Patients Bear the Brunt as Mental Health Remains Unchartered Territory for Top Insurance Companies

In spite of a long-awaited directive by the insurance regulatory authority on mental health cover that brought new hope to millions of Indians suffering from psychological problems, the situation on the ground remains grim as most insurers still don’t have a policy for mental disorders and remain reluctant to venture into uncharted waters.
The Mental Healthcare Act 2017 that came into force on May 29 this year has clear-cut provisions for ensuring health insurance to patients. As per the Act, “every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.” However, nearly three months after the Act took effect, most insurers refuse to provide cover for people with mental illness, say patient advocacy groups.
Many top insurers including Apollo Munich Health Insurance, Religare Health Insurance and ICICI Lombard told Pharmabiz that they didn’t have provisions to cover psychological disorders. While ICICI Lombard and Religare have no policy available in their current package for people with mental disorders, Apollo Munich has a ‘day-to-day cover’, which means reimbursement for out-patient expenses. Even this policy comes with many strings attached and is offered only to residents of five major cities.
The insurers’ unwillingness to comply with the Act has prompted the regulator to intervene in the issue. In a circular issued on August 16, the Insurance Regulatory and Development Authority of India (Irdai), asked all insurers to make provisions for mental health cover. Referring to the Mental Healthcare Act 2017, Irdai asked companies to comply with immediate effect.
The reluctance of insurers to implement the provisions of the new Act worries healthcare activists who are working day in and day out to take the stigma out of mental ailments and reduce the financial burden on families. “The insurers should have already implemented it as the Mental Healthcare Act clauses are crystal clear. Now with the Irda order, these firms can’t shirk responsibility,” said Rajeshwari Iyer, founder of Roshni Action for Mental Illness India, a non-profit group.
According to a report published recently by the World Health Organisation, around 56 million Indians or 4.5 per cent of the country’s population suffer from depression and another 38 million have anxiety disorders. Almost 7.5 per cent of Indians suffer from major or minor mental disorders that require expert intervention, the report shows.
The overall incidence of mental illness in the population was estimated to be 13.7 per cent. A particularly vulnerable group is people aged between 40-49 years where the common complaints are psychotic issues, bipolar disorder, depression and neurotic and stress-related ailments.
“The lack of health insurance is definitely an impediment and limits patients’ access to therapy. The new Act has stressed on a patient’s right to access treatment of affordable cost. And therapy can be costly. A single session can cost the patient up to Rs 1,500 and he/she may need 4-5 sessions a month,” a Delhi-based senior psychiatrist pointed out.
“The new Act focused on the rights of the patient. An insurance cover will not only help individuals overcome lack of resources but will also help them live with dignity. Even now, only a miniscule percentage of patients seek professional help. Many of the sufferers are unaware of their condition and even if the family knows about it, we still have a habit of sweeping it under the rug,” Iyer opined.
According to patient right groups, patients who are keen on getting insurance cover may have to wait further despite the Irda instruction. The insurers who want to add mental health cover to their portfolio should submit a fresh application and may have to revise rates too. So far, no insurance company has taken a step in this direction, they say.