India has a pervasive public health care system, which is majorly underused. The unregulated private sector meets the substantial demand for curative treatments. Treatment costs in these sectors are very high, resulting in the High Out-Of-Pocket (OOP) treatment cost. Factors such as the ageing population increased in the cases of high cost noncommunicable diseases, and the increase in people’s awareness and expectation towards technologically advanced treatments has resulted in the soaring price of healthcare. According to a report from The World Bank, 1 out of every 4, I.e., 25% of Indian hospitalized is pushed below the poverty line due to indebtedness. In India, nearly 30% of the population does not have health insurance, as indicated by economic times.
Given the condition of health insurance, which primarily focuses on physical health, the idea of mental health insurance seems quite utopian. According to Swachh India NDTV, 7.5% of Indians have Mental disorders. Out of which 56 million people suffer from depression, 39 million people suffer from anxiety, and India rounds up about 36% of the Global suicide rate. In 2017, 197.3 million people in India were diagnosed with mental disorders, accounting for one in every seven of the population, with those aged 30–49 years being the most affected. The Indian government and private insurers, on the other hand, have been prolonged to implement mental health insurance. In April of this year, India passed the National Mental Health Act, which includes health insurance for people suffering from mental illnesses. The Indian government and private insurers, on the other hand, have been prolonged to implement mental health insurance. In April of this year, India passed the National Mental Health Act, which includes health insurance for people suffering from mental illnesses.
As part of the Ayushman Bharat initiative, which provides health insurance to 500 million people, the Mission also includes financial support for screening and treating mental health issues. A highlevel facility should be referred to those with mental illnesses. The facility can provide inpatient and outpatient services and counselling services to patients and their families, dispense medicines to psychiatric disorders, and send patients to addiction treatment programs. According to India’s Insurance Regulatory and Development Authority (IRDA), all insurance companies must provide policies to people with mental illnesses by Oct. 1, 2020. However, as of 2022, there are only a handful of private insurance companies covering mental health treatment, namely ICICI Lombard, HDFC Ergo, Aditya Birla Health Insurance Company, and Digital General Insurance. For private insurers, the situation is unclear. The Ayushman Bharat scheme of
the Government of India included the cost of inpatient and outpatient care for patients with mental illnesses. Private insurers have excluded outpatient care coverage, even though it is a significant part of treatment for mental illnesses. While the government and concerned agencies are working to develop the best solution to this problem, it is crucial to understand what the insurance holders think about a mental health insurance policy.
A survey titled “Perceived Need for Mental Health Insurance Policy in India” was conducted. This survey was designed for working-class people with full-time jobs as they are significant buyers of the health insurance policy. The gender division of the survey participants was 34.1% female and 65.9%, male. Professions of over 18 different fields participated in this survey. 61 % of the respondents were insured individually or under the family health insurance plan. 53.7% of them have directly purchased a health policy themselves, and 46.3% were planning to purchase an insurance policy soon. Apart from the standard criteria like return, premium amount, and claim coverage, the participants look for factors like disease covered, the network of the medical institution, and less documentation before purchasing the insurance. The majority, I.e., 87.8%, of participants believed that health insurance should cover the treatment of mental illness. When asked about the reason behind it, 47.2% believed that mental illness is as genuine and important as physical health, 22.22% people believed that now more than ever, more and more people have a mental illness. Around 11% of people believe that covering mental illness under health insurance will increase awareness about the issue; around a similar percentage of people believe that the treatment of mental illness is costly, so should be insured. Over 5% of survey takers believed that the COVID pandemic had a detrimental effect on people’s mental health. So, it should be included in the health insurance policy. Interestingly, 2.78% of survey
takers believe that the supreme court’s order to cover the cost of mental health treatment is a genuine reason to cover it under health insurance. Also, around 90% of survey takers accepted that they would be more willing to seek help for their mental health issues if their health insurance covered the treatment cost.
These data points show that despite having little awareness about mental health issues, most people believe that there is a need for a policy that covers the cost of these treatments. However, there are significant challenges to successfully achieving this vision. The mental health infrastructure in India needs substantial improvement. This area is still considered taboo, and a considerable amount
of work is needed to spread awareness about mental health. A policy inclusive of physical and mental health would help tackle multiple relevant issues. Firstly, it will increase awareness and acceptance of mental illness. Many Indians are yet to acknowledge mental illness as a problem; including it in a policy will validate mental health and increase its acceptance. Secondly, it will encourage people to seek treatment who were restricted due to financial factors. According to a report by NCBI, the average cost of treating a mental illness is around 30,000 INR. India’s per capita net national income is 1,25,000 INR. This means that the treatment cost is 24% of the yearly income. Covering the treatment cost will help reduce the significant burden. Lastly, it will help in the development of the economy. According to a WHO report, India will experience an estimated loss of 1.03 trillion USD between 2012 to 2030 due to mental health conditions. The preventive cost of illnesses will be much lower than the economic cost.
For the insurance companies, the survey results indicate that more than half of the potential and current customers believe that there is a need for a mental health insurance policy. By providing all-inclusive policies, the companies will attract more customers. Also, since physical and mental health is linked, there is a possibility that physical illnesses can be prevented or reduced in intensity by taking care of mental health. This may reduce the burden on the insurance companies. This is a long shot and needs further exploration. However, it is worth giving a benefit of the doubt. A mental health insurance policy is not a matter of debate but a need of the hour. This policy will, directly and indirectly, impact various segments of society and the economy. While it is encouraging that the government has mandated mental health treatment in health insurance, its adaptation and implementation is a work in progress.
