Introduction:
Mental Health is one such discrete domain that stands at an unequal footing from the mundane physical illness. The above statement is in accordance with the substantially growing and highly competitive society. According to WHO, Mental health is a requisite of wellness by which an individual can deal with the strain that life has to offer and can work through it efficiently making notable grants to society. Mental health has a significant impact on our emotional, social and psychological well-being. It modifies the way we perceive the world, alters our notions and develops every sector of human life.
Grave disruption in mental health gives birth to mental illness that includes a varied number of health conditions but precisely all of them interrupts the mood, behaviour and thinking ability of an individual. Symptoms of the same include depression, inability to deal with one’s problems, self-destruction, paranoia and the list goes on.
Mental Illness a Part of Insurance?
The cost of dealing with an illness can cause a serious financial threat to the lifelong savings of an individual so to safeguard an individual from such budgetary constraints, health insurance policies were shaped. During the period of insurance, the policyholder or insured if gets struck by some critical ailment or meets with an accident, the expenses sustained for the remedy is endured by the insurer itself.
Mental health as mentioned above, cannot be detached from the gravity of health perceived by people. For the purpose of making mental healthcare remedies accessible to all and upon the ratification of the Mental Healthcare Act 2017, The Insurance Regulatory and Directive Authority (IDRA) by virtue of the circular dated August 16, 2018, promulgated that mental illness is to be incorporated under the ambit of circumstances where health insurance scheme is required[1]. IDRA instructed the insurance corporations to place mental illness on the same pedestal as any physical ailment for the equitable functioning of society and to bring mental health under the purview of health insurance policies. According to the Mental Healthcare Act 2017, any person facing difficulty having a stable mood, unable to perceive things as a prudent human and having forgetful memory will satisfy the essentials of mental illness.
History
Previously, people used to regard mental illness as a personality disorder and as a sign of inferiority. [2]People with such predicament were not deemed to be dignified citizens of the society and were treated with contempt. From previously dodging this utmost serious issue to eventually beginning to talk about it and specifically amending the antiquated legislation and provisions in favour of the same, we have certainly evolved from this unjust thought. This revolution happened due to education and raising awareness among people regarding mental health and its prominence, making consistent attempts to convince people that Mental Health should not be Taboo.
Laws and Acts Concerned
United Nation Conventions On Rights Of People With Disabilities[3]
Article 1 of the Convention aims to secure, facilitate and guarantee the benefit of all the fundamental rights and duties to people similarly circumstanced with disability so that they live a dignified life. The convention assures the rights to people who have chronic physical, mental, sensory ad intellectual disablement that could otherwise deprive them of their significant involvement in society.
The convention establishes the fact that people with such complications are looked down upon and their right to live a dignified life, to be equitably treated and all such rights stand hindered just because of the variance in attitude that they possess, a cause which is beyond their control.
Article 8 of the Convention puts forth the altered social sphere by adopting a method to spread awareness regarding mental health among considerate countries to break the stereotypical ad cliché mentality of people.
Article 2 puts forth ‘Reasonable Moderation’, basically an adjustment made for the person with a disability without any inappropriate burden or influence so that person can get benefitted from that right on a rational basis.
Article 5 emphasizes equality and measures that can be adopted for such people so that that they stand on an equal footing with the general citizens.
Article 7 specifically secures the right of disabled children so that they enjoy all human rights and freedoms on a rational basis with other children.
The Mental Healthcare Act, 2017[4]
It is an act that was put into force for safeguarding the rights of the people crippled with mental illness and it attempts to provide basic healthcare facilities to such people. It recognizes the right to equality and prohibits discrimination on grounds of mental illness. Section 21(4) of this act states that “Every insurer shall alter their provisions for medical insurance as to put mental illness on the same domain as any physical ailment.” [5]Following are some of the provisions of the mentioned act:
- Every person shall have a right to access mental healthcare and treatment from health organizations run or supported by the Government.
- Mental health services of reasonable cost, of good quality, available in proper amounts, should be obtainable without discrimination on grounds of caste, creed, religion, race etc.
- Provision was put forth for mental health services to endorse the family of the person with mental illness or home-based restoration.
- Provision for mental health both for child and an aged person was put forward
- Aimed to provide treatment in a manner, which encourages such an individual with a disability to reside in the society with dignity.
- To ensure that the basic healthcare facilities financed by the government should be available to each marginal district.
Insurance Regulatory Directive Authority[6]
The Hon’ble Supreme Court promulgated notice to the government and Insurance Regulatory and Development Authority (IRDA), on account of an appeal seeking guidelines to all insurance corporations to provide compensation for mental illness as provided for any physical ailment upon the issuance of The Mental Healthcare Act. The appellant argued that the directions of The Mental Healthcare Act, 2017 have not been applied to the directives of the insurance companies and the same is unjust and wrongful because it places the mentally crippled patients in a separate domain from people who are physically injured.
Section 21(4) of the Mental Healthcare Act specifically states, “Every insurer shall alter their provision for medical insurance for treatment of mental illness on an equitable sphere with a physical ailment.”
The petitioner’s claim succeeded and IRDA issued a notice dated August 2018 instructing insurance companies to obey the directives of The Mental Healthcare Act, 2017.
International Perspective and Survey[7]
World Mental Health Survey Initiative measures the different types of mental health issues and disorders and assess their societal costs, these are community surveys carried out in 28 developed and developing countries and notify its mental health policymakers of those countries to identify challenges and the unmet mental needs of their populace.
The WMH Survey Consortium includes nationally or regionally representative surveys in 29 countries, representing all regions of the world, and with a total eventual sample size of more than 160,000.
WHO guidelines on Mental Health[8]
- Special emphasis on adolescents having an increased risk of mental disorders such as indulgence in self-harm due to exposure to adversity.
- Youngsters often face complex societal, environmental, and economical issues like changing family dynamics, employment instability, forced displacement. Youngsters from minority and migrant communities are affected disproportionately by mental health conditions.
- Adolescent girls are twice as likely as adolescent boys to be affected by common mental disorders.
- Sociocultural factors, such as lower education levels, poverty, exposure to domestic violence and abuse and low decision-making power tend to increase the risk of depression in girls and women.
- Mental health is a major issue for adolescents: up to half of all mental health conditions start before the age of 14. Poor mental health is the leading cause of disability in young people and accounts for a large proportion of the global disease burden during adolescence.
Case Brief: Shikha Nischal V. National Insurance Company Limited[9]
Facts:
The Appellant who was a regular customer at Nation Insurance Company limited frequently obtained health insurance policies from it. In May 29th2020, the appellant procured a policy that secured him Rs. 3, 95000. This policy was valid for a year. The very next month after securing the policy, the appellant was diagnosed with Schizoaffective Disorder and was admitted to the hospital for a month. The appellant when applied for remuneration from the insurance company for the expense incurred, payment for which was guaranteed by the insurance company relying on clause 1.1 of their mentioned policy, they refused to compensate the appellant stating that the said illness was not cited in their policy and was excluded from the list of complications for which reimbursement was expected. The appellant then contacted Insurance Ombudsman, depending upon The Mental Healthcare Act, 2017 but it was rejected on grounds that the clauses of the Insurance company are to be relied upon and not the Mental Healthcare Act,2017
Judgement:
The High Court of Delhi held that the insurance corporations cannot exclude mental illness from the domain of disease because it is equivalently significant to any physical ailment. The physical ailment is generally visible to a person whereas mental illness is not and can be even more devastating.
The High Court further instructed the IDRAI to ensure that the directives of The Mental Healthcare Act, 2017 are abided by the insurance corporation and the people diagnosed with such diseases get compensated by the altered provisions of the insurance corporation.
So The Court of appeal concluded by determining that National Insurance Company Limited and all other insurance companies should bring mental illness under the ambit of the insurance coverage under Section 21(4) of The Mental Healthcare act, 2017.
Conclusion and Self Analysis
Mental health is a facet of health that is extremely important and uncompromising. This cannot be discriminated against from the physical ailment because each of them has an equal weightage. Mental health plays a vital role in coping with any physical illness while prolonged physical illness may lead to the development of mental trauma which may lead to severe sickness.
So both physical and mental health is crucial for a sustainable life.
Covid 19 has also disrupted the mental health of people to a massive extent apart from sabotaging their physical health. From school students to homemakers, from workers to industrialists, all age groups regardless of the profession were affected and were equally vulnerable in this context. Several mental health campaigns were publicized on various social media platforms to spread awareness and the prominence it carries. We are significantly evolving from the stereotypical mentality of people avoiding the issue of mental health and mental illness and regarding it as an undignified personality trait. Also, the Inclusion of The Mental Healthcare Act, 2017 and changes made in IDRAI states that we are certainly moving ahead.
References:
[1] SS. Rana and Company https://ssrana.in/articles/mental-illness-insurance-policies/
[2]All you need to know about Mental Illness Coverage by Reliance Health Insurance https://www.reliancegeneral.co.in/Insurance/Knowledge-Center/Insurance-Reads/All-you-need-to-know-about-Mental-Illness-Coverage-by-Health-Insurance.aspx
[3] UN Convention on rights of people with Disabilities, By Professor Emeritus Ron McCallum AO Chair Professor Emeritus Ron McCallum AO Chair
[4] The Mental Healthcare Act,2017, The Gazette Of India REGISTERED NO. DL—(N)04/0007/2003—17 APRIL, 7, 2017/CHAITRA 17, 1939 (SAKA)
[5] Section 21(4) of The Mental Healthcare Act, 2017
[6] Mint , updated on June 16, 2020 https://www.livemint.com/news/india/sc-notice-to-centre-irda-on-plea-to-extend-insurance-for-mental-illness-11592291880958.html
[7] https://www.hcp.med.harvard.edu/wmh/participating_collaborators.php Regional Coordinator : Sergio Aguilar-Gaxiola, MD, PhD Centre for Reducing Health Disparities University of California, Davis
[8] World Health Organization https://www.who.int/health-topics/mental-healthtab=tab_1
[9] W.P.(C) 3190/2021
Other Sources:
https://www.psychiatry.org/patients-families/what-is-mental-illness
https://www.medicalnewstoday.com/articles/154543#definition
https://ssrana.in/articles/mental-illness-insurance-policies/
https://www.godigit.com/health-insurance/what-is-health-insurance
120818093927291_2012_08+The+UN+Convention+on+Rights+of+Persons+with+Disabilities_ENG.pdf
https://www.who.int/health-topics/mental-health#tab=tab_1
https://www.hcp.med.harvard.edu/wmh/participating_collaborators.php
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