The context of the paper's analysis is the arguably poor state of mental health care in India, as well as an unprecedented level of policy attention to the issue. The questions posed pertain to (1) the provision of such care in hospitals, (2) non-hospital provision, including by non-medical providers, (3) issues of education and social acceptance, (4) affordability, (5) within-country variation of care and possibilities for benchmarking, (6) aggregate resource impacts of a concerted effort to change policies and improve care, and (7) the shape of a more effective “continuum of care for mental health issues. The paper argues that, while new laws and policies being introduced in India propose ideas and changes that are groundbreaking for that country, leading to cautious optimism, there still are many gaps in the understanding of the challenges of the provision of increased access to, as well as better quality, mental health care throughout the country. These challenges can be understood on two fronts: one is the psychiatric and medical aspect of the issues, and the other is the management and administration of the system. A priority in achieving the goals of greater access and better quality is to increase the number of trained personnel at all levels of specialization and skilling that are relevant. Further, while the new legal framework and policy identify the importance of information technology in rapid expansion of access to mental healthcare, more context-specific research and trials are needed. With respect to the administration and management needs of the public system, important challenges will be the need for significant organizational innovations in the education system, and cultural changes that allow specialized medical professionals to accept the use of software and less-qualified, more dispersed, frontline providers. A final area is the interface between the public and private sectors, including the role of non-profit organizations: challenges include information sharing, division of ...
