Mental health insurance
The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuro-psychiatric disorder is much higher than diarrhea, malaria, worm infestations and tuberculosis if taken individually. Mental, neurological, and substance abuse (MNS) disorders account for an increasing proportion of the global burden of disease. The World Health Organization (WHO) attributes to these disorders 14% of all of the world’s premature deaths and years lived with disability.1 In addition to imposing high costs on the health system, mental and neurological disorders and substance abuse also lead to lost worker productivity, impaired functioning, personal stigma, caregiver burden on family members, and, in some instances, to human rights violations.
Ref: http://www.who.int/bulletin/volumes/89/3/10-082784/en/
According to the estimates DALYs loss due to mental disorders are expected to represent 15% of the global burden of diseases by 2020.
Ref: http://www.who.int/bulletin/volumes/89/3/10-082784/en/
According to the estimates DALYs loss due to mental disorders are expected to represent 15% of the global burden of diseases by 2020.
DALYs are calculated by taking the sum of these two components.
DALY = YLL + YLD
The DALY relies on acceptance that the most appropriate measure of the effects of chronic illness is time, both time lost due to premature death and time spent disabled by disease.
One DALY, therefore, is equal to one year of healthy life lost.
Citation: Disabled World News (2011-11-07) - Disability adjusted life year is a measure of overall disease burden expressed as the number of years lost due to ill-health disability or early death: http://www.disabled-world.com/definitions/daly.php#ixzz2Q7k41m2z
Mental, neurological, and substance abuse (MNS) disorders account for an increasing proportion of the global burden of disease. The World Health Organization (WHO) attributes to these disorders 14% of all of the world’s premature deaths and years lived with disability.1 In addition to imposing high costs on the health system, mental and neurological disorders and substance abuse also lead to lost worker productivity, impaired functioning, personal stigma, caregiver burden on family members, and, in some instances, to human rights violations.2–4
Although several cost-effective strategies reportedly reduce the disability associated with mental and neurological disorders and substance abuse,5–8 the fraction of those affected who receive appropriate treatment remains disturbingly low.9 This treatment gap appears especially wide in countries classified as low- or middle-income by The World Bank, where around 85% of the world’s population resides. In such countries, treatment rates for these disorders are suboptimal and range from 35% to 50%.
INDIA
During the last two decades, many epidemiological studies have been conducted in India, which show that the prevalence of major psychiatric disorder is about the same all over the world. The prevalence reported from these studies range from the population of 18 to 207 per 1000 with the median 65.4 per 1000 and at any given time, about 2 -3 % of the population, suffer from seriously, incapacitating mental disorders or epilepsy. Most of these patients live in rural areas remote from any modern mental health facilities. A large number of adult patients (10.4 - 53%) coming to the general OPD are diagnosed mentally ill. However, these patients are usually missed because either medical officer or general practitioner at the primary health care unit does not ask detailed mental health history. Due to the under-diagnosis of these patients, unnecessary investigations and treatments are offered which heavily cost to the health providers.
The Government of India has launched the National Mental Health Programme (NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it.
Aims
1. Prevention and treatment of mental and neurological disorders and their associated disabilities.
2. Use of mental health technology to improve general health services.
3. Application of mental health principles in total national development to improve quality of life.
2. Use of mental health technology to improve general health services.
3. Application of mental health principles in total national development to improve quality of life.
Objectives
1. To ensure availability and accessibility of minimum mental health care for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of population.
2. To encourage application of mental health knowledge in general health care and in social development.
3. To promote community participation in the mental health services development and to stimulate efforts towards self-help in the community.
2. To encourage application of mental health knowledge in general health care and in social development.
3. To promote community participation in the mental health services development and to stimulate efforts towards self-help in the community.
Strategies
1. Integration mental health with primary health care through the NMHP;
2. Provision of tertiary care institutions for treatment of mental disorders;
3. Eradicating stigmatisation of mentally ill patients and protecting their rights through regulatory institutions like the Central Mental Health Authority, and State Mental health Authority.
2. Provision of tertiary care institutions for treatment of mental disorders;
3. Eradicating stigmatisation of mentally ill patients and protecting their rights through regulatory institutions like the Central Mental Health Authority, and State Mental health Authority.
Mental Health care
1. The mental morbidity requires priority in mental health treatment
2. Primary health care at village and subcentre level
3. At Primary Health Centre level
4. At the District Hospital level
5. Mental Hospital and teaching Psychiatric Units
2. Primary health care at village and subcentre level
3. At Primary Health Centre level
4. At the District Hospital level
5. Mental Hospital and teaching Psychiatric Units
District Mental Health Programme
Components
1. Training programmes of all workers in the mental health team at the identified Nodal Institute in the State.
2. Public education in the mental health to increase awareness and reduce stigma.
3. For early detection and treatment, the OPD and indoor services are provided.
4. Providing valuable data and experience at the level of community to the state and Centre for future planning, improvement in service and research.
2. Public education in the mental health to increase awareness and reduce stigma.
3. For early detection and treatment, the OPD and indoor services are provided.
4. Providing valuable data and experience at the level of community to the state and Centre for future planning, improvement in service and research.
Agencies like World Bank and WHO have been contacted to support various components of the programme. Funds are provided by the Govt. of India to the state governments and the nodal institutes to meet the expenditure on staff, equipments, vehicles, medicine, stationary, contingencies, training, etc. for initial 5 years and thereafter they should manage themselves. Govt. of India has constituted central Mental Health Authority to oversee the implementation of the Mental Health Act 1986. It provides for creation of state Mental Health Authority also to carry out the said functions.
The National Human Rights Commission also monitors the conditions in the mental hospitals along with the government of India and the states are currently acting on the recommendation of the joint studies conducted to ensure quality in delivery of mental care.
Thrust areas for 10th Five Year Plan
1. District mental health programme in an enlarged and more effective form covering the entire country.
2. Streamlining/ modernisation of mental hospitals in order to modify their present custodial role.
3. Upgrading department of psychiatry in medical colleges and enhancing the psychiatry content of the medical curriculum at the undergraduate as well as postgraduate level.
4. Strengthening the Central and State Mental Health Authorities with a permanent secretariat. Appointment of medical officers at state headquarters in order to make their monitoring role more effective;
5. Research and training in the field of community mental health, substance abuse and child/ adolescent psychiatric clinics.
2. Streamlining/ modernisation of mental hospitals in order to modify their present custodial role.
3. Upgrading department of psychiatry in medical colleges and enhancing the psychiatry content of the medical curriculum at the undergraduate as well as postgraduate level.
4. Strengthening the Central and State Mental Health Authorities with a permanent secretariat. Appointment of medical officers at state headquarters in order to make their monitoring role more effective;
5. Research and training in the field of community mental health, substance abuse and child/ adolescent psychiatric clinics.
Comments
1. For the first time in the last 40 years mental health has been chosen as the theme for the World Health Day 2001: "Mental Health: Stop Exclusion - Date to Care", Why? The recent evidence for the importance of mental health has been so striking that the WHO decided to give it a priority during year 2001, the beginning of 21st century.
2. There is no initiative from the mental health professional to take active part in this programme. Most of them are not aware of the programme.
3. There is shortage of professional manpower and training programmes are not able to meet the demand in providing all medical private practitioners and medical officers.
4. Appropriate mental health can be provided at the sub centre and village level by minimum training of the health workers that will help in providing comprehensive health care at the most peripheral level.
5. The targets set for the programme are not achieved till today after lapse of more than one decade. This indicates that there is a poor commitment of the government, psychiatrists, and community at large.
6. The programme has given more emphasis on the curative services to the mental disorders and preventive measures are largely ignored. More public awareness programmes are required.
7. The medical care in the hospitals are custodial in nature and this needs to be changed to a therapeutic approach.
2. There is no initiative from the mental health professional to take active part in this programme. Most of them are not aware of the programme.
3. There is shortage of professional manpower and training programmes are not able to meet the demand in providing all medical private practitioners and medical officers.
4. Appropriate mental health can be provided at the sub centre and village level by minimum training of the health workers that will help in providing comprehensive health care at the most peripheral level.
5. The targets set for the programme are not achieved till today after lapse of more than one decade. This indicates that there is a poor commitment of the government, psychiatrists, and community at large.
6. The programme has given more emphasis on the curative services to the mental disorders and preventive measures are largely ignored. More public awareness programmes are required.
7. The medical care in the hospitals are custodial in nature and this needs to be changed to a therapeutic approach.
Some messages from Indian psychologists group
Hi All,
--- On Thu, 4/18/13, Shubha Thatte <thatteshubha@yahoo.com> wrote:
Hi All,
There are two types of group insurance we are talking about
1. Is for persons diagnosed with Mental Illness to be covered for other conditions... as is available to conditions under the National Trusts Acts which has been consistently and deliberately excluding persons with MI... ESP THE PARENTS LOBBY.- For this Sir i request you to get IRDA to write to the census commissioner as they have collected the data or you can use NSSO 58th round which is available on the Ministry of Statistic Website- link as below- you can buy it.. It will give mental illness data.
NSS 58th Round (July 2002 - December 2002)
Disability
| |||
485
|
Disabled Persons in India, July-December 2002
|
250rs
|
7080rs. for cd
|
2. Insuring the carers who do not have any specific illnesses to nominate their ill dependent.
Here you can assume for every patient there can be 1 carer who can get insured... so you can use the same number. The younger the carer, the better the premium. So if carers can be in the range of 30 -60 years and 100 of them an NGO can get a group insurance cover.
For both different types of data are required.
Census 2001 has revealed that over 21 million people in India as suffering from one or the other kind of disability. This is equivalent to 2.1% of the population. Among the total disabled in the country, 12.6 million are males and 9.3 million are females. Although the number of disabled is more in rural and urban areas. Such proportion of the disabled by sex in rural and urban areas. Such proportion has been reported between 57-58 percent for males and 42-43 percent females. The disability rate (number of disabled per 100,000 populations) for the country as whole works out to 2130. This is 2,369in the case of males and 1,874 in the case of females.
Among the five types of disabilities on which data has been collected, disability In seeing at 48.5% emerges as the top category. Others in sequence are: In movement (27.9%), Mental (10.3%), In speech (7.5%), and In hearing (5.8%). The disabled by sex follow a similar pattern except for that the proportion of disabled females is higher in the category In seeing and In hearing.
Across the country, the highest number of disabled has been reported from the state of Uttar Pradesh (3.6 million). Significant numbers of disabled have also been reported from the state like Bihar (1.9 million), West Bengal (1.8million), Tamil Nadu and Maharashtra (1.6 million each). Tamil Nadu is the only state, which has a higher number of disabled females than males. Among the states, Arunachal Pradesh has the highest proportion of disabled males (66.6%) and lowest proportion of female disabled.
TABLE 20 : NUMBER OF DISABLED POPULATION AND TYPE OF DISABILITY
Population
|
Percentage (%)
| |
| Total population |
1,028,610,328
|
100.0
|
| Total disabled population |
21,906,769
|
2.1
|
| Disability rate ( per lakh population) |
2,130
|
--
|
| Type of Disability | ||
| (a) In seeing |
10,634,881
|
1.0
|
| (b) In speech |
1,640,868
|
0.2
|
| (c) In hearing |
1,261,722
|
0.1
|
| (d) In movement |
6,105,477
|
0.6
|
| (e) Mental |
2,263,821
|
0.2
|
| Source : Census of India 2001. | ||
--- On Thu, 4/18/13, Shubha Thatte <thatteshubha@yahoo.com> wrote:
From: Shubha Thatte
Subject: Re: [IndianPsychologists] mental health insurance policy of India
To: "IndianPsychologists@yahoogroups.co.in"
Date: Thursday, April 18, 2013, 1:57 PMI think this kind of insurance ( policy holders i.e. patients get benefit after carers are no more ) will be very useful as carers will feel comfortable as their patients will get assured income. We have ( at our institute , Institute for Psychological Health , IPH , www.healthymind.org ) a very big group of caregivers who will be immensely relieved .Dr. Shubha Thatte ,IPH, Thane.
From: Nithya Poornima Santosh
To: IndianPsychologists@yahoogroups.co.in
Sent: Wednesday, April 17, 2013 2:12 PM
Subject: Re: [IndianPsychologists] mental health insurance policy of IndiaDear Mr. Roy,It might be useful to contact mental health professionals who have trained or worked abroad. In the U.S.A. for instance, mental health insurance has been in practice for several years. You may get a point of reference for mental health insurance coverage and policy holders.Best regards,NithyaNithya Poornima Ph.D.Sampurna Montfort College,Bangalore
Comments