Why Do Gaps Still Persist in Mental Health Coverage?

Limited access, stigma, low sub-limits, lack of OPD coverage still remain key challenges

- SURINDER BHAGAT

Mental health, long overlooked in India's healthcare discourse, is finally gaining attention. A major milestone was the Mental Healthcare Act (MHCA), 2017, which came into effect on 7 July 2018, replacing the outdated 1987 Act.

It redefined the rights of people with mental illnesses and made it mandatory for health insurance to cover mental health.

In individual policies, psychiatric ailments are covered by default as all policies must follow regulations. Yet, despite the law, a gap remains in practice. Many employees still hesitate to use mental health support at work due to fear of judgment.

Some insurers apply sub-limits depending on the plan, while others cover up to the full sum insured. Group policies, tailored to group needs, may offer flexibility but can be less comprehensive due to budget constraints.

Mental ailments typically begin around age 18, peaking at about 40—years that are often the most productive. In India, the incidence of common disorders like depression is about 2.7%, with a treatment gap close to 85%.

This shows a large disease burden and that few affected individuals seek or access quality care.