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This viewpoint examines neurodevelopmental and sociocultural stressors in coaching environments, critiques policy gaps, and proposes a comprehensive three-tier prevention framework. 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Medical College, Jodhpur, Rajasthan, 1Department of Psychiatry, Pacific Medical College and Hospital, Udaipur, Rajasthan, India  \nABSTRACT  \nThe competitive entrance examination system in India has led to a concerning mental health crisis among students, especially in coaching centers such as Kota, Rajasthan, where student suicides persist despite greater awareness and policy intervention. This viewpoint paper examines the neurodevelopmental and sociocultural stressors affecting adolescent students in coaching environments, critiques existing policy gaps, and proposes a comprehensive three-tiered prevention framework for integrating mental health support within coaching ecosystems. The framework encompasses universal support mechanisms, targeted early identification protocols, and crisis response systems to reduce psychological distress and promote resilience in high-stakes academic settings. Implementation models distinguish between minimal and ideal components to accommodate diverse resource settings, while maintaining evidence-based prevention principles. The framework addresses stakeholder concerns through culturally adapted interventions that reconceptualize mental health support as integral to educational environments, rather than an ancillary service. For Indian psychiatry, this crisis necessitates expanded professional roles that encompass prevention, consultation, and the development of educational systems beyond traditional clinical treatment. Sustainable solutions require collaborative partnerships between coaching institutions, mental health professionals, families, and policymakers to create environments where academic excellence and psychological well-being are mutually reinforcing rather than competing priorities.  \nKey words: Academic stress, coaching institutes, mental health prevention, student suicide prevention  \nINTRODUCTION  \nStudent suicide represents the critical public health crisis in India. The National Crime Records Bureau documented over 170,000 suicide deaths in 2022, with students accounting for 7 .6% and 2,248 deaths attributed to exam failure.[1] This crisis is particularly pronounced in Kota, Rajasthan, the coaching  \nAddress for correspondence: Dr. Ashok Seervi, Department of Psychiatry, DR. SN Medical College, Jodhpur, Rajasthan, India.  \nE‑mail: [dr.ashokmedicaledu@gmail.com](dr.ashokmedicaledu@gmail.com)  \nSubmitted: 26‑May‑2025, Revised: 25‑Sep‑2025, Accepted: 12‑Nov‑2025, Published: 18‑Dec‑2025  \n\n| Access this article online |  |\n| --- | --- |\n| Website:\u003Cbr>[https://journals.lww.com/indianjpsychiatry](https://journals.lww.com/indianjpsychiatry) | Quick Response Code |\n|  | |\n| DOI:\u003Cbr>10.4103/indianjpsychiatry_537_25 |  |\n\ncapital of India, where academic pressure and psychological vulnerability converge among students preparing for the National Eligibility cum Entrance Test (NEET) and the Joint Entrance Examination (JEE). A recent newspaper-based analysis of 491 student suicide cases (2019–2023) identified Kota asthe most common reported place for student suicide cases (N = 63) .[2] Despite media coverage and policy intervention, Kota recorded 26 student suicides in 2023, 17 in 2024, and 14 by mid-2025.[3] Concurrently, the coaching industry has experienced declining revenue and enrolment.  \nThis is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑NoDerivatives 4.0 License (CC BY‑NC‑ ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nFor reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com) ","cbCaib6AqKDhJyig","https://ap.wps.com/l/cbCaib6AqKDhJyig","pdf",654387,"English","# Abstract\n# Introduction\n# Adolescent Neurodevelopment and Vulnerability\n# Sociocultural Context","[{\"question\":\"What problem does this viewpoint paper address?\",\"answer\":\"It addresses the ongoing mental health crisis and student suicides associated with India’s high-stakes coaching center environment, especially in Kota, Rajasthan.\"},{\"question\":\"What are the core components of the proposed prevention framework?\",\"answer\":\"The framework includes universal support mechanisms, targeted early identification protocols, and crisis response systems integrated into coaching ecosystems.\"},{\"question\":\"How does the framework support different resource settings?\",\"answer\":\"It provides implementation models that distinguish between minimal and ideal components, allowing adaptation while preserving evidence-based prevention principles.\"}]","Psychiatric interventions and suicide prevention in India’s coaching centers - Framework development from Kota’s experience | PDF",1790702503,18]