Stigma, lack of youth-friendly services keep adolescents away from mental health support, says review

CHENNAI: With the proposed draft of ‘National Mental Health and Well-Being Policy for Schools’ still in the pipeline, the George Institute-led review identifies key barriers preventing Indian adolescents from seeking mental health care.

The review, held in multiple cities including Chennai, shows stigma, poor mental health literacy, and limited youth-friendly services as major challenges to help-seeking.

Published in SSM – Mental Health, the review analysed evidence from 26 studies conducted across India and identified significant barriers that continue to keep young people from accessing care during one of the most critical stages of their development. The findings come at a time when India is grappling with a growing mental health burden among adolescents, who make up one of the world’s largest youth populations.

The review, one of the most comprehensive examinations of adolescent mental health help-seeking behaviour in India to date, covered studies from Delhi, Mumbai, Chennai, Hyderabad, Bengaluru, Pune, Goa, Odisha, Bihar, Assam, Vijayawada, and several other regions.

Researchers found that stigma was the most commonly reported barrier to mental health care. Many adolescents feared being judged, labelled, or treated differently if they disclosed emotional or psychological difficulties.

The review also highlighted widespread gaps in mental health literacy among adolescents, parents, and teachers. Limited awareness often prevents early recognition of symptoms such as anxiety, depression, and emotional distress, delaying timely intervention and treatment.

“Adolescence is an important phase for emotional and psychological development, and many young people face barriers that limit their access to timely support,” said Sudha Kallakuri, a senior research fellow at The George Institute for Global Health, India and lead author of the review. “Evidence shows that stigma, low mental health literacy, worries about privacy, and service access frustrations deter many from seeking help. Addressing these challenges requires coordinated efforts across schools, communities, families, and health services.”

Beyond stigma and awareness, the review identified structural barriers that continue to widen India’s adolescent mental health treatment gap. Researchers found that a shortage of trained mental health professionals, lack of adolescent-friendly services, financial constraints, long travel distances to healthcare facilities, and negative experiences with healthcare providers often discourage young people from seeking care.

Concerns about confidentiality emerged as another major issue. Many adolescents feared that personal information shared during counselling sessions would not remain private, leading them to rely on friends and peers rather than professional mental health services.

The review found strong evidence that school-based mental health programmes can play a vital role in improving outcomes. Such initiatives have been shown to increase mental health literacy, reduce stigma, strengthen coping skills, and encourage help-seeking behaviour among students.

Experts argued that schools might be uniquely positioned to identify mental health concerns early and connect young people with appropriate support before problems become severe. And, the review also highlighted significant gaps in existing research, particularly concerning adolescents living in urban slums and other resource-poor settings.

Researchers found very few studies examining help-seeking behaviour among marginalised adolescents, even though these groups often face greater social, economic, and environmental challenges that may increase their vulnerability to mental health problems.

Meanwhile, Union Minister of Education Dharmendra Pradhan chaired a detailed discussion during a review meeting with officials, committee members and domain experts on the proposed draft National Mental Health & Well-Being Policy for Schools. The deliberations focused on strengthening mental well-being among students, teachers and the wider school community.