– Pankti Galia
We all have come across the term ‘Mental Health’ during the COVID-19 pandemic but what exactly is Mental Health? Mental health includes emotional, psychological and social well-being which affects how we think, feel and act. According to WHO (2015), “It is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” Mental health awareness and mental healthcare aids individuals to openly talk about their mental illnesses and seek right kind of help. The individual may have to reach out to a psychiatrist, psychologist or even admit them to rehabilitation centers or hospital.
According to Mental Healthcare Act, 2017, the act is “to provide mental healthcare and services for persons with mental illness and to protect, promote and fulfil the rights of such persons during delivery of mental healthcare and services and for matters connected therewith or incidental thereto”. The Chapter V (Right to access mental healthcare) of the act mentions the following- “(1) Every person shall have right to access mental healthcare and treatment from mental health services run or funded by the appropriate Government; (2) The right to access mental healthcare and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically without any discrimination; (3) The appropriate Government shall make sufficient provision as may be necessary, for a range of services required by persons with mental illness” and so on.
The current situation of policies in India are related to only physical health and mental health conditions are not covered. After the implementation of Mental Healthcare Act, 2017, “mental and genetic disorder can’t be excluded from health insurance coverage”, says IRDAI as the insurers can no longer deny the coverage to those suffering from mental and genetic disorders. After this announcement and implementation, the insurers were selective in providing such covers to limited mental disorders. According to IRDAI, treatment of mental disorders, stress, neurodegenerative and psychological disorders which need hospitalization will have to be covered. According to 2017 reports, only 44% of 1.3 billion people in India have health insurance policy and low levels of education and economic cost of the care of a person with mental disorder per month out-of-pocket expenditure was INR 1000-1500, as a huge burden especially for those belonging to lower socioeconomic strata with disability, chronicity, severe mental disorders and relapses (Bijal et al., 2019).
In today’s scenario, in India there are limited insurance companies which cover limited mental health conditions in their policy plan. Such plan are not yet fully advocated yet, Indian citizens are still not aware of such policies and the policy plan are not provided in detail. Outpatient services, medical treatment, medications, therapy sessions, professional practitioner fees are not covered and high amount of ‘premium’ is to be paid. Some of the private companies like HDFC ERGO, ICICI Lombard Health Insurance, Max Bhupa Premia, Aditya Birla Captial, etc and public health insurance schemes like Biju SwasthyaKalyan Yojana of Odisha offers free or limited treatment, reimbursement and coverage of the mental health conditions. (Bijal et al., 2019; Singh, 2019). All such schemes and policy plans must include the cost of OPD treatment
Follow-up for mental disorders, good awareness and advocacy of the plans for better implementation of the act.
In a survey held, 48 responses (18 and above age group, residing in India)were taken regarding what community knows about mental health, how they perceive mental health situation in India and what are the community needs regarding mental health and its policies. The survey had 60.4% female and 39.6% males participants with various educational qualification. Participants were asked that are they aware of what mental health is, 79.2% said ‘yes’, 12.5% said ‘no’ and 8.3% said ‘maybe’. According to the survey reports, 93.8% think that mental health is as important as physical health, 89.6% think that mental health affects physical health and 77.1% of them or their family members suffer from diagnosed mental illness. When asked that are they aware of any mental health policy in India, most of them were not aware of any policy but 75% think that there should be mental health policy like physical health policy, 72.9% think that people not aware of such policies and 72.9% think that there is a need for mental health policy. Respondents were also asked for suggestion and 77.1% think that mental health and its policies requires improvement in coverage and awareness. According to the community need, the criteria which a mental health policy should include are coverage for therapies, medications, inpatient and outpatient treatment, psychological tests, therapists or psychologists fees, hospital charges, more inclusion of psychological disorders/ conditions like depression, pre and post hospitalization and its advertisement or awareness.
According to the current private and public plans and community needs, India needs proper, well-defined and well-detailed policy plan for all age groups without any discrimination on the basis of caste, creed, race, religion, sex and socio-economic strata. The Mental Health Policy Plan should cover various mental health conditions like- Schizophrenia, Depression, Anxiety disorder, Autism Spectrum, Attention Deficit Hyperactivity Disorder, Mood Disorders, IDD (Intellectual Developmental Disorder /Mental retardation), Personality disorders, Cerebral Palsy & Genetic disorders and Dementia.
It is seen that Indians invest their money in learning, stocks, physical health, etc but not on mental health where post COVID-19, mental health is given importance and our country must have policies for all communities in India without discrimination and proper advocacy.