Opinion Men and boys are not all right. India can’t keep ignoring this crisis

While mental health is gaining attention in India’s public health discourse, it continues to be a quieter emergency claiming thousands of lives each year. According to the National Mental Health Survey (NMHS, 2015–16), nearly 14 per cent of India’s population lives with some form of mental disorder. Yet only one in 10 individuals with a mental health disorder receives any treatment. Among men, the situation is particularly stark — suicide rates are 2.6 times higher than among women, with 1,18,979 men dying by suicide in 2021 compared to 45,026 women. While women exceed men in internalised mental health disorders, men exhibit more externalised forms including substance abuse, aggression and violence. Conversations around gender and mental health have rightly focused on women’s experiences of inequality, domestic violence and care burdens. Men’s mental health remains a largely unseen crisis, owing to the stigma around seeking care, more so among men.

The Culture Problem

Findings from TGI’s ARTEMIS (Adolescents’ Resilience and Treatment Needs for Mental Health in Indian Slums) study on adolescent mental health in urban slums of Delhi and Vijayawada reveal how early these patterns form. One community volunteer recounted, “One boy was addicted to alcohol and had become depressed. I engaged him in games and conversations, and he changed a bit. This gave me great joy.” Another volunteer described a father’s refusal to let his son seek help.

Adolescents spoke about peer stigma that discourages them to seek help. One boy shared, “My friends discouraged me because they said they did not have mental problems and so they would not come [for meetings].” Another described a moment of crisis: “I was trying to slit my wrist with a blade but stopped myself. Then you people came and explained everything patiently. After listening, I changed.”

These stories show that silence is not innate but socially constructed and reinforced by a person’s surroundings. Boys internalise early that emotional expression is incompatible with masculinity. This conditioning often continues into adulthood, strengthened by societal expectations that a “real man” must suppress pain and endure hardships without complaint.

The SMART Mental Health (SMH) project, which engaged adult men in rural communities of Andhra Pradesh and Haryana, illustrated the continuity of this mindset. Participants repeatedly referred to social stigma, lack of privacy, and fear of ridicule as key deterrents to seeking care.

Structural Barriers and Systemic Gaps

Systemic deficiencies further exacerbate the mental health crisis. Even when men want to seek help, health systems often fail to support them adequately. A participant from SMH Project in Haryana described the challenges of accessing public health facilities:

“There is no attention on the mental health of people like us, it is only for those with money. We don’t even know where the doctors sit or which doctor to go to. The doctors send us from one to another.”
Suicide deaths among male daily wage earners surged by 170.7 per cent between 2014 and 2021, reaching an SDR of 34.6, compared to 13.1 among women. For working-class men, especially those in daily-wage labour, economic instability compounds the barriers to seeking mental healthcare.

As one participant shared, “They called me to the camp, but I was not at home. Even today, I was told to go to the camp, but I cannot let the chance of earning around 600 or 700 rupees go. So, I had to skip the camp.” Transport and affordability add another layer of exclusion.

The lack of gender-sensitive and culturally relevant services only deepens the divide. In tribal and rural areas, where alcohol is often embedded within social practices, excessive drinking becomes a normalised coping mechanism. Without context, health programmes risk alienating communities rather than supporting them.

While national policies and programs like the National Mental Health Policy (2014) and Tele-MANAS (2022) have improved visibility and access of mental health care to the population, they remain largely gender neutral, hence, a targeted approach to address unique needs of sub-population groups is essential. Very few interventions are designed to address the unique experiences of men, the societal pressures, workplace stressors, and family expectations that shape their mental well-being.

When distress is bottled up, it spills over into aggression, substance use, and domestic conflict. Poor mental health among men impacts families through strained relationships and emotional neglect. It also affects the economy, through reduced productivity, absenteeism, and burnout.

A counsellor, peer, or community health worker could facilitate access for men — but only if the system allows these connections.

Way Forward

Addressing men’s mental health requires moving beyond just awareness to sustained, gender-sensitive action.

Firstly, gender sensitivity must be integrated into the design and delivery of all mental health policies and programmes. Training frontline workers to engage men with empathy, confidentiality, and without judgment can bridge much of the current gap.

Secondly, promoting mental health literacy in schools, workplaces, and communities must be an intentional practice. Thirdly, community-based interventions such as peer-support groups and local champions need crucial investment, particularly in rural and marginalised areas where traditional services are scarce. Strengthening primary care to ensure continuity, privacy, and follow-up can address many of the concerns voiced by men in the SMART MH study.

Finally, research and funding must explicitly prioritise men’s mental health. Currently, less than 2 per cent of India’s health budget is allocated to mental health, and virtually none targets specific-gendered needs. Policies, programmes, and interventions that include men as part of the gender-equity conversation, not as its counterpart, can foster healthier, more compassionate expressions of masculinity.

Kallakuri is senior research fellow, Saluja is thought leadership advisor & program manager, Ubuntu Initiative for Building Partnerships in Africa, and Paslawar is research fellow, mental health at The George Institute for Global Health