Mental Illnesses to be covered under Health Insurance

Mental Health issues have become predominant post-pandemic. According to the report released by World Health Organization, about 20% of Indians will suffer from mental health disorders by the end of the year. A Mental Health study conducted by NIMHANS in 2016, found that nearly 14% of Indians required active therapeutic interventions.

India has failed in building awareness and improving the mental health of the Indian population. First, the government has a very small budget assigned to promote mental health. Second, there is a stigma about mental health and seeking therapeutic interventions. Third, lack of psychiatrists and trained mental
health professionals. Lastly, the cost of medicines and therapeutic services.

Despite having awareness about their mental health condition. People willingly do not seek treatment. One major reason is that India’s large population cannot afford the cost of psychiatric medicine, long-term counseling sessions, and hospitalization for mental illnesses not being covered under health policies.

According to the Mental Healthcare Act, of 2017
Section 21 (4) of the Act states ‘every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for the treatment of physical illness and now it is the responsibility of the welfare state to make insurance facilities available for all kinds of mental illnesses.

The IRDAI had instructed the insurance policies to cover mental health expenses in the Health Insurance. The insurers did not abide by the rules of IRDAI. A petition was filed in the Supreme Court against insurers for violating the provision Mental Healthcare Act 2017.

Finally, after 2 years of battle. The Indian Regulatory and Development Authority of India (IRDAI) has made it mandatory for all insurance policies to cover mental illness in health insurance. All the insurers have been asked to adhere to the rules by 31 st October 2022.

“All insurance products shall cover mental illness and comply with the provisions of the MHC Act, 2017 without any deviation. Insurers are requested to confirm compliance before October 31, 2022,” the latest circular by IRDAI read.

The mental disorders whose treatment will be insured are bipolar affective disorder, acute depression, schizophrenia, panic disorders, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), personality disorder (PD), eating disorders, and dissociative disorders. The health policies will cover the cost of the patients who need in-hospitalization treatment for mental illness, including medicines, diagnoses, and therapy.

The health policies do not include intellectual disabilities, substance abuse, or the cost of therapy, and also for OPD patients. It would not cover the treatment cost of intentional self-inflicted injury or suicide attempt.

There is still ambiguity about the implementation of mental illness in health policies such as the cost of policies, types of mental health policies, and the mental disorder included. There is a need for a standardized mental health policy that includes all the mental health issues and also bare the cost of therapy.

We have a long way to go to make sure that all mental health issues are covered under health policies.