The first person to notice that a child is struggling may not be a psychiatrist.

It could be an Anganwadi worker who notices a change in a three-year-old, a teacher who sees a normally engaged child withdrawing from classmates, or a college faculty member who realises that a young person is no longer coping.

Odisha is trying to build a system around that first observation. One of the first states in India to do so.

The state has launched a Mental Health and Wellbeing Programme for Children, Adolescents and Young Adults, covering children from the Anganwadi stage at three years through young adulthood. Instead of treating mental health only when a child reaches a crisis or specialist service, the programme focuses on prevention, early identification, and referral where children already spend much of their lives—Anganwadi centres, schools, and colleges.

“This is a life-cycle approach,” says Dr Meena Som, Health Specialist, UNICEF Odisha, who helped develop the guidelines.

The programme divides children into five developmental stages — 3–5/6 years, 6–10, 11–14, 15–18 and 18 years and above. Each has its own operational guideline because, Som says, “the issues are different in each of the age groups, the breaking points are different, distresses are different.”

The government’s framework similarly identifies different developmental priorities: early brain development and attachment for 3–6-year-olds; emotional management and peer relationships for 6–10-year-olds; identity and peer influence during early adolescence; academic pressure, identity and risk-taking among 15–18-year-olds; and the transition to adulthood and academic stress among young adults.

The aim of the programme

“Addressing children's mental health is critical in the digital age,” says Dr. Aditya Mohapatra, Additional Director, Child Health, Government of Odisha. “Providing a strong life-cycle approach to mental health and well-being, from early childhood through adolescence and into young adulthood, will enable children to develop psychological resilience. Recognising this need, the state has launched the mental health guidelines,” he added.

"The health and wellbeing of children and young people is fundamental to the State's development. Mental wellbeing is an integral part of it. Ensuring their wellbeing requires a coordinated and whole-of-government approach, with all departments working together to provide timely support and create enabling environments for children and adolescents," he added.

The Department of Health & Family Welfare, Government of Odisha, has developed the Mental Health and Wellbeing operational guidelines for Children, Adolescents and Young Adults in response to the evolving national policy context and the need to strengthen mental health promotion and early support for young people in the State.

In Odisha, geographical, social, and economic challenges make interdepartmental convergence essential. Schools, Anganwadi Centres, colleges, and other community institutions provide the Government's most effective platforms to reach children and young people, making coordinated action across sectors critical.

"The guidelines have been developed through a consultative process initiated by the Department in early 2026, with inputs from concerned government departments, academic and technical institutions, mental health professionals, development partners, civil society organisations and other stakeholders. The consultations helped shape the programme framework, including the age groups, institutional platforms and roles for implementation," Dr Mohapatra says.

The teacher is not being asked to become a counsellor

The distinction is important.

Odisha’s programme does not expect an Anganwadi worker or teacher to diagnose depression, anxiety or another mental-health condition. Their job is to notice, respond and refer.

The government’s guidelines explicitly say front-line workers are to be equipped to “observe, respond, and refer — not to diagnose.” They also promote a trauma-informed approach in which behaviour is understood as communication rather than simply bad behaviour.

For an Anganwadi worker, Som explains, the guidelines are intended to answer practical questions: How do you recognise that a young child may need support? How do you approach the child? What should you say to the parents? What should you avoid saying? And, importantly,

Where do you refer the child?

For older children and adolescents, the booklets similarly provide guidance on identification and response, emergencies, referral pathways and services available within the district, including Tele-MANAS.

The guidelines have been designed as relatively short, pictorial and easy-to-understand booklets rather than technical clinical manuals, Som says.

Why Odisha?

For Dr Vivek Virendra Singh, Health Specialist at UNICEF, the significance of the programme lies partly in the fact that it has been taken up by the state itself.

“Health is a state subject,” he says.

UNICEF works with teams across states through its field offices, and those teams can help catalyse discussions when an issue appears as important for children. But, Singh says, the initiative ultimately reflects Odisha’s own recognition that children’s mental health needs attention.

“The visionary health team would have picked it up in that state,” he says, crediting Odisha for recognizing that mental health is an important issue for children today.

The underlying premise is that mental-health concerns are not confined to one age group.

“Mental health issues are real for children and at all ages,” Singh says.

The challenge, he adds, is that there has not always been enough suitable-for-age content on how to recognise and manage those concerns.

Odisha’s age-specific guidelines intend to address that gap.

One framework, five stages

The programme has been developed as a convergence initiative led by the Department of Health and Family Welfare, with the involvement of departments including School and Mass Education, Women and Child Development, Higher Education, Skill Development and Technical Education, and SC & ST Development, among others. The state’s Mental Health Institute and medical colleges are also part of the wider ecosystem.

This matters because a child’s mental health cannot be separated neatly from the environment around them.

The state framework identifies poverty, neglect, disrupted family circumstances and other structural vulnerabilities as factors that can increase mental-health risks. It also points to migration, urbanisation, educational disadvantage, early marriage, child labour and substance use as issues influencing children’s wellbeing in parts of Odisha.

Rather than creating a completely separate system, the programme is designed to connect with existing health and education structures.

At the Anganwadi level, workers can refer children to services including RBSK and primary healthcare. Schools can connect students to counsellors and health services, while higher educational institutions are expected to have Mental Health and Wellbeing Centres, faculty mentors and peer supporters. At the district level, the District Mental Health Programme is envisaged as the specialist referral backbone.

What happens when a teacher notices something?

This may ultimately be the most important test of the programme.

The operational guidelines follow three broad steps: routine mental-health awareness; identification and response; and monitoring and reporting.

That means mental health shouldn't appear once a year as an awareness lecture.

The intention is to build awareness into everyday systems, teach adults what signs to notice, provide an answer that does not stigmatise or punish the child, and create a route to professional help when needed.

The programme also recognises that parents need to be part of this process. The guiding principles call for community participation and describe parents as partners in supporting children’s wellbeing.

The programme is only now moving into implementation

The guidelines were released on September 26, and training is expected to begin around late October or early November, according to Som. The materials have also been translated into the local language alongside the English versions.

This is important because the programme is currently moving from policy to practice.

Odisha’s framework calls for master trainers from participating departments, followed by cascading training, induction training for new staff, refresher training, and monitoring of training quality and coverage.

Schools are expected to integrate mental-health activities into their timetables and designate mental-health focal persons at secondary and senior-secondary levels. Higher educational institutions are expected to establish functional Mental Health and Wellbeing Centres and designate mental-health nodal officers.

The question now is whether this structure can work at scale.

Because recognising distress is only the first step. A teacher may notice that a child has changed, but the system also needs to ensure that the teacher knows what to do next — and that the child actually reaches someone who can help.

The goal is to make mental-health support part of the places where childhood already happens.

Not just when a child is in crisis- but when someone first notices that something has changed.