Yesterday, the Supreme Court issued a notice to the Insurance Regulatory and Development Authority of India (IRDAI) seeking an explanation for the failure of insurance companies in India to provide coverage to mental healthcare.
The notice was based on a petition filed before the court by an advocate, Gaurav Kumar Bansal, who highlighted this failure on part of Indian insurance companies. India’s Mental Healthcare Act, 2017 states that “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.” In furtherance of the statute, in August 2018, the IRDAI had directed insurance companies to comply with the statute and make provisions for the coverage of mental healthcare under their respective insurance policies. The petitioner, Bansal, had also submitted an RTI application last year seeking specifics about the implementation of the law, but the IRDAI replied to him in February 2019 acknowledging that none of the insurance companies had complied with it thus far. In his present petition, Bansal has alleged that the situation hasn’t changed since.
Without health insurance to cover the costs, therapy continues to be a luxury for many Indians. “The session costs are pretty steep and one session is never enough. To go for prolonged sessions means dedicating both time and money. A good therapist charges an easy [Rs.] 1,500 to 2,000 a sessions. Once, twice, it’s okay. After a point, it pinches your pocket and only results in more stress. And since it’s still a taboo in the society… it’s not really easy to come out to your parents and ask for help,” a 25-year-old interviewed by The Swaddle in 2019, said. Moreover, the massive expenses lead people to pull out of mental healthcare the moment they start to feel a little better simply because they cannot afford to go ahead with the sessions.
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Alongside the steep expenditure, the stigma and lack of awareness around mental health in India also lead people to treat mental healthcare as an optional expense. But, it is hardly an optional expense given mental health in India is already in dire straits. A WHO report states that one in every 20 Indians suffers from depression, and nearly 15 percent of Indian adults need active intervention for one or more mental health issues. The National Mental Health Survey in India, published in 2016, had revealed that nearly 80 percent of people suffering from mental disorders had not sought treatment despite suffering for more than 12 months.
While 56 million people in India are suffering from depression, 38 million are suffering from anxiety disorders. And, mental distress is believed to be the key reason behind one student committing suicide every hour in India. In fact, according to the WHO, India leads the list of countries most affected by anxiety, schizophrenia and bipolar disorder. “India does not simply have a mental health challenge… it is facing a possible mental health epidemic,” President Ram Nath Kovind had said in 2017.
The coverage of mental healthcare under health insurance policies in India in the face of these alarming statistics is, undoubtedly, one of the best ways to address the issue of expenditure involved in private counselling. Also, extending insurance coverage to mental healthcare can not only be a step towards recognizing how important mental health is and normalizing therapy, but also addressing the stigma surrounding it in India that stands in the way of healthy discourse on the subject.
