India's Tele-MANAS: evolution, early outcomes and a scalable blueprint for digital public mental health

India's Tele-MANAS (Tele Mental Health Assistance and Networking Across States) programme, launched in October 2022, is the world's largest government-led tele-mental-health initiative. Operating via a multilingual 24/7 helpline, it provides stepped-care support, offering immediate counselling and escalating complex cases to psychiatrists or local services. In its first few years, Tele-MANAS has responded to more than 3.43 million calls across all Indian states and union territories. The majority of callers present with anxiety, depression or psychosocial stressors, while a critical minority report suicidal distress. Features such as linguistic inclusivity, anonymity and integration with India's digital health ecosystem have driven rapid uptake, particularly among young adults. A World Health Organization (WHO) assessment has recognised Tele-MANAS as a scalable and equity-focused solution. The initiative illustrates how low- and middle-income countries can leverage technology and task sharing to reduce the treatment gap, offering a potential global blueprint for digital mental health care. This article aims to provide a programmatic overview of Tele-MANAS, including its design, early outcomes and key implementation challenges.