Rising cases of suicide and mental health treatment seeking in India reflect a widening gap between goals and achievements under the National Mental Health Programme (NMHP) and its components at district levels. Closing the gap remains a challenging task if the issues of lack of mental health professionals and inadequate mental healthcare infrastructure remain unaddressed. Growing income inequalities, the digital divide, and the gender divide are key factors that continue to impact access to mental health services. Failure on the part of the society to comprehend the importance of mental well-being in the pursuit of a better life has also allowed stigma and discrimination towards people suffering mental health issues and unable to cope with stress in their daily life. In Assam and other northeastern states, sustainability challenges posed by natural disasters such as floods and erosion, conflict and displacement, lack of employment avenues, etc., exacerbate mental health issues and depression. Such region-specific issues call for a clear regional focus in the national approach and strategy which considers the socio-economic and environmental reality in the northeast region. The objectives of the District Mental Health Programme are to provide suicide prevention services, workplace stress management, life skills training and counselling in schools and colleges; to provide mental health services, including prevention, promotion and long-term continuing care at different levels of the district healthcare delivery system; to augment institutional capacity in terms of infrastructure, equipment and human resources for mental healthcare; and to promote community awareness and participation in the delivery of mental healthcare services. The rising burden of the district healthcare delivery system in treating patients suffering from various ailments leaves little space for focused care of the people seeking treatment for mental health issues. The pragmatic approach is to prioritise early screening for mental stress or depression for timely intervention by family members and seeking professional help through telecounselling. For students, educational institutions – often regarded as the second home – are required to play the crucial role in early screening and counselling. A supportive home environment is needed for individuals experiencing mental stress and depression to make them feel confident to share their ordeal and seek help. Similarly, the atmosphere at the educational institutions and workplaces being supportive is vital for students and individuals experiencing such stress and depression to open up and share about their mental health issues to seek help without fear of discrimination or stigmatisation. The pertinent question is to find out how many homes, schools, colleges, universities, professional institutions, and workplaces truly empower individuals to share about their struggle to cope with mental stress without being judged and dismissed. The answer lies in a proactive approach that prioritises early screening and intervention and not the usual reactive response, which often leads to delay in seeking counselling and requiring treatment at healthcare institutions. The World Health Organisation in its report ‘World Mental Health Today’ highlighted a grim picture of about one billion people living with mental health conditions, yet most not receiving adequate care. WHO findings also show that suicide is the third leading cause of death among those aged 15–29 years — second for young women and third for young men. The National Crime Records Bureau has identified various causes of suicides, like professional/career problems, sense of isolation, abuse, violence, family problems, mental disorders, addiction to alcohol, financial loss, and chronic pain. These findings have pressed the alarm bells on the urgent need for multi-sectoral, region- and state-specific approaches and strategies that mainstream addressing the social, economic and environmental triggers of mental health conditions in addition to clinical treatment and psychological counselling. In rural areas of the northeast region, mental health conditions in people cannot be isolated from the agrarian crisis resulting from crop failure, non-remunerative prices of produce, and lack of employment avenues triggering migration in search of alternative livelihoods and better education. Likewise, low income compared to hard work in towns and cities causing financial stress often compounds the mental stress experienced by rural-to-urban migrants. Similarly, job losses among the urban middle class are triggers of mental health conditions, which, if left unaddressed, only worsen the psychological vulnerability and increase the burden of inadequate mental health infrastructure. Adoption of economic policies that create new opportunities for migrant populations, ensure remunerative prices for agricultural produce, create sustainable cities, andbalance environmental protection with development can significantly reduce anxiety over economic and financial security and help people cope with multiple stresses encountered daily. Reduced financial anxiety is essential to create the space for sharing at home and at the workplace, as individuals then get a peace of mind to reflect on the mental health education they receive through awareness campaigns and encourage family members to speak up if they are experiencing any stress or depression. India urgently needs a comprehensive mental health policy that addresses new realities beyond clinical care and integrates socio-economic factors of mental well-being into the core framework.