Lack of insurance causing mental health to deteriorate, UAE doctors say

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Dubai - Relatively high costs of treatment deterring patients from seeking medical help.

Published: Sat 31 Jul 2021, 3:03 PM

By
Suneeti Ahuja Kohli

Treating mental health issues is just as important as physical health. Yet, one of the first things people usually think about when it comes to therapy is how much it costs, whether such ‘unconventional’ medical expenses are covered under insurance or is it an out-of-pocket expense.

The relatively high costs for therapy and prolonged sessions in some cases have deterred many from seeking medical help they need.

Cynthia B. is one among them. The 36-year-old mother of two school going boys in Dubai was struggling with mental health issues, but was unable to seek treatment because of no psychiatric coverage under her insurance.

“I was unable to cope with simple challenges like an added responsibility at work, online classes for my kids. My routine had gone haywire, and I was having difficulty keeping my mood upbeat. This year, I decided to call it quits and spend time with family at home to see if this might help. I was having a meltdown.”

Common mental health issues for which patients seek medical help include anxiety disorder, panic disorder, insomnia, depression, obsessive compulsive disorder (OCD), stress-related issues, marital problems, family dynamics issues, gadget addiction, and attention-deficit hyperactivity disorder (ADHD).

“A good number of these conditions are covered under insurance, if the policy covers for psychiatry (roughly 30 per cent policies provide coverage for mental health issues and that too with a very high premium),” said Dr Shaju George, Specialist Psychiatrist, Dubai Community Health Centre, Dubai.

Changes announced by Dubai Health Authority

On July 7 this year, the Dubai Health Authority (DHA) announced a remarkable measure stating mental health and psychiatry benefits will be included in the Essential Benefit Plan (basic plan with minimum mandatory health benefits only for low salary band individuals). There is an annual limit of Dh10,000 per annum with a 20 per cent co-pay.

"This will come in effect within two months of the circular date and will be a game changer for the utilisation of mental health services in the region,” said Dr Katrina Hassan, Chief Medical Officer, Trudoc24x7.

The EBP provided by DHA starts at Dh560 per annum. The Thiqa free healthcare programme by the Abu Dhabi government has been offering mental health coverage for a few years now.

“All the insurance companies like Axa Insurance, RAK National Insurance Company, ADNIC and Union Insurance, which have partnered with the DHA and provide EBP will have mental health cover as well,” said Shiv Gupta, Co-Founder, MyMoneySouq, a financial product marketplace in the UAE.

While the inclusion of mental health and psychiatry benefits in a basic plan is commendable, the premiums in case of other plans are still high, which deters people from seeking the help they need.

Why mental health issues should not be ignored?

Mental health issues can affect all of us at any time – regardless of age, gender or social status. Common conditions as recorded by the National Institute for Health and Care Excellence can include depression, anxiety, panic, obsessive compulsive disorder and post-traumatic stress disorder (PTSD).

“During the last 12-18 months, and as a direct result of the pandemic, we have experienced an increase in patients seeking help and support for depression, anxiety, PTSD and relationship issues, as many struggle to cope with huge uncertainty about the future,” said Tanya Dharamshi, Clinical Director and Counselling Psychologist at Priory Wellbeing Centre.

“Any time there is an adjustment to our usual situation, emotions such as anxiousness, sadness, impulsivity, feelings of sadness and hopelessness and depression can surface. The current pandemic is an extreme case in point. It may cause a resurgence of depressive and anxious symptoms in existing patients, in addition to an increase in new referrals — many of whom have never experienced such symptoms before.”

According to Dharamshi, “The key to remember is, if left untreated, our mental health invariably worsens and can have a long-term negative impact. Fortunately, both depression and anxiety are treatable and respond well to treatment, particularly if initiated early.”

Mental health in the UAE

The number of people requiring psychiatric help is on the rise. It can be attributed to the direct and indirect effects of the pandemic and the increase in the awareness of the people regarding mental health.

"There has been an exponential rise in people with anxiety disorder including panic disorder, depression and people presenting with unexplained medical symptoms and insomnia. Many patients who were on existent treatment for psychotic illness or mood disorders too have experienced flare ups due to the current stressful scenario." said Dr Arun Kumar K, Specialist Psychiatrist, Aster Clinic, Bur Dubai & Aster Hospital, Qusais.

Last year, academics from the University of Sharjah, Zayed University and the United Arab Emirates University conducted a wide-ranging study on the psychological impact of Covid-19 on the resident population. The results, published in March this year, were an eye-opener. Of the 4,426 people surveyed on various social media platforms, more than a third felt their mental health had deteriorated during the pandemic. About 36 per cent reported increased stress due to work, home or financial matters. This necessitates medical help and people, therefore, have been hunting for medical covers for such costs.

The demand for medical policies covering mental health issues have increased during the pandemic.

“Statistical medical data shows depression and mental-related issues are the second-most diagnosed medical conditions in 2021 and expected to be first most common diagnosis by 2023. TruDoc offers stand-alone virtual mental health benefits which were included as riders on quite a few basic and enhanced plans over the last year and a half since the pandemic outburst,” says Dr Hassan.

High premium, low coverage, travel restrictions deter patients from seeking treatment

“Mental health is as important as physical health,” said Dr Gupta.

“Though people are realising the importance of mental health, the consultation fee and recurring counselling fee, which is expensive is keeping them away from help. Once these are made available on the health insurance cover for free or less expensive fee, individuals opting for such benefits will be huge.”

“Earlier, mental health treatment was under exclusion at these insurance providers and available only to the individuals who opted for it by paying extra. But now it will be offered on the DHA EBP itself,” he added.

According to medical professionals, a large number of patients continue to pay from their own pocket.

“Most of the insurance companies do not cover psychiatric conditions. A handful of them cover or provide reimbursement,” says Dr Naresh Kumar Dhar, Psychiatrist, Prime Medical Center Jumeriah.

“Based on the clinic experience less than a third of the outpatient visitors have their consultation covered by insurance and others have to pay in cash,” says Dr Arun Kumar K, Specialist Psychiatrist, Aster Clinic, Bur Dubai & Aster Hospital, Qusais.

“Considering the expenses of medication and regular follow-up visits, many patients are not able to keep up with the treatment plan leading to incomplete remission and relapse of illness.

“Earlier many patients had the option of getting treated in their hometowns, but recent travel restrictions have blocked that option too. Many prefer to live with their problems due to financial constraints. Some clinics cater to the needy by offering discounts in the fees and having free follow-up visits, but a true relief would be when there is insurance coverage.”

—suneeti@khaleejtimes.com