The proposed national budget for FY2026-27 brings a flicker of hope for Bangladesh’s struggling healthcare system. However, beneath this record-breaking health allocation is a familiar reality where mental health remains largely invisible.
Historically, mental health has received a considerably low share of the health budget, with spending disproportionately concentrated in specialist tertiary psychiatric hospitals. Despite rising economic pressures and increasing psychological toll on citizens, the macro-level framework of public spending suggests that we are still treating psychological well-being as an afterthought. However, as the new health budget aims to shift its focus towards grassroots healthcare, policymakers must recognise that mental health is a crucial prerequisite for the prevention of non-communicable diseases (NCDs) and other chronic physical health issues.
This would require acknowledging that mental and physical health don’t exist in silos; rather, poor mental health directly drives behavioural risk factors—such as physical inactivity, dietary risks, sleep disturbances, and chemical dependency—that can increase the risk of NCDs. We also need to understand that investing in mental wellness is not a drain on fiscal resources, but a highly strategic cost-containment measure for the rest of the healthcare system. For instance, studies suggest that for every $1 invested in scaling up treatments for common mental disorders like depression and anxiety, there is a $4 return in improved health outcomes and restored economic productivity. Furthermore, comprehensive economic frameworks modelling adolescent interventions and suicide prevention show staggering returns, reaching an average lifetime return on investment of $24 for every dollar spent.
The World Health Organization (WHO) has rigorous budgetary provisions and economic planning frameworks under its Comprehensive Mental Health Action Plan 2013-2030. These international guidelines provide a standardised outline of population-based and individual-level interventions specifically tailored to help low- and middle-income countries maximise health outcomes within strict budgetary constraints. However, without an administrative foundation, any attempt to execute these grassroots interventions will hit a major roadblock. There is hardly any routine screening or recording at the primary care tier, which makes the national psychiatric registry a highly unrepresentative database. Without baseline statistics, we remain fundamentally blind to our own psychiatric epidemiology and the actual care pathways patients traverse within our health system. Therefore, the government must fund the development of a dedicated mental health database or fully incorporate psychological screening metrics into existing digital and analogue health registries.
To build a modern, humane health ecosystem, the government must also broaden its fiscal strategies. The new budget introduces laudable tax waivers and duty cuts on raw pharmaceutical materials and medical devices to reduce out-of-pocket medical expenses.This strategy must be explicitly extended to mental health. Psychiatric medications carry high financial burdens that cause widespread treatment discontinuation. The government should actively channel these newly announced concessions to exempt duties on imported raw materials used specifically for psychiatric drugs, remove corporate taxes for local manufacturers, and apply zero VAT policies on digital tele-counselling platforms to help both urban and rural populations.
Crucially, addressing this crisis does not require specialised hospitals worth crores of taka. For instance, the government can leverage its massive, ongoing public healthcare recruitment drives by adding basic psychological first aid and primary mental health screening—tied directly to a digital registry—into the standard training curriculum for frontline workers. Similarly, a small fraction of the education budget should fund mandatory mental health desks in schools to counter rising mental health issues among the youth, while a minor portion of health funds can establish dedicated “mental health corners” within the existing upazila health complexes.
The private sector in Bangladesh hosts a growing network of counselling services, but most of them remain financially out of reach for the average citizen. To bridge this gap, the government should introduce robust financial subsidies for private counselling and psychotherapy services. These subsidies must strictly be tied to an independent, state-vetted quality assessment framework to ensure ethical standards, professional competence, and evidence-based care. Simultaneously, the state must upgrade its own capacity. The health ministry must create permanent institutional posts and actively employ qualified psychotherapists and clinical psychologists.
Finally, for this fiscal plan to truly serve everyone, it must recognise that economic resilience is fundamentally impossible without mental resilience. This is a call upon the policymakers to ensure that, in the final implementation of this massive financial expansion, a portion is directed towards creating a robust mental health framework. Treating mental wellness not as an isolated luxury but as an indispensable human right is the only way Bangladesh can step out of the shadows of this silent epidemic.
Dr Imdadul Haque Talukdar is adjunct assistant professor of psychology in the Department of History and Philosophy at North South University (NSU).
Views expressed in this article are the author's own.
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