Not long ago, mental illnesses were looked down upon. It was considered widely unacceptable to have mental problems and people who did were labelled weak. Such beliefs could be a result of media normalising a constant state of happiness, the society placing a higher value on “having it all together” at all times and us being conditioned to look down on failure.
Suppressing emotions to be acceptable by society was seen as a solution by those suffering and in many cases this is still a common practice. With basic needs such as job security always under threat, and workplace stress being on the rise, instances of mental illness have increased.
With the increase in candidates and fewer jobs, people are willing to do more work for less pay. The increased pressure to stand out from the crowd has led to many cases of burnouts, panic attacks and nervous breakdowns at workplaces. According to NMHS, National Mental Health Survey, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) in 2016, approximately 150 million Indians need mental healthcare services. However, only 10-12 percent of them articulate their need for support.
Prominent public figures such as Deepika Padukone and Ellen Degeneres have started spreading awareness about depression and mental health by sharing their personal experiences on public forums. Such acts have had some effect on the mental health conversation, slowly increasing the openness to take part in such conversations. As a result, mental health is starting to be taken a bit more seriously now.
Corporate giants and even smaller startups have realised the link between a sound mind and the quality of work. This has led them to invest in the mental health of their employees. One of the reasons for this shift is workplace stress, one of the biggest concerns for employers. Countless measures such as compulsory leaves, paid vacations, workshops, art therapy etc. have been taken to battle workplace stress.
Although a step in the right direction, they haven’t completely eliminated the onslaught of poor mental health. Those suffering often need professional help. But like general healthcare, mental care is also quite expensive. The high costs of good mental healthcare facilities started a debate as to whether mental illnesses should be covered in health insurance. In May 2018, the speculations ended as the IRDAI (Insurance Regulatory and Development Authority of India) bringing mental health within the scope of health insurance with the Mental Health Care Act, 2017.
The Act, stated that every insurer offering health insurance products should cater to policyholders with mental illnesses the same way they cater to physical illnesses or injuries. The IRDAI further released a circular on 16th August 2018 stating that insurance companies will have to make provisions to insure mental illness, according to the rules laid down by the Mental Healthcare Act, 2017. According to Section 21(4) of the Act, every insurer needs to make provisions for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.
The circular also stated that insurers will need to comply with these provisions with immediate effect. However, the underwriting norms of the health insurance companies will play an important role at the ground level implementation of the Act. Another important factor is to know what one is insured for. Typical insurance policies cover in-patient hospitalisation and not out-patient treatment. This means that the policy will cover you only if you are hospitalised on account of mental illness. But the number or mental illness cases requiring hospitalisation are very few in number. Most cases require out-patient consultation. This is not the only shortfall. Experts have suggested that insurance companies could also carve out other coverage exclusions for mental health, like they typically have for treatments related to obesity, AIDS and fertility related treatments, among several others. There might be effects on pricing as well.
Insurance experts are of the opinion that these factors indicative of the fact that out-patient insurance coverage in India is underdeveloped. The policies that cover OPD are few and the coverage is not high.
The Mental Health Care Act is definitely a step forward in shedding light on something that should have been recognised years ago. There is no doubt it’s the right one too. Mental health is as important as one’s physical wellbeing and to a large extent can safeguard it as well. Thus, it should rightly be covered by health insurance providers. Mental health is crucial to an individual, their family as well as their workplace. Mental health and productivity go hand in hand.
The world behavioural healthcare market is expected to hit $240 billion by 2026. There have also been significant advancements in technology with the development of ’emotionally intelligent’ AI bots for mental wellbeing support. Traditional forms of therapy have undergone change with counselling being made available to people online in the comfort of their homes. As a result, quality mental healthcare is slowly becoming more accessible at affordable prices.
These developments have taken place in a short time. With an increase in research and allocation of resources, several innovations are in-store. Just as physical wellbeing is critical, everyone deserves mental wellbeing too.
A lot is being done to support and encourage people on social media. However, there’s only so much these well-intended campaigns can achieve. As a society, we have an active role to play. Sympathy needs to make way for empathy. We must look out for and help people in our immediate social and professional circles. With a more collaborative approach between science and humanity, we can address mental illnesses in ways that are more accepting, thoughtful, accessible and affordable, making the world a better place in the long run.