From Policy to Right: India’s Supreme Court Makes Mental Health a Constitutional Guarantee

Suhana Roy

In July 2025, India’s Supreme Court made history. In a judgment that could reshape health rights jurisprudence, the Court declared that mental health is not just a matter of policy or welfare, it is a constitutional guarantee under the Right to Life (Article 21). For millions of students, workers, and vulnerable communities navigating mental health struggles, the decision offers both recognition and hope.

The case of Sukdeb Saha v. State of Andhra Pradesh & Ors was a public interest petition highlighting the crisis in mental health support for students following the suspicious death of a 17-year-old student preparing for the national pre-medical entrance exam. Overcrowded student hostels, relentless academic competition, and insufficient counselling services are linked to rising levels of anxiety, depression, and suicide. The Court not only acknowledged these conditions as an infringement of dignity and life but also issued binding directions to the Union of India and state governments, as well as educational institutions, to provide accessible counselling, anti-discrimination measures, and safe, stigma-free environments.

Crucially, in its ruling the Court linked its reasoning to the Mental Healthcare Act, 2017, which guarantees the right to affordable, quality mental healthcare and elevated those statutory rights into constitutional obligations. The ruling means that state inaction is no longer a matter of poor policy; it is now a breach of fundamental rights under the Constitution, enforceable through judicial intervention.

The Court also laid down binding guidelines for educational institutions, invoking its powers under Article 32 and Article 141 of the Constitution. It held: “Mental health is an integral component of the right to life under Article 21 of the Constitution. … mental health is central to this vision.” The guidelines include instituting mental health policies in schools, appointing counsellors for institutions with over 100 students, and creating district-level monitoring committees chaired by district magistrates. Institutions must adopt policies aligned with national programs such as the National Suicide Prevention Strategy, and these remain binding until formal legislation is enacted.

A rights-based shift in mental health jurisprudence

Why does this matter? In practical terms, when a right is enshrined in constitutional law, it gains enforceability. Citizens can challenge inadequate provision of services in court, and governments are compelled to allocate resources accordingly.

The judgment aligns India’s constitutional framework with obligations under the International Covenant on Economic, Social and Cultural Rights (ICESCR), particularly Article 12, which recognises the right to the highest attainable standard of physical and mental health. It also resonates with World Health Organization’s Comprehensive Mental Health Action Plan 2013–2030, which calls for scaling up services, community-based care, and anti-stigma strategies.

Indian courts have historically touched on mental health issues, often in the context of disability rights or prisoner welfare, but seldom with this level of explicit recognition. By framing mental health as integral to dignity, autonomy, and community participation, the Court has broadened the constitutional imagination of the right to life.

The implementation gap

Yet, the judgment lands in a country where the gap between legal rights and lived reality is stark. India has less than one psychiatrist per 100,000 people, far below the WHO recommendation of a minimum three per 100,000 people. Mental health expenditure remains below 1% of the national health budget, and services are concentrated in urban centres, leaving rural populations dependent on overstretched primary health systems.

Social stigma compounds the problem. Many individuals avoid seeking help for fear of being labelled “unstable” or “unfit,” with consequences for employment and social acceptance. Among students, the culture of silence is reinforced by fear of academic penalties or parental disapproval.

Without structural investment, rights risk becoming what Indian courts themselves have warned against: “rights on paper.” The judgment creates a legal imperative for the government to act; however, unless it is followed by binding budgetary commitments, the recruitment of trained personnel, and community engagement and education campaigns, the constitutional promise may remain aspirational.

The July 2025 judgment is more than a technical legal development, it is a moral statement. By bringing mental health squarely under the ambit of Article 21, the Court has shifted it from the periphery of public health discourse to the centre of constitutional protection and demands that the state uphold not just life, but life with dignity.

Suhana Roy is a BA LLB (Hons) student at Hidayatullah National Law University, Raipur, India.