more-in Mumbai: Welcoming the government’s decision to extend medical insurance cover to the mentally ill, pyschiatrists said this was long overdue, and such patients suffer as much as those with other ailments. An order by the Insurance Regulatory and Development Authority (IRDA) after Parliament passed the Mental Healthcare Act, 2017, makes it mandatory for insurance companies to cover mental illnesses. While there is apprehension of a spurt in unnecessary hospitalisations, stakeholders are also waiting for clarity on mental illnesses that can be covered by insurance, and the technicalities involved. The city’s psychiatrists, who have been rooting for change for a long time, were excited by the development. Dr. Ajit Bhide, president, Indian Psychiatric Society and a Bengaluru-based practitioner, said, “We are all quite thrilled about the circular. So far, mental health was not covered by medical insurance, even though it leads to the same helplessness brought on by other diseases. There could be some discussion and fine-tuning, but on a whole, it is a great move.” While a majority of such patients are treated in outpatient departments (OPD) which may include medication and counselling, some may require hospitalisation. According to Dr. Bhide, nearly 15% of patients with mental illness require in-patient treatment. “Of these, 80% have severe mental illnesses, but the rest of them may still require hospitalisation.” ‘Will reduce stigma’ The IRDA circular, issued on August 16, says as per section 21 (4) of the Mental Healthcare Act, 2017, insurers shall make provision for medical insurance for treatment of mental illness on the same basis as physical illness. The order, to be implemented immediately, will help reduce stigma attached to mental illness, say experts. Dr. Bharat Vatwani, who was conferred with this year’s Ramon Magsaysay Award for his work with the homeless and mentally ill, said the IRDA directive is a positive step. He said, “Patients suffering from severe schizophrenia, bipolar disorder, severe depression with suicidal tendencies often need hospitalisation. On an average, hospitalisations are for a minimum 15 days, but many need much longer periods.” His 15-bed pyschiatric nursing home in Borivali, says Dr. Vatwani, is always 90% occupied. “For 15 days, the overall cost runs up to between ?60,000 and ?80,000.” Hospitalisation expenses are often too high for the patient’s family, and relatives either ignore his or her suffering or opt for measures like confinement or constant sedation.

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