Tuesday, June 25, 2024

FYI :Mental health insurance coverage- A welcome step or a confused case?

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As per a survey report by Deloitte in 2022, 80 per cent of the workforce reported mental health issues, and reaching out to mental health professionals is a luxury! Health insurance companies had never covered mental health until the pandemic compelled them to do so. Tanisha Saxena provides a detailed analysis of  recent developments following the Insurance Regulatory and Development Authority of India’s mandate that companies cover mental illness as well as physical illnesses.

While the conversation on mental health has gained traction and there is incessant commentary around it from all major quarters, the field is still riddled with stereotypes and stigma. It is often not thought of as a legitimate illness that requires intervention by a trained and licensed professional. Until now, health insurance plans have only covered physical ailments, but the Mental Healthcare Act of 2017 and IRDAI’s recent push to include mental illness in insurance is a step in the right direction!

“Mental health is not just a concept that refers to an individual’s psychological and emotional well-being; rather, it’s a state where an individual is able to use their cognitive capabilities to meet the ordinary demands and functions in society,” Vaneeta Batra, a transformational life coach, explained. According to the WHO, there is no single ‘official’ definition of mental health.There are many factors, theories, and assessments that affect how mental health is defined. Mental health is related to the personality of a person as a whole. Vaneeta elaborates, “One of five people around the world is experiencing potential mental health problems.

To make things even more worrisome — children and teenagers have a bigger proportion. Mental health determines how you think, feel, and act. In a state of good mental health, one feels positive about everything, while those who experience issues dealing with day-to-day problems are going through phases in life that they can’t control; this could be a sign of a mental health problem and should be addressed.” Like in any other physical illness, we spend a significant amount of money in hospitals and on medications; similarly, someone suffering from mental illness spends a significant amount on outpatient department expenses such as doctor consultations, medicines, and daycare treatments.

“With the rise in overall stress levels and mental health disorders, which can occur at any age and are more common in today’s world due to the pressure of day-to-day life, peer pressure, all increasing at an alarming rate, the idea of getting mental health insurance does make sense! Just keep in mind to opt for policies that include OPD expenses as well! Mental health disorders are not limited to a particular age. However, people with a family history, those who have been through a traumatic experience, or those who have a history of antidepressants should strongly consider purchasing insurance,” the life coach advised.

Abhishek, a senior sales executive at Policy Bazaar, gives us insightful information about the implementation of mental health insurance coverage. He says, “When we do surveys, it reveals the loopholes in the system. Until recently, the IRDA had paid no attention to mental health insurance coverage, but since the pandemic has brought the issue to the forefront, things appear to have changed. Now, conditions such as anxiety, depression, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and psychosis will be covered in the health insurance. It will be covered after 30 days if the case is fresh.

On the other hand in case of pre-existing conditions, depending on the severity of symptoms, it will get covered in 2 to 4 years. Moreover, if any mental condition arises due to alcohol consumption or drug abuse it will be excluded from insurance policy.” Having said that, Abhishek points out that the implementation is at an initial stage and the premiums are also getting revised. Some companies have not yet adopted it, so gradually things will change.

While IRDAI’s announcement is indeed a great step, there’s more that needs to be done than said. We connected with mental health professionals to hear their point of view, too. Welcoming the initiative, Vaibhav Khandelwal, co-founder of Felicity, a start-up aiming to help people get access to mental health therapy through online video counselling in Hyderabad, says, “The step acknowledges the importance of mental health and recognises that it is a legitimate form of healthcare that should be accessible to all.

This can help to reduce the stigma associated with seeking mental health treatment and make it more affordable and accessible for individuals who need it.” But Vaibhav looks at the bigger picture and shares what could be the challenges in the process of implementing mental health insurance coverage. He stressed the fact that, “As insurers start to re-examine their policies and incorporate mental health into their plans, it is imperative that we look into the impact this will have on the insurance premiums. While keeping it affordable to ensure maximum coverage, the insurers also have to make sure that top-quality care and qualified professionals are provided to the beneficiaries.

With the limitations of physical centres in terms of accessibility and breadth of experience, online therapy providers will have a huge role to play in the proliferation of mental healthcare.” Another big challenge that Vaibhav shed light on is the fact that it can be difficult for insurance companies to determine the cost and coverage for mental health services, as it is often more difficult to measure the effectiveness of these treatments compared to traditional medical treatments.

There are only 75 psychiatrists in India for every one crore Indians. Furthermore, the cost of medications and treatment is so high that it is far beyond the means of society’s middle class! In fact, only 30% of Indians have general insurance policies. In conclusion, mental health insurance needs to be more nuanced and accessible to the masses.

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