Turn on chat, therapist is available

rashmi pratap | Updated on January 24, 2018

Photo: Andrey Popov/Shutterstock

Photo: Mindscanner/Shutterstock

Easy in mind: Online counselling services allow patients to interact with therapists over video chat and pay for it online. Courtesy: Healtheminds

Ankita Puri, co-founder and CEO of HealthEminds

Chaula Patel, co-founder of

Beating the queues and the stigma, people in need of psychotherapy are logging on to the many online counselling services in India

Back in 2004, when Chaula Patel was providing psychological counselling to IT and BPO employees in Pune, she had more cases than she could handle. From youngsters carrying home work-related stress and vice versa, to small-town boys and girls dealing with heartbreaks and odd working hours in the big cities, the number of distressed callers far outstripped the hours in a day. Together with her friend and fellow psychologist Niloufer Ebrahim, she struggled to reach out to all. Until, in 2007, they came up with a handy solution, — an online space where people can pour out their grievances any time of the day or night, and the counsellors could respond to them more speedily.

Miles away in Bengaluru, Ankita Puri took a cue from telemedicine, her former area of work in the US, to launch HealthEminds — an online marketplace for psychological counselling, which she co-founded with Dr Sunita Maheshwari. She has brought together psychologists, psychiatrists, psychotherapists, life coaches, parenting and relationship experts, nutritionists and other counsellors on one platform, letting people choose the service they need. Visitors log on to the website, choose their counsellor, fix an appointment, discuss their problems through video chat and pay online. Within six months of launching, the website is already handling 200 cases a month and has 45 specialists on board. The number of cases is nearly doubling every month.

The rising number of cases received by websites like HealthEminds and corroborates mental health statistics. According to WHO, India had 10 million people with depression in 2012. An Assocham report released in April says over 42 per cent of private sector employees in India suffers from anxiety or depression due to demanding schedules, high stress levels worries over and performance-linked perquisites. A study by the National Institute of Mental Health and Neurosciences (NIMHANS) found that 36 per cent of techies in Bangalore showed signs of psychiatric disorder even as the government itself reports that one in five Indians suffers from mental health problems.

With one doctor for every three lakh mental health patients in India and an industry pegged at ₹1,400 crore, online psychological counselling holds out great promise.

Look ma, no stigma

“Owing to the social stigma, people don’t discuss depression and relationship issues in an open forum, and refrain from seeking help despite being aware of the problems. In such a scenario, an online platform is ideal for masking identity and seeking help,” says Puri.

Patel would agree. When she started her counselling practice nearly three decades ago, she went days without any clients and people questioned her career choice. Nobody was willing to admit they had mental health issues. Today, the situation has changed for the better. “People are getting more tech-savvy and are at ease when interacting online. Online counselling is also popular because even people looking for personal consultation are not getting appointments on time,” she adds.

It was this shortage of specialists that prompted Delhi-based Dr SK Sharma to launch online counselling in 1994 under his medical initiative Ethos Healthcare. “People used to come from other cities for counselling; some even came from other countries. They were spending a lot of time and money. Besides, there were problems in the follow-up treatment. We then decided to use technology to reach out to people,” he says.

Handholding in small towns

HealthEminds gets many enquiries from small towns and remote places, with people reaching out not just for themselves but also their family and friends. “The ease of access and the promise of anonymity in the online medium are driving this trend. A lot of people hesitate to consult local practitioners, as they may be known to them. Moreover, appointments are difficult to get,” Puri says.

“It is also not easy to find qualified and trained counsellors in places that are far from the major cities,” says Sharma.

Sneha Singh, a college student in Nagpur, knows this all too well. Her mother Gita, a homemaker, was taking depression medication prescribed by the local psychiatrist. “It led to side-effects like loss of appetite, nausea and tiredness. Due to this my mother was reluctant to continue using the medicine.”

Looking for answers online, she came across HealthEminds and shared her mother’s story. The counsellor recommended regular counselling sessions. “After hesitating initially, my mother agreed and soon got used to video chatting. The counsellor also suggested exercises to overcome her negative thoughts. Today, she has come out of her depression,” Singh says.

Young and troubled

While people of all ages seek psychological counselling, young professionals in their late 20s and 30s are found in larger numbers. “They have problems with relationships, as lack of time is often an issue and they are unable to address their own emotions. At the workplace, the issues revolve around lack of confidence, deadline pressures, loss of motivation and so on,” says Patel.

Another major segment seeking counselling services today is made up of cancer patients, survivors and their families. From diagnosis to treatment, patients find it hard to deal with the side-effects and the inability to lead a normal life. Pune-based Prashanti Cancer Care Mission is readying to launch online counselling for them. “Twelve counsellors have been trained so far,” says Patel, who is associated with the initiative.

The unique mode of service offered by online counsellors necessitates a different kind of revenue model. Patel’s charges a fixed sum from the companies using its services. For individuals, the charges are on hourly basis. Ethos charges the same for personal, phone or online counselling, and the fee depends on each session’s duration. Puri’s HealthEminds takes a commission per session, but she declines to reveal the figure. The charges on her website vary from ₹500 to ₹1,500 per 45-minute session, depending on the experts chosen.

Pooling expertise

Interestingly, several of these experts are based outside India, offering consultations from places such as Malaysia, the US or Canada. All of them have a licence to practise in India. “Each of our experts is screened, interviewed multiple times, and trained on ethics and guidelines to adhere to our quality standards. Online counselling is an unregulated space and people with barely three months of training become counsellors. But lack of expertise can be damaging,” Puri says. Her website has counsellors with not less than four years of experience.

Wary of the many pitfalls, Sharma has refrained from hiring a team. He handles cases, both domestic and international, on his own. “Counselling is a delicate job. If not done correctly, it can prove counter-productive. Till now I have managed on my own and will continue to do so for the next few years,” he says.

Puri, on the other hand, is ready for a big bang expansion. From 45, she hopes to increase the number of counsellors to 250 over the coming year. And she is in talks to raise funds. “Investors are beginning to show interest in the sector,” she says. From and Your Candid Friend to, the online counselling space in India has many players lending a patient ear. And all of them are gunning for venture funding.

No more tête-à-têtes?

Despite all the enthusiastic response, it is still moot whether online counselling can totally replace one-on-one interaction. “In a face-to-face conversation, we get a lot more clues about the intensity of emotions besides other non-verbal clues. With email and online counselling, not everyone is able to put across their thoughts accurately,” says Patel.

Puri agrees that in the case of psychiatric disorders such as schizophrenia, an online treatment will have its limitations. But she receives few such cases. The majority of her clients are those grappling with depression or cancer-related anxieties and who, in fact, find it difficult to step outside the home for help. “For them, online is helpful,” she says.

Sharma is confident that online and offline services can coexist as different people have different needs and mindset. “Some people need to meet personally. Some are not tech-comfortable. For some others, communication is more complete with eye contact, facial expression etc. They feel better only with a personal meeting,” he says.

While the online vs. offline debate has no clear answers, it’s undoubtedly win-win for the help-seeker, who now can confide on her own terms.

Published on June 26, 2015

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