributed to low call volumes in several states, perpetuating stigma and limiting the platform’s reach. Many Indians, particularly in rural and tribal areas, are unaware that the helpline number 14416 exists or that mental health support is available free of cost.

Integrate 14416 awareness into the communication materials of Accredited Social Health Activist (ASHA) workers, Anganwadi centres, and Ayushman Arogya Mandirs, embedding the helpline number within the existing last-mile public health infrastructure rather than relying on digital campaigns that do not reach underserved populations.

4. Digital literacy barrier: Although digital infrastructure has expanded significantly, only 38% of Indian households are digitally literate, creating a significant barrier to effective use of the Tele MANAS mobile application and video consultation facility. While the audio helpline remains accessible without digital literacy, the programme’s newer features risk being captured by an already advantaged urban population.

Suggestion: Maintain the audio helpline as the primary, fully supported channel and ensure that digital features are positioned as additions rather than replacements. Evaluate digital feature usage data disaggregated by state and urban-rural breakdown before expanding them further.

5. Absence of outcome measurement: Tele MANAS currently reports call volumes and referral counts as its primary metrics. There is no publicly available data on clinical outcomes, whether callers experienced symptom reduction, whether referred callers completed treatment, or whether repeat callers show improvement over time. The absence of structured feedback mechanisms means frontline workers rarely receive updates on patient outcomes, hindering continuous learning and service refinement.

Suggestion: Develop a standardised outcome tracking protocol using validated mental health screening tools administered at first contact and at 30-day follow-up, with outcomes published in annual programme reports.

Way Forward

Tele MANAS has done something India has never done before: it has put a free, multilingual, round-the-clock mental health service within reach of every citizen with a phone. In a country where mental health was treated as a niche medical concern for much of its policy history, that is not a small achievement. Nearly 30 lakh calls in three years represent 30 lakh moments when someone in distress chose to reach out and was met by a trained counsellor rather than silence.

But call volumes are not the same as mental health outcomes. The programme’s next phase must be defined by quality, continuity, and clinical integration rather than scale alone. The treatment gap that Tele MANAS was designed to address is not just a gap in access; it is a gap in sustained, evidence-based care. A caller who receives one supportive conversation and then drops out of the system has not had their mental health need met in any meaningful sense.

The path forward requires three things working together. First, a serious investment in the mental health workforce, more trained counsellors, better supervision structures, and protected pathways from Tele MANAS into the DMHP network. Second, a shift in how the programme measures itself, from calls handled to lives improved, using validated outcome tools and transparent public reporting. Third, a genuine community outreach strategy that places the helpline number in the hands of ASHA workers, school teachers, railway station staff, and anyone else who sits at the intersection of community life and human distress.

India has spent decades under-investing in mental health. Tele MANAS is the most serious structural response to that neglect yet seen. Whether it becomes a genuine system of care or remains a well-intentioned helpline depends on what happens in the next phase of its implementation.

Selected References and Important Links

Ministry of Health and Family Welfare. (2025, April 1). Update on National Tele Mental Health Programme (NTMHP). Government of India. https://www.mohfw.gov.in/?q=en/pressrelease-242
Ministry of Health and Family Welfare. (2025, December). Update on National Tele Mental Health Programme. Government of India. https://www.mohfw.gov.in/?q=en/pressrelease/update-national-tele-mental-health-programme
Press Information Bureau. (2025, February 3). Measures taken to improve mental healthcare. Ministry of Health and Family Welfare. https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=2100593
Naveen Kumar, C. et al. (2025). A review of India’s national tele-mental health initiative. IOSR Journal of Nursing and Health Science, 14(2), 29-30. https://www.iosrjournals.org/iosr-jnhs/papers/vol14-issue2/Ser-1/E1402012930.pdf
Observer Research Foundation. (2025, August 8). India’s readiness for digital therapy: Tele MANAS and the road ahead. ORF Expert Speak. https://www.orfonline.org/expert-speak/india-s-readiness-for-digital-therapy-tele-manas-and-the-road-ahead
Citizen Matters. (2025, November 13). Explained: How Tele MANAS is shaping tele-mental healthcare in India. https://citizenmatters.in/explained-how-tele-manas-is-shaping-tele-mental-healthcare-in-india/
Medindia. (2026, May 14). How Tele MANAS is expanding mental healthcare access across India. https://www.medindia.net/news/how-tele-manas-is-expanding-mental-healthcare-access-across-india-223374-1.htm
Tele MANAS Official Portal, Ministry of Health and Family Welfare: https://telemanas.mohfw.gov.in
National Institute of Mental Health and Neuro Sciences (NIMHANS): https://nimhans.ac.in
District Mental Health Programme, NHM: https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=1043&lid=359

About the Contributor: Lubina Dua is a Research Intern at IMPRI with a strong interest in policy research, governance and public welfare. She has represented India at the Harvard Conference on Asian and International Relations (HPAIR) and participated in the World Bank Youth Summit. Her research interests span governance, institutional design and evidence-based public policy.

Acknowledgement: The author extends sincere thanks to the IMPRI team for their guidance.

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organization.

Name of the reviewers: Shreeya Dixit, Pallavi Lad