Mind The Gap: Why Mental Health Coverage In Insurance Is Needed?
The financial burden of untreated mental illness also spills over to families, highlighting the need for financial mode to support mental health care.
By Dinesh Mosamkar
As per WHO ‘Mental health is an integral part of health; it is more than the absence of mental illnesses. It is the foundation for well-being and effective functioning of individuals. It includes mental well-being, prevention of mental disorders, treatment, and rehabilitation.’
In recent years, mental health has gained significant momentum as a global concern. From awareness campaigns to prominent public figures talking about their struggles, mental health has entered mainstream media. However, access to mental health care remains a concern, mainly due to the financial stress it imposes on patients and their families.
As per the National Mental Health Survey of India, 2015-16, nearly 10.7 per cent of the Indian population suffers from a mental health illness, with the treatment gap still remaining at more than 80 per cent across states. The rates differ across states from a low of 5.8 per cent to a high of 14.1 per cent, pushing for the development of mechanisms to deliver mental health care. The inequitable distribution of services has been reported not only for the quantity but also for the quality of mental health services.
These gaps emphasise the critical need for comprehensive health insurance that incorporates mental health care, bridging the divide between mental health needs and affordability.
The Burden of Mental Illness
Mental health disorders are more common than many realise. As per the World Mental Health report published by the World Health Organisation (WHO) in June 2022,: ‘In all countries, mental health conditions are highly prevalent. About one in eight people in the world live with a mental disorder. The prevalence of different mental disorders varies with sex and age. In both males and females, anxiety disorders and depressive disorders are the most common.’ , ‘Mental disorders are the leading cause of years lived with disability (YLDs), accounting for one in every six YLDs globally.’ and that ‘Overall, the economic consequences of mental health conditions are enormous. Productivity losses and other indirect costs to society often far outstrip health care costs.’
Therapy, medications, screenings, and hospitalisations can be hard on pocket, especially since mental health conditions often require long-term treatment. These costs lead many to stop treatment, resulting in conditions that exacerbate over time and even death, in dire cases. The financial burden of untreated mental illness also spills over to families, highlighting the need for financial mode to support mental health care.
Challenges in Seeking Mental Health Care
One of the most talked about challenge to mental health care is its cost. Mental health is often viewed as a secondary concern rather than an essential need, causing many to stop treatment due to financial constraints. Lack of adequate health insurance coverage for mental health care is worsening this issue. Many policies exclude mental health or provide limited benefits, creating a significant gap in coverage.
The stigma around mental health issues further makes individuals hesitant to seek help, even when they can afford it. Moreover, the distribution of mental health resources is inequitable. Urban areas may have access to doctors and facilities, but rural regions often face shortages of proper care.
The Case for Mental Health Care in Health Insurance
A comprehensive health insurance that includes mental health care can create a positive impact towards communities’ mental well-being in following ways:
Easing financial burden: Preventive evaluation, therapy, medications, and hospitalisation coverage can make treatment much more affordable and accessible to a broader group of people.
Normalising mental health treatment: Coverage for psychiatric health sends a strong message that mental health is considered an illness and must be dealt with seriousness.
Societal benefits: Access to mental health care will improve the overall mental well-being of the larger population, reduce absenteeism, and increase productivity. It also alleviates the economic burden of untreated mental illnesses, including unemployment and disability-related costs.
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Existing Gaps in Insurance Policies
Most health insurance policies cover hospitalisation due to a mental illness but exclude outpatient consultations, therapy, and medication costs—key aspects of mental health care.
A lack of awareness about mental health benefits further compounds the issue. The limited offering of insurance plans often discourages people from utilising their benefits. To address these gaps, insurers must offer transparent and inclusive policies that cater to the full spectrum of mental health needs.
The Way Forward
Closing the mental health care gap requires a multipronged approach:
Comprehensive Care: Authorities must ensure well-rounded mental health coverage in all plans, including both in-patient and outpatient for all types of treatment.
Tailored Insurance Products: Insurers should design affordable policies with simple terms to cater to mental health care needs.
Awareness Campaigns: Public education about mental health coverage is crucial to reducing stigma and increasing policyutilisation.
Employer Initiatives: Employers can support mental health by offering group insurance policies with mental healthcare benefits.
Penetration: Making mental health care facilities reach the last mile is the need of the hour, particularly in rural areas where cases of mental health issues are on the rise.
Health insurance for mental illness is not just a financial necessity, it is a societal imperative. By making mental health care more accessible and affordable, insurance can significantly improve mental health outcomes and work towards a more inclusive society. As India is working towards ‘insurance for all’, addressing financial hurdles to mental health care is one of the key priorities. A comprehensive, collaborative approach involving policymakers, insurers and society is essential for achieving mental health parity and building a healthier, more resilient future.
(The author is SVP of Consumer Underwriting at TATA AIG General Insurance Company)
[Disclaimer: The opinions, beliefs, and views expressed by the various authors and forum participants on this website are personal and do not reflect the opinions, beliefs, and views of ABP News Network Pvt Ltd.]
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