The Insurance Regulatory and Development Authority (IRDA) has issued a welcome directive to health insurers to include mental illness in medical insurance policies. The order is with immediate effect and insurance companies have to make provisions to cover a whole range of mental disorders. The notification is in accordance with the rules laid down under the Mental Healthcare Act, 2017. The order has made it clear that the treatment of mental illnesses has to be on the same basis as that of physical illnesses. The World Health Organisation has, in its latest World Mental Health Atlas, pointed out the need for more effective mental health policy-making and planning in most countries. The IRDA’s decision will address an important aspect of that need by meeting the cost of treatment of mental illness in accordance with actuarial norms. The decision also takes India into the group of countries which provide for mental health insurance for citizens.
Insurance companies have till now refused to insure mental diseases and the exclusion has aggravated the injustice meted out to those who suffer from them. There have always been stigmas and taboos associated with mental disorders. There is a reluctance to acknowledge mental disorders as medical conditions that need treatment. The possibility of insurance may now help to show that it is like a physical ailment and can be treated. Mental illnesses are of various kinds. Insurers will have to make changes in their various policies to include mental illness or come out with specific products. The terms and conditions of the policies should be framed in such a way as to include all those who need coverage. Most health policies now do not cover out-patient (OPD) consultation, medication and treatment. But the treatment of most people with mental conditions consists of out-patient consultation, counselling and medication, and these need to be covered by policies. The majority of patients will not benefit if the policy covers only hospitalisation expenses.
According to the National Mental Health Survey of 2016, about 15 crore Indians suffer from some form of mental illness. Only a small number get treated and the cost of treatment is high for most people. The infrastructure for treatment and the numbers of qualified medical personnel are also inadequate in India. These need to be scaled up if the people are to benefit from insurance. The WHO says investment in treatment of common mental ailments will bring in four times return to the society in the form of better health and productivity. The insurance plan should be designed and implemented in such a way as to benefit the maximum number of people.