India needs stronger interventions for perinatal mental health, say experts at George Institute seminar

Hyderabad: A recent report in Kerala about perinatal mental health estimated that maternal suicide accounted for nearly one in five maternal deaths in 2020.

Data shows that maternal suicide constitutes an increasing proportion of maternal deaths, even as maternal mortality in India has reduced by over 50 per cent since the early 2000s to 97 deaths per 1 lakh women.

Urgent need to improve perinatal mental health

The importance of speaking up about perinatal mental health was discussed at the seminar hosted by The George Institute for Global Health India.

The consultation, ‘National Expert Consultation on Perinatal Mental Health and Social Determinants’ held in New Delhi, highlighted the urgent need to create a roadmap for action and to improve perinatal mental health while addressing its key social determinants, particularly for women in rural India.

Mental health among young mothers goes untreated

India has more than 25 million births per year, but most women with mental health problems during pregnancy and one year after birth (the perinatal period) go undetected and untreated, especially in rural areas.

A recent systematic review among perinatal women in India found that the prevalence rates for perinatal depression ranged from 14–24 per cent in community-based studies, while some meta-analyses reported a pooled estimate of around 22 per cent for postpartum depression.

Lack of an integrated framework

The disparity is made worse by stigma, lack of access to mental health services and growing socio-economic inequalities. Despite several efforts by NGOs, healthcare workers and policymakers, there is a lack of an integrated framework to address these complex challenges that demand urgent action.

The Perinatal Mental Health (PRAMH) Project

The consultation was held as part of the Perinatal Mental Health (PRAMH) Project, led by The George Institute for Global Health India in partnership with the University of Oxford, supported by the UK Medical Research Council.

Findings shared from the PRAMH study in Telangana and Haryana highlighted the importance of engaging with perinatal women on their mental health and emphasised the need for scalable, culturally sensitive interventions integrated within health systems.

The PRAMH study is working to integrate perinatal mental health into routine maternal care by addressing barriers such as poverty, gender inequity, domestic violence and stigma.

After identifying critical gaps in states like Telangana and Haryana, Phase 2 of the PRAMH study tested practical, scalable models to ensure mothers in rural India receive timely and culturally sensitive support.

Speaking at the consultation, Prof. Pallab Maulik, Director of Research, The George Institute for Global Health India, said, “Perinatal mental health is a major concern in India with a large number of women with undiagnosed and untreated perinatal depression and psychosis, which not only affects the mother but also the health of the baby and well-being of the family.”

The national consultation featured two insightful panel discussions.

Panel about women from the grassroots

The first panel, ‘Voices from the Ground,’ brought together leading professionals who highlighted women’s experiences and grassroots realities. The panel included Dr Prasanthi P, Deeksha – Centre for Learning and Action, Shalini Sharma, Jagori, Paromita, Parichiti, Dr Bijoya Roy, CWDS, Dr Vinod Bobjy, Siddipet PHC, and Dr Anmol, Tigaon PHC.

The session highlighted how deep-rooted male child preference and rigid social norms continue to deny women autonomy over their bodies and decisions around pregnancy.

Domestic violence and stigma

Speakers discussed the mental health impact of repeated pregnancies, domestic violence and stigma faced by women, especially when giving birth to a girl or a child with a disability.

The discussion called for breaking these harmful traditions, educating sarpanches, in-laws, especially men, employers across all job sectors, ASHAs, and frontline health workers and closing critical gaps through capacity building, orientation and practical training.

Larger engagement from community leaders, infrastructure

Panellists emphasised the importance of engaging community leaders, politicians and religious figures, while also establishing clear tools, protocols and a robust referral system to extend counselling support not only to women but also to their families.

They highlighted the need for strong institutional backing to ensure better outcomes in perinatal mental health, along with affordable and accessible childcare facilities, such as crèches, to support mothers and families more effectively.

Address social challenges in mental health

Speaking about the key role of social determinants, Dr Nicole Votruba (University of Oxford, UK), who is the Principal Investigator, said, “The findings from the PRAMH project underscore the profound impact that social determinants—child sex preference, domestic violence, and poverty—have on maternal mental health. It is imperative that we not only prioritise the mental health of women but also address these underlying social challenges within the communities. Supporting women in both areas is essential for fostering healthier mothers, children and families and stronger societies.”

Perinatal maternal mental health in national programs

The second panel, ‘Policy Perspectives and Opportunities for Scaling Perinatal Mental Health,’ brought together leading professionals, including Prof. Rajesh Sagar, AIIMS, Prof. Prabha Chandra, NIMHANS, Dr Vandana Prasad, PHRN, Prof. Aditi Iyer, PHFI and Dr Rajitha Reddy, Fernandez Foundation.

The discussion focused on the urgent need to integrate perinatal maternal mental health into national programs, noting that while women’s mental health is mentioned in policies, there is no dedicated program or screening mechanism in place.

Experts highlighted gaps in training for doctors, nurses and ASHAs, the lack of culturally relevant tools, and the stigma that prevents women from seeking psychological help even when screened positive.

Creating decentralised solutions

They called for state-specific strategies, collaboration across states, capacity building and mandatory history-taking during antenatal care.

Panellists stressed the importance of engaging policymakers in a language they understand, creating decentralised solutions, and amplifying the voices of women who are directly affected, so that policies address not just treatment but also the social and financial realities surrounding perinatal mental health.

The discussion also highlighted the critical link between perinatal mental health, child health and the importance of early childhood development.

Finding sustainable solutions

Speaking about priorities for the future, Dr YK Sandhya, Program Lead – Mental Health, The George Institute for Global Health India, said, “It is critical to ensure that perinatal mental health is not seen as a standalone as this might increase the stigma and discrimination that women with perinatal mental health problems face; rather it should be included within the routine antenatal and postnatal care that pregnant and lactating women receive, thus making it sustainable.”

The consultation concluded with a commitment to build a unified roadmap involving government, civil society, academics, and frontline health workers. The goal is to ensure that every mother in India can access the mental health care she needs.

About The George Institute for Global Health

The George Institute for Global Health is an independent medical research institute aiming to improve the health of millions of people worldwide by generating effective, evidence-based and affordable solutions to the world’s biggest health challenges.