Mental Health - Not so much the resources but the funding

Since Covid hit we have seen a marked incraes in people's awareness of mental health and the distinct lack of support we have in the general community.

As an adviser, mental health comes up in discussion on a regular basis. Be it working through an existing application, discussing the terms of cover an insurance company has offered or dealing with a claim.

This prompted me to have a closer look at what services are available and what funding and financial support for mental health exists for you, if you need it.

I'm not going to go to detail about what these services do, there is plenty of information on their web sites if you need it.

• Your first point of call is likely to be your GP or public hospital
  • They will assess and probably give you a script for medication, likely anti-depressants but they may start with sedatives to help you sleep too.
  • They will probably recommend counselling and then manage your situation from there.
  • Clinically if you have medical concerns or questions you should talk to you GP or a suitable health professional
• If you are in a bad enough state, your GP may refer you to your local hospital for more direct intervention and if you’re already there, they will do what they do as you’re already there.
• There are a number of phone-based services that assist with mental health and specific situations too.
• Hospice will also help with grief counselling. More on Hospice here 
• The Mental Health Foundation, more on them here 

Where do the costs come in?

If you are starting with your GP then there will be the cost of the visits and the prescription charges for the medicines they prescribe.

It is likely you will be referred for things like a CT and MRI to rule out anything sinister that may be contributing to your situation. This will probably involve a neurologist too. If you wait for the public system then this could take a while, if you go private, there are costs for this.

Admission to a hospital tends to be a dramatic approach. Usually a public hospital and this is publicly funded, so no extra costs here. Though there are private options that would have costs associated. If this is happening there is something significant going on, there will be financial impact elsewhere in your household too.

That’s the catching you and stabilising you, but it does not solve the underlying problems. This is where counselling usually comes in, and most of your out of pocket treatment expenses.

Where can you get funding for your treatment?

Starting with your GP and prescription costs, it is possible to insure for these, though we find unless you are a high user, it is more expensive to insure at this level than it is to just pay your way.

If you are dealing with a grief situation then Hospice is an organisation you can talk to. Hospice is a volunteer organisation and fund raises all year to provide their services. Donations are gratefully welcomed by Hospice, both in money and items suitable for their stores to help the fund raising effort.

If your situation comes from an assault or sexual assault aspect, then ACC could be involved. ACC is likely to recommend the provider and contribute to your costs, though with ACC there is often a shortfall you do have to cover.

If you are receiving benefits from WINZ, then WINZ may assist with some or all of your treatment costs.

Admissions to public hospitals are fully funded, assuming you are a citizen or here on a working visa longer than 2 years. As I mentioned before, hospital admissions impact financially in other areas of your life.

Lastly with possible funded support, EAP services provided though employers and soem community services can be helpful, however these typically are limited to 2-3 sessions and you won't get consistent acecss for longer term issues.

For everything else, it is pay as you go.

So where does the insurance support really come in?

What surprises a lot of people are the majority of medical insurance policies exclude psychology and psychiatric costs and services, as a base policy exclusion.

• There are one or two medical policies that do provide some contribution to your counselling treatments, there are limits in how much can be claimed. All plans have their strengths and weaknesses, the provider in this area doesn't tend to be quite as good at the other end dealing with the more extreme costs associated with cancer treatment.
• What would be covered on your typical medical policy are the investigations into physical conditions that may be contributing to your situation. Your specialist consults and tests would be picked up by your medical insurance. The neurologist consult and CT & MRI testing I mentioned above would be expected to be paid for by your medical cover. As would anything that comes from this, if a physical condition is diagnosed.
• If you do have a public hospital stay, your medical policy may contribute a nominal sum per day, which helps financially.
• I pulled this article together discussing medical insurance support in more detail 

Once your condition has been identified correctly, stabilisation and treatment are the next steps.

• When it comes to the real rehabilitation and treatment planning what might surprise you, when it comes to insurance, is this is found in your income protection policy. This is triggered by your inability to do your job.

Hang on, I found this article in the medical section, why are you talking income protection?

Yes, that's correct. Medical is where everyone goes looking for this particular answer. If I posted this in the income protection section, unless you searched for it, you probably wouldn't have found it, as the common expection is this is covered in medical insurance, unfortunately it's not.

Back to your household

Assuming you have a typical household, working regular jobs and have kids at school, then your external financial support if you have to deal with mental health issues, is likely to be limited without insurance. This is where I come in as your insurance adviser.

As I mentioned above there are options for your medical policy to contribute something to your treatment costs, but this could be limited.

Income protection, if you are disabled, will be your primary help with treatment and rehabilitation. It will also replace your lost income while you are disabled and working through recovery too.

If you happen to be in the unlikely situation that your mental health condition prevents you from ever working again, total permanent disability could also pay. This is both a benefit on its own, as well as being built into some trauma policies.

All of this does have a caveat; you need to have insurance cover before you develop a mental health condition. Because mental health is a significant area of claims, especially with income protection, the insurance companies often take a hard line on mental health medical history.

Most of the time, we see this as an exclusion for mental health related conditions.

So the message is, get your cover now before you develop a history.

Work related stress is a common starting point, as is relationship stress. Talking to your GP about this is often where we find the medical history starting and the insurance companies have a lot of experience after reviewing so many medical histories over the years.

My final point, so it is not going to happen to you, ok sure. I've seen and heard this plenty in the past, I certainly hope you're right, but the stats suggest 1 in 5 kiwis are dealing with a mental health situation at any point in time.

That is not to say it's disabling, just there is something that is causing pressure that is not normal, every individual will deal with it differently. Though about 40% of new disability claims and about 80% of ongoing disability claims are due to mental health issues, the ongoing claims are often mental health issues as a secondary condition to the primary claim.

If you want to discuss a tailored approach to your insurance planning, get in touch.