Monday, August 31, 2009

Dare to Care: Stop the Exclusions!

Some insurance companies are making health policies in Kenya which exclude treatment for mental illnesses. As if to demonstrate further ignorance in this area, they are even naming suicide attempts (often a sign of severe mental illness and distress) as exclusions.
I have seen policies that specifically exclude depression, 'psychological problems', suicide attempts, alcohol related problems and other mental disorders from their cover.
Many Kenyans accept these exclusions
1) due to ignorance and
2) due to a stigma that presupposes that mental illness only affects the 'other' person, so the exclusion is not important.

For the second group, I have news for you: Mental illness is more common than you think! About 1% of most populations suffer from a serious mental disorder called schizophrenia. Twice that number suffer from Bipolar Disorder, another severe mental disorder. Studies have shown that upto 25% of the population have suffered an episode of depression in their lifetime.
Indeed, in Kenya, upto 50% (yes, half, or one in two!) of patients seeking health services in a general setting (casualty, outpatient, private clinics, etc) suffer from depression, ranging from mild to severe.
What this means is that a large proportion of the population is at risk of developing one mental illness or another, and therefore insurance coverage will come in handy for their treatment.
It is for this reason that the Mental Health Act, Cap 248 of the Laws of Kenya, specifically provides for insurance cover for persons with mental disorders.
Which brings me to the first group above. To address their ignorance, I attach below (In quotes) the full text of s46 of the Mental Health Act (1989):

"46. Insurance for treatment of persons suffering from mental disorder.

46. (1) Every person in Kenya shall, be entitled, if he wishes, to insurance providing for his treatment as a person suffering from mental disorder and no insurance company shall make any insurance policy providing insurance against sickness, which excludes or restricts the treatment of persons suffering from mental disorder
(2) An insurance company which makes any insurance policy which expressly excludes or
puts restrictions on the treatment of any person suffering from mental disorder shall be guilty of an offence."

Please be informed, and insist on your right of coverage for mental disorder. Indeed, even if a company has an explicit exclusion for mental disorders, the exclusions are illegal, non-binding, and may attract prosecution!
For representatives of insurance companies, all I can say is : Dare to Care! Stop the Exclusions!

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