Mental health in the UAE: Limited insurance cover is huge barrier for patients

Even after individuals reach out for help, access to psychiatry and psychology in the UAE can be very expensive and barely covered by insurance plans, if at all.

Dr Yousef Abou Allaban, medical director at American Center for Psychiatry and Neurology. Satish Kumar / The National
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Making the difficult decision to reach out for help with anxiety, depression or an assortment of other mental health issues is only the first hurdle.

The next challenge is meeting the hefty cost of therapy. Even with health insurance, the expense of co-pays and high deductibles can add up.

Dr Yousef Abou Allaban, medical director at the American Center for Psychiatry and Neurology, has spoken often about the benefits that the UAE could reap from having a legislation similar to the Mental Health Act in the United Kingdom.

“Mental health is just not being treated the same as physical health,” he says. “But it’s the same. And though there are other barriers, such as stigma, a patient’s inability to get treatment because of limited insurance and the high costs of treatment is a huge barrier.”

Medical and health-insurance coverage depends on the insurance company, level of coverage and diagnosis. While some policies cover psychiatry, psychology or family therapy, the extent to which this is the case varies.

For Emiratis, under the Thiqa insurance plan offered by Daman, full access to mental-health care is available for free at more than 50 public and private locations.

“Visits to psychiatrists and psychotherapists are covered once weekly through direct billing, up to four times a month,” says Ahmed Al Neyadi, director of Thiqa at Daman. “More sessions in a week will be covered if they are part of the patient’s treatment plan. For new patients, visits to the doctor are covered, up to six sessions a month with the same doctor to allow for a full evaluation.”

Most insurance plans for expatriates do not cover psychiatric treatment or sessions with a psychologist. While psychiatric services are included as standard in Daman’s comprehensive premiere plan for non-Emiratis, and in some enhanced plans offered for larger organisations, the maximum value of the coverage is only Dh3,500 a year.

The Abu Dhabi National Insurance Company’s medical insurance, for example, does not cover psychiatry treatment and psychological counselling for bronze-tier members, and only up to Dh1,500 for silver-tier members. These are the two most affordable and common coverage schemes. Other private health insurance companies, such as Alliance Insurance, AXA Gulf and Green Crescent, do not cover psychiatric treatment in their general plans, although coverage can be added at extra cost.

Allaban says this insurance shortfall is “absolutely unethical” and makes it incredibly hard for mental-health professionals to do their jobs.

Sometimes, patients are aware they need help and seek it, but avoid seeing a therapist because they simply can’t afford it, says Dr Nadia Dabbagh, a child and adolescent psychiatry consultant at Rashid Hospital in Dubai, and co-founder of Camali Clinic, a child and adolescent mental-health centre.

Last year, for example, an anorexic 16-year-old stopped coming to follow-up appointments and was discharged against medical advice.

“He had a very low body-mass index of 14 and had gone three years without any treatment,” says Dabbagh.

“We do think that the financial aspect, that his family were having to pay for treatment because their insurance did not provide coverage, was a factor in why they didn’t stay. That’s just heartbreaking, because that boy needs our help.”

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