The mail was short but spoke volumes. "I have an issue: I’m 13 I have depression and I tried to commit suicide you are helping me hold on to myself thanks for everything."The recipients of the grateful email were the creators of Wysa, a mental health chatbot, launched by Jo Aggarwal and her husband, Ramakant Vempati, in January this year. The artificial intelligence-driven chatbot is designed to help those struggling with minor mental health issues by using cognitive behavioural therapy techniques, somewhat in the manner of an interactive self-help book or a "wise friend" (hence the name), and it has 1,00,000 users from around the world currently. Aggarwal remembers when they got the mail, to the date. "On May 29, when she wrote to us saying we were helping her hold on to herself, Ramakant and I cried and hugged each other," she says. For the two IIT-Delhi alumni who had quit their corporate careers in London and moved to Bengaluru, it was one of those moments of validation in their fledgling venture’s journey that assured them they were on the right track.Richa Singh recalls a similar moment from the year she founded YourDOST, an online mental health counselling platform. The IIT graduate had launched the venture in 2014 in the background of the suicide of a college friend who was unable to withstand the pressure of placements, combined with the stress she herself had experienced during that time."One of the incidents close to my heart was when a girl who was raped by her teacher in school contacted us," Singh recalls. At the time she got in touch, she was in college but was considering dropping out. She had been undergoing therapy for four years but had been unable to tell her therapist about the rape, since they were both in the same small town and she was worried it would get around. "She told us she was so happy that a service like this had been launched and that, if it had been around earlier, she might have spoken out and saved herself many years of struggle." Since its launch three years ago, Singh says 1.3 million people have reached out to YourDOST for its services.According to the National Mental Health Survey released in 2016, nearly 150 million Indians need mental health care services but less than 30 million are seeking care. This mirrors global trends. The World Health Organization reports that in low- and middle-income countries, 76-85% of people with mental disorders receive no treatment for their disorder. There are a range of reasons for this, from a lack of awareness about mental illness to limited access to professional help and the cost of treatment.Wysa, YourDOST, Lean On Me and other new digital ventures in mental health are able to harness technology to leap over one of the biggest reasons people don’t seek treatment — stigma. The anonymity and privacy these apps and websites offer goes a long way in removing the inhibitions those grappling with mental health issues might have in seeking professional help."Yes, there is a shortage of mental health professionals in India but it is not as if the ones that we have are overbooked, unlike in a country like the UK, where there is a one-year wait-list to see a psychologist," says Aggarwal, who terms Wysa a "fire extinguisher" that can be in everyone’s pocket.Stigma is also a reason CR Chandrasekhar, a former professor of psychiatry at NIMHANS in Bengaluru, opened free counselling centres away from the mental health hospital so that people might be more at ease. "There is less stigma with the word counselling, as opposed to terms like mental disorder or treatment," says Chandrasekhar, a well-known psychiatrist and the author of numerous books on mental health in both English and Kannada. He has also been instrumental in training volunteer "lay counsellors" through three-month courses, who lend an empathetic ear at the counselling centres and direct those who need it to professionals. Though their interventions would be limited, Chandrasekhar sees lay counsellors’ services in the nature of psychological first aid."The idea is that anybody can reach out and help these people. This is their first port of call." Many people often go to "faith healers" and others of the ilk before they finally turn to psychiatrists and psychologists, he says.There are other initiatives as well that are looking to break down the walls of misconception around mental illnesses, or even just offer a safe space to listen and be listened to. One of them is Living Stories, started by Sanchana Krishnan, a 24-year-old who has been struggling with bipolar disorder and borderline personality disorder since she was very young. Krishnan calls it "a space to talk and gain knowledge and awareness" because talking, she believes, is acknowledging, which will lead to action. At a Living Stories event, those going through mental illness like depression or bipolar disorder will don the hat of a book and visitors can choose to have one-on-one conversations with as many "books" as they would like."When I was young, I had a heightened awareness of my behaviour and realised I needed to see a doctor. But my mother told me I didn’t need a psychologist and that I should stop giving myself such labels. The taboo was the most ridiculous reason not to get help," says Krishnan, on the phone from Delhi. After events in Bengaluru and Delhi, Living Stories is heading to Chennai next and Krishnan hopes to do it in regional languages as well and take it to smaller towns in coming months. Krishnan also hopes to start support groups for family and other caregivers of those grappling with mental illness, a need that often goes unacknowledged.A University of Pittsburgh study on the burden of depression on the family quotes the husband of a woman with recurrent depression, "I have always felt like I was walking on eggshells but no matter how softly I walked, they broke...," an exhaustive state of mind to be in and one that is often overlooked when all the focus is on the patient alone. Others, like Bengaluru headquartered White Swan Foundation, are looking to spread awareness about mental health issues.These initiatives and others like it, which target those with less severe mental illnesses, are crucial to bridging the gap between the demand for mental health care and supply. But while these efforts are important, the state, too, needs to play its part in a populous country like India, with its heavy burden of mental illness. The paucity of mental health professionals as a whole, the quality of treatment and the concentration of qualified personnel in cities is one area that needs urgent intervention, say experts.In a reply to Parliament in December 2015, the Union health ministry said India has 3,800 psychiatrists and 898 clinical psychologists. This works out to 3 psychiatrists per million people while the commonwealth norm is 5.6 psychiatrists per 1,00,000 people, translating into a shortage of 66,200 psychiatrists, as data journalism site IndiaSpend pointed out. "We need more psychiatrists and psychologists.The government should create the post of psychiatry in district hospitals and make mental health care part of the general health care system," says Chandrasekhar.With psychologists, there is also a need to regulate the quality of assistance, says Bhairavi Prakash, a Chennaibased psychologist and consultant who has herself sought out help. "Unlike in the US, we don’t have a licensing body for therapists which affects the quality of care," says Prakash. Even psychologists offering counselling online need to be more compassionate, she says. "Finding a good therapist is hard. Finding a non-judgemental therapist is even harder," she adds.Aggarwal says there is also a tendency among general practitioners to prescribe antidepressants rather than referring them to therapists and, often, without informing patients adequately about side-effects. Living Stories’ Krishnan has seen this happen. "There is so little information about pills out there. I know people with borderline schizophrenia who have been given the same medication that I am on."Data from pharmaceutical market research company AIOCD Pharmasofttech AWACS shows that antidepressant sales have risen by over 30% in the last four years.Chandrasekhar points out another area where the government needs to step in — the provision of rehabilitative care. "Rehabilitation centres are needed for those who are severely mentally ill but not enough to be institutionalised," he says. Called halfway homes, these transitional facilities, where they exist, are currently run by the private sector or by non-governmental organisations. They usually take in those with mental illnesses who have been under psychiatric care and are now better, but have still not recovered sufficiently for their families to be able to take care of them.At the Medico Pastoral Association (MPA) in Pottery Town in Bengaluru, the country’s first halfway home, there are about 40 residents who are psychotic patients on medication. "After their hospitalisation, their symptoms have to be monitored regularly, they have to be given medication and be in a structured routine. Families are often ill-equipped to handle the symptoms of psychosis," says Babita Gupta, a psychologist at the association. The idea, she says, is to rehabilitate them and help them return to society through a structured programme that will train them in new skills and improve their self-esteem, among others. One of the residents is Arun* (name changed to protect identity), a 30-year-old electrical engineering graduate, who began hearing voices and hallucinating but refused to take medication.His parents then tried to give him his medication by mixing it in his food but he soon discovered their ruse. At the MPA, Gupta says his condition has improved significantly and he is currently undergoing a job-readiness programme. "But when they leave this compound and return to their families, society has to accept them. Otherwise, it is equal to harassing them," she says. While the charges at MPA work out to Rs 13,800 a month (excluding medicines) and is targeted at middle-class families, there are other high-end facilities where it costs residents anywhere between Rs 50,000 and Rs 1,00,000 a month.For patients unable to afford these sums, there are hardly any options. Once they are discharged, they may have to go back to the same institutions or may be reduced to living on the streets, if their families are unable to take care of them or refuse to. The National Mental Health Survey mentions that homelessness is both a cause and a consequence of mental illness, with nearly one-third to half of homeless persons estimated to be suffering from a diagnosable mental disorder, a disturbing statistic.An important beginning to remedy this is the passage of the Mental Health Care Bill 2017 earlier this year. As part of the draft Act, an expert committee has recommended that the Centre establish these halfway homes, as part of the rules under it, according to reports. In March, the Delhi High Court had also told the state government to speed up setting up halfway homes for mentally ill prisoners of Tihar Jail.The Mental Health Care Bill 2017, which replaces the Mental Health Act of 1987, focuses on the rights of the patient, and states that "persons with mental illness have the right to equality of treatment, protection from inhuman and degrading treatment" among others. It also decriminalises suicide and prohibits the use of electroconvulsive therapy without anaesthesia. Additionally, it specifies that every insurer should also make provisions for medical insurance for treating mental illness "on the same basis as is available for treatment of physical illness."These efforts, once implemented effectively, would go a long way in securing the rights of those with mental illnesses, complemented by players in the private sector. Perhaps then, we might be a step closer to a world in which mental illness is not mocked or feared, and where there is no shame in seeking out help. A world which, as Krishnan wishes, does not divide people into "normal" and "mentally ill".