South Asia comprises eight countries that share significant socio-cultural and economic backgrounds. The countries in this region: India, Pakistan, Bangladesh, Afghanistan, Sri Lanka, Nepal, Maldives, and Bhutan, account for nearly a quarter of the world’s total population. There is a considerable treatment gap for mental health services, which is further exacerbated among the older adults (aged over 60 years). The lack of awareness, stigma, limited mental healthcare infrastructure, and the presence of medical conditions in old age, combined with rapidly changing demographics and societal conditions in the region, render the older adults highly vulnerable to the ill effects of untreated mental illnesses. A collaborative effort, including policy changes and shifts in attitude, is necessary to mitigate this risk. This chapter seeks to explore the existing public health aspects of psychiatric illness.