Mental health crisis: Can Indians afford the price of getting help?
Source: Business Standard
One in every five individuals worldwide experiences symptoms of mental health illness, according to the World Health Organization (WHO). In India, between 60 to 70 million people are estimated to suffer from common and severe mental health disorders. Addressing these issues faces numerous challenges, with financial barriers being one of the biggest obstacles.
“While the average may range between Rs 1,000-4,000 for an hour session of therapy or consultation, it could be much higher given the level of care required,” said Garima Nagpal, a Mumbai-based emotional wellness consultant. “Psychiatrist consultations tend to cost more due to their specialised knowledge of altering the brain’s biology,” she added.
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The financial impact of therapy on individuals
Nagpal pointed at the stark contrast in therapy fees, noting that some professionals in Mumbai charge as much as Rs 7,000 for a 50-minute session. “The cost depends not only on a therapist’s professional experience but also on their lived experience, which plays a crucial role in influencing the lives of others,” she explained.
State of mental health insurance in India
In 2019, the Insurance Regulatory and Development Authority of India (Irdai) made it mandatory for insurance providers to include mental health coverage in their policies. However, the gap between this legal requirement and the actual insurance coverage provided remains wide.
“Despite the legal mandate for mental health parity, the coverage in India is still limited,” said Jasmine Damkewala, senior partner at Circle of Counsels and advocate-on-record at the Supreme Court of India. She added that most insurance plans still do not fully cover outpatient mental health services, focusing instead on inpatient care.
A recent whitepaper by Marsh McLennan India revealed some key findings about the state of mental health insurance in India:
* 43% of organisations do not offer mental health benefits in their group insurance plans.
* Claims utilisation for mental health remains below 1% in India, indicating dissatisfaction.
* There is a lack of specialised mental health hospitals and rehabilitation centres.
* Many group insurance plans exclude treatments for substance abuse, self-harm, or suicide.
Many companies offer Employee Assistance Programs (EAPs) or wellbeing initiatives to support mental health. However, these services often go underutilised due to a lack of awareness or stigma. , “A well-rounded insurance plan can help manage business risks and improve employee wellbeing,” Sanjay Kedia, CEO of Marsh McLennan said.
Nagpal also pointed out that “stress isn’t a mental health issue; it’s a response to one’s environment.” She underlined the importance of understanding individuals in the context of their life experiences rather than seeing them in isolation.
Mental health insurance is available, but it often comes with several riders.
According to Policybazaar, some common exclusions in mental health coverage are:
* Waiting periods of 1-2 years before claims for mental health treatments are accepted.
* Caps on the number of therapy sessions, often limited to 10-15 per year.
* Delayed coverage for pre-existing mental health conditions.
“Most health insurance plans offer some level of support for therapy, but they usually impose a limit on the number of covered sessions, which might not fully offset the cost of long-term treatment,” said Siddharth Singhal, Head of Health Insurance at Policybazaar.
Legal rights under the Mental Healthcare Act, 2017
Damkewala explained that the Mental Healthcare Act, 2017, provides specific rights to policyholders, including:
* Coverage for mental health treatment on par with physical health.
* Protection against discrimination based on mental illness.
* Confidentiality of mental health treatment records.
* Right to appeal claim rejections.
Comparison with mental health coverage in the US
“While therapy costs in the US can range from $90 to $180 (Rs 7,555 to Rs 15,000) per session, some clinicians offer sliding scale fees based on income. Public insurance often provides mental health coverage but may offer lower rates than private insurance,” Prarthana Khullar, a therapist based in Connecticut, USA, said.
Khullar also pointed out disparities in accessibility across the US, with rural areas having fewer clinicians and lower-income neighbourhoods facing limited mental health resources.
“In lower-income neighbourhoods, mental health services might be severely limited compared to wealthier areas,” she added.
This indicates that the lack of support for mental health is not just an Indian problem.
Demand for mental health coverage is increasing
“There’s a growing awareness of mental health, and younger individuals are increasingly seeking insurance policies that cover mental wellness,” Amit Bhandari, Chief Technical Officer at Magma HDI said.
Singhal added, “Mental health is gaining recognition, and comprehensive health insurance plans in India now cover conditions like anxiety, depression, and PTSD.”
Leading insurers in India, such as ICICI, Niva Bupa, and Star Health, offer outpatient mental health services, including therapy and tele-consultations.
Different types of mental health issues
Common mental health issues include:
Anxiety disorders
Depression
Bipolar disorder
Post-traumatic stress disorder (PTSD)
Schizophrenia
Eating disorders
Disruptive behaviour disorders
Neurodevelopmental disorders
