A 17-year-old Chinese schoolgirl, Xiaoyu, watches her grades collapse as severe anxiety and depression take hold. Afraid that a diagnosis could bring shame to her family and hurt her university prospects, she suffers in silence. Her mother dismisses her exhaustion as laziness. It is only when an empathetic classmate steps in, understands her distress and helps her reach a community counselling clinic that Xiaoyu begins to understand that mental illness is not a failure of character.
In an educational manga created to tackle mental-health stigma in China, a doctor explains it through a simple metaphor: a mental health condition, like a broken leg, may require treatment and support. By the end, Xiaoyu has returned to school with tools to manage her condition — and is helping another struggling student seek support.
The story is designed to challenge ideas around “losing face”, parental blame and the notion that seeking psychological help is a sign of weakness. But it also illustrates a larger challenge facing countries across the BRICS grouping: how to make mental healthcare more accessible, acceptable and closer to where people live.
That is where a newly-established BRICS Network of Centres of Excellence (CoEs) in mental health, which will be piloted by India, hopes to play a role, bringing together approaches developed across member countries and adapting them to local health systems. “The hope is that this network will mitigate the existing treatment gaps across BRICS countries by scaling task-sharing models and digital tele-health platforms. It will also aim to integrate mental healthcare into primary health centres, bringing services to hard-to-reach and rural populations,” says Dr Naveen Kumar C, professor of psychiatry at NIMHANS and one of those working on setting up the network.
A major focus will be to upskill frontline and non-specialist health workers so that basic mental-health support, identification and referral can become part of routine primary care.
This approach is particularly relevant in countries where specialist services are concentrated in cities while large populations live in rural or underserved areas.
Learning from each other
The examples are varied. China is using storytelling and educational material such as the manga to address stigma among young people. Indonesia has developed a 24×7 digital platform aimed at responding to mental-health crises and suicide prevention. South Africa has explored pictorial, story-based screening approaches that can help community health workers identify mental-health concerns during home visits. The UAE has been using virtual-reality-based clinical simulations and interventions, including for anxiety-related conditions.
Russia, meanwhile, provides examples of technology-assisted assessment and rehabilitation. Approaches being explored there include physiological measures such as heart-rate variability and galvanic skin response (sweaty skin), alongside biofeedback and other non-invasive technologies. Some centres have also used technologies such as transcranial magnetic stimulation and virtual reality in clinical and rehabilitation settings.
India brings its own experience to the table, particularly with tele-mental-health services that can plug into the existing healthcare system.
The idea is not necessarily to replicate one country’s model in another, but to understand what works, under what circumstances, and how such approaches can be adapted for different populations and health systems.
Bringing care closer to communities
The network has three broad objectives: integrating mental health care into primary care, building the capacity of healthcare workers, and encouraging collaborative research, particularly around digital interventions.
“Collaboration within the network will span technical expertise, joint research, capacity building, and knowledge exchange rather than pure monetary grants,” says Dr Naveen.
Potential areas of joint research include AI-assisted screening, digital interventions, suicide prevention, biomarkers and epidemiological mapping of mental-health conditions across BRICS countries. The network is also expected to share operational blueprints for digital platforms, tools and learning-management systems.
“A compendium of evidence-based clinical protocols, culturally adaptable tools and public-education strategies is also envisaged,” says Dr Naveen. A BRICS training hub would provide continuing professional education, train-the-trainer programmes, webinars and standardised certification for non-specialist health workers.
The collaboration will extend beyond clinical care. Members will also work on common approaches to issues such as data privacy and cybersecurity, ethical deployment of AI and human-rights-based mental-health policies.
Why this matters for India
The scale of India’s challenge makes such knowledge-sharing particularly relevant. “An estimated 197.3 million individuals in India were affected by mental health disorders in 2017. And, there was a 70% to 92% treatment gap. There is a shortage of psychiatrists, clinical psychologists, and psychiatric nurses with most specialists being concentrated in the city. And, mental health conditions in India are projected to result in economic losses of USD 1.03 trillion between 2012 and 2030. Learning from the other countries may help India address these challenges,” Dr Naveen says.
Building a shared mental-health toolkit
The network is currently being operationalised, with participating Centres of Excellence, formal agreements, contact points and governance mechanisms being worked out. NIMHANS, as the coordinating centre, is developing the governance protocol, while a multi-country steering committee and technical working groups are being formed.
The New Delhi Declaration had called for the network to facilitate collaborative research, policy dialogue, exchange of best practices and the co-development of evidence-based mental-health promotion strategies across BRICS countries. The larger ambition, then, is to create a shared toolkit rather than a single model of care — combining community workers, primary healthcare, digital platforms, technology-assisted interventions, research and public education.
And Xiaoyu’s story captures why that matters. Closing the mental health gap is not only about getting more people into treatment. It is also about making sure that people recognise distress early, know where to turn and do not feel ashamed when they ask for help. In that sense, the manga’s final image — Xiaoyu supporting another struggling student — mirrors the broader goal of the BRICS network: turning isolated experiences of mental illness into a system of shared understanding, support and care.
India brings its own experience to the table, particularly with tele-mental-health services that can plug into the existing healthcare system. 
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