Free mental health consultations and growing awareness have improved access, but stigma and affordability issues still keep many from seeking care
Mental health is no longer a subject confined to clinics or counselling rooms. As conversations around anxiety, depression, stress and burnout become more common, the need for timely mental healthcare has gained increasing recognition. Yet, despite growing awareness, many people continue to hesitate before seeking professional help. While therapy is often perceived as expensive, mental health professionals say that financial constraints are only one part of a much larger challenge.
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Speaking to GPlus, Dr. Mythili Hazarika, Associate Professor of Clinical Psychology and Former Head of the Department of Clinical Psychology at Gauhati Medical College and Hospital (GMCH), said that although cost can discourage some individuals, affordable and even free mental healthcare is
already available through government institutions.
"Cost can be a barrier for some people, especially when seeking care in private practice. However, it is important to know that mental health services are available free of cost in many government hospitals like Gauhati Medical College and Hospital, where consultations with psychiatrists, clinical psychologists, psychiatric social workers and other mental health professionals are provided."
According to Dr. Hazarika, focusing solely on affordability often overlooks the deeper reasons why people avoid therapy.
"Although cost can be a barrier, the bigger barriers are often a lack of awareness, stigma, and misconceptions about mental illness rather than cost alone."
Sharing a similar perspective, Dr. Bornali Das, a Mental Health Professional at GMCH, said that the affordability of treatment largely depends on where an individual seeks help.
“It is all about where you seek treatment."
She explained that counsellors are available in most government medical colleges and district civil hospitals, where counselling sessions are either free of cost or available at a nominal fee. Besides institutional services, initiatives such as the 104 toll-free mental health helpline and Tele-MANAS also provide free counselling and psychological support.
However, she pointed out that private counselling and psychotherapy remain expensive for many families.
"Private counselling and psychotherapy are chargeable, which may be a barrier since in India there is no comprehensive insurance coverage for mental health services."
The discussion also raises a larger question, should mental healthcare be treated differently from physical healthcare? Experts believe it should not.
Highlighting the need for stronger insurance support, Dr. Hazarika said mental health is an essential component of overall well-being and deserves equal importance.
“Mental health is an integral part of overall health, and psychological treatment should receive the same importance as treatment for physical illnesses. While free mental healthcare is already available in government hospitals, insurance coverage would make quality mental healthcare more accessible in the private sector as well, giving people greater choice and reducing financial burden."
She further noted that Section 21(4) of the Mental Healthcare Act, 2017, mandates insurers to provide coverage for mental illnesses on the same basis as physical illnesses. Although hospitalisation related to mental illness is generally covered today, outpatient psychotherapy and counselling continue to be excluded from many insurance policies, making regular therapy financially challenging for several people.
Beyond policy and affordability, personal experiences often reveal another reality.
A patient who has been attending therapy sessions regularly shared that misconceptions initially stopped them from seeking help.
"I was not aware of the free sessions and thought therapy would be expensive to start. Moreover, I was also ashamed of seeking therapy as I thought people would think something about me was wrong. But now I know there is nothing to be ashamed of and I am okay and happy."
To understand what truly keeps people away from therapy, GPlus asked Dr. Das whether the real barrier is money, stigma or lack of awareness.
“All three may contribute to being the real barriers, not just one. The importance varies from person to person."
She explained that counselling is not an overnight process. In many cases, meaningful behavioural or cognitive changes require at least eight to ten sessions, making both time and money important considerations. At the same time, choosing a qualified therapist also plays a significant role in the effectiveness of treatment.
Dr. Das added that therapy is based on trust and collaboration. Every therapist follows a different approach, and even subtle aspects such as words, silence or gestures may influence the therapeutic relationship. In person-centred therapy, the goal is not to make decisions for clients but to help them reach their own.
She described the profession as a "double-edged sword," where therapists must use their knowledge and communication carefully to guide healing without imposing decisions.
Another misconception that continues to circulate is that therapy becomes repetitive and is unnecessarily prolonged to generate income.
Responding to this belief, Dr. Das clarified:
"Each therapeutic approach is unique and sometimes blended. It may not be right that it is repetitive. Every therapist has unique ways of handling clients. Clients have every right to question the therapist about their approach and process so that they can work together to reach the desired goal. Clients or caregivers need to be informed and aware."
According to her, therapy is tailored to the individual's needs and evolves over time rather than following a repetitive pattern.
Dr. Das also observed that social attitudes towards mental health have gradually improved over the years. More people are now willing to seek professional help, while others are taking the first step through app-based counselling platforms, mental health chatbots, or AI-powered search tools that provide preliminary guidance.
However, she believes that the most difficult cases are often those where individuals fail to recognise symptoms or refuse to acknowledge their mental health condition because of lack of awareness or rigid beliefs. Improving mental health literacy, reducing stigma and expanding affordable services, she said, remain the need of the hour.
Concluding with a message for those delaying treatment because of financial concerns, Dr. Hazarika urged people not to let the fear of cost prevent them from seeking help.
"Please don't let financial concerns stop you from seeking help. Government hospitals offer free mental health consultations and treatment, and many institutions and professionals provide affordable or subsidised services. Mental health problems are treatable, and seeking help early can prevent more serious difficulties later. Your mental well-being is important, and support is available regardless of your financial situation."
As conversations around mental health continue to grow louder, experts believe the focus should move beyond the question of affordability alone. Free services exist, awareness is increasing and legal provisions are gradually evolving, but hesitation still persists. Whether the biggest hurdle is money, stigma, misinformation, or a combination of all three, one question remains: How can society ensure that seeking help becomes as natural as seeking treatment for any other illness?