In India, pathways to geriatric mental health care are multifaceted, addressing the unique psychological needs of the elderly. The primary care system serves as the initial touchpoint, where general practitioners screen for mental health issues. These professionals often refer patients to specialists in psychiatry or geriatric medicine when more complex care is required. Community-based programs play a significant role, offering services through NGOs and government initiatives. Organizations like the National Institute of Mental Health and Neurosciences (NIMHANS) provide specialized training for healthcare workers to identify and manage geriatric mental health conditions. Additionally, telemedicine is becoming increasingly vital, especially in rural areas, bridging the gap between patients and mental health professionals. Support groups and helplines, such as those operated by the HelpAge India and Dignity Foundation, offer emotional support and counseling. These groups provide a platform for the elderly to share their experiences and receive peer support, enhancing their mental well-being. Government policies like the National Mental Health Programme (NMHP) aim to integrate mental health services into primary care and promote awareness. However, challenges such as stigma, lack of specialized training for healthcare providers, and limited access to services in rural areas persist. Addressing these issues requires ongoing efforts to educate the public, enhance infrastructure, and ensure equitable access to mental health care for all elderly individuals in India. This chapter evaluates the various pathways to geriatric mental health care in India.