It was a proud moment for Meghalaya in November 2022 when it notified its Mental Health and Social Care Policy. The state became the first in the Northeast and only the third in the country to have such a policy. Drafted with the Chennai-based NGO The Banyan after extensive consultations with dorbar shnongs, traditional healers, churches and service users, the document was praised in The Lancet for being culturally rooted.
Unlike the usual hospital-centric approach, Meghalaya’s policy recognised a simple truth: in a matrilineal, community-bound society, mental distress is not first taken to a psychiatrist, but to the family, the headman and the pastor. It therefore proposed to make village headmen, tribal leaders, religious teachers and traditional healers partners in early detection, to focus on children and youth, to bring inpatient mental healthcare under the Megha Health Insurance Scheme, and to create a chain of care from the State Mental Health Authority to district convergence committees chaired by Deputy Commissioners down to Village Health Councils.
In practice, for nearly two years it remained a paper without teeth. It was only in December 2024 that the Cabinet approved the Meghalaya Mental Healthcare Rules, finally providing a regulatory framework for registration and monitoring of institutions.
Three years on, it is time to ask: how far has this progressive, model policy travelled, and what is happening on the ground?
Walk into any district today and ask for mental health services. What do you get? Shillong Civil Hospital and Tura have a psychiatrist. For 32 lakh people, the state has fewer than ten psychiatrists and barely twenty clinical psychologists in public service. The promised Policy Implementation Unit exists but its outreach is invisible. The district convergence committees meant to anchor implementation have not met with any seriousness. The Village Health Councils, touted as the nodal agency, are largely unaware of their role in mental health.
Our state wears its youth like a badge — over 70% of the population is below 35. But that youth is restless, disconnected and increasingly distressed. The signs are everywhere, yet we rarely name them. Meghalaya bears one of the highest substance use burdens in the Northeast and has seen a disturbing number of teenage suicides. How many schools have a trained counsellor? How many colleges teach digital wellness?
The national helpline Tele-MANAS (14416) is active and the state’s own helpline (14410) exists, but few know about them. In villages, distress is still labelled as a weakness of faith, pushing young people into silence rather than towards support.
A policy does not heal. People do. Meghalaya got the vision right before others. What it needs now is implementation with the same urgency it shows for tourism and infrastructure.
The Economic Survey 2025-26 warns that anxiety, gaming disorder and compulsive scrolling among 15-24 year-olds are eroding productivity and learning. The response cannot be more posters. Schools must become the first line of defence and colleges must talk about mental fitness, not just placements. At this juncture, the state should mandate a counsellor in every higher secondary school cluster and train dorbar shnongs as first responders, not bystanders.
For a state that was first to write a beautiful policy, let it not be slow to save the minds it was written for.
