KENYA – Aga Khan’s University’s Brain and Mind Institute (BMI), in partnership with the Mental Health Alliance of Kenya (MHAK) hosted a consultative forum with stakeholders on how to improve efficiency in the insurance sector concerning mental health.
The stakeholders included insurance companies, regulators, policyholders, private sector, academia, government and non-profit organizations.
The forum was meant to promote the efficiency and effectiveness of claim resolutions for users of psychiatric services and to review the state of insurance regarding mental health services in Kenya.
The stakeholders also explored avenues to bridge the gap between policy and practice and carry out comparative best practices studies.
“Mental health is a human right, and people living with mental illness should not be subjected to unnecessary barriers to access to care,” said Prof Zul Merali, BMI Founding Director.
While the newly signed Mental Health (Amendment) Bill states that “a person with mental illness shall have the right of access to medical insurance for the treatment from public or private health insurance providers.” It is clear that there is a divide between practice and policy.
“It is an offence to discriminate against people with mental illnesses, and the law is clear. Moreover, mental health is an essential package in the Universal Health Coverage. Still, there needs to be proper pricing for mental illnesses,” said Dr Nasri Omar, Ministry of Health, Mental Health System and Policy Lead.
Kenya has made steady progress in providing mental health services to its population, but some areas require more work.
Access to quality insurance for people with certain mental illnesses is still challenging. Many insurance policies do not cover pre-existing conditions except after a year.
For example, some private insurance schemes do not cover neurodevelopmental disorders for individual cover holders.
Additionally, all insurance providers have clauses that expressly exclude suicide victims or attempted suicide survivors from insurance claims or coverage.
The socioeconomic progress of people with mental illnesses is impacted, and this happens because of decreased productivity, strained relationships, and cycles of disadvantage and poverty.
The health, quality of life, and life expectancy of people with mental health disorders can all be improved by investments in mental health, which can also lessen suffering.
“Treating mental illness has an actual return to the economy. Therefore, we should look at mental health coverage as an investment rather than an expenditure,” said Prof Lukoye Atwoli, BMI Associate Director and Dean, Medical College, East Africa Aga Khan University.
Insurance covers which limit mental health conditions include ordinary life, which has no coverage or extension; group life which charges a higher premium; medical, which gives a lower benefit; and group personal accident with the potential of denial of claim and sub-limits.
“We need to explore other options for ensuring coverage for mental health. For example, insurance companies can start by testing out excluded mental health coverage and using generated data after a while to make a clearer decision,” Prof Zul Merali.
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