For many Indians, more than seeking therapy, continuing with it is the harder choice. Most prefer a silent exit after a few sessions.
Consultation fees ranging from Rs 1,000 to Rs 3,000, added to the price of medicines, quickly become unsustainable, forcing people to discontinue treatment midway. This dropout is rarely about stigma or denial anymore. It is about money.
Ironically, this financial crunch exists even though mental health coverage in India is legally mandated to be treated at par with physical health under the Mental Healthcare Act, 2017 and IRDAI guidelines.
Most standard health insurance policies today cover in-patient hospitalisation for mental illnesses such as severe depression, bipolar disorder, schizophrenia, anxiety disorders and PTSD, including room rent, investigations and medicines during hospital stay.
Yet, the everyday reality of mental healthcare remains uncovered, leaving those who seek help to pay out of pocket until they can no longer afford to continue.
OPD care is the missing spine
“Mental health insurance is not usually a separate policy; it is embedded within regular medical insurance. Legally, coverage terms are similar to physical illness, but in practice the difference lies in usage. Physical illnesses often involve hospitalisation, while mental health treatment is mostly outpatient, which insurance still does not fully support,” explained financial adviser Saibal Biswas.
Biswas pointed out that while the law mandates parity, the real gap remains OPD care and therapy. Adding an OPD rider increases premiums because insurers begin covering recurring outpatient services such as psychiatrist consultations, therapy sessions, diagnostics and medicines.
This often raises premiums by 8 to 10 per cent or adds several thousand rupees annually, placing meaningful coverage out of reach for many.
Policy acknowledgement without everyday access
The Union Budget 2026 has acknowledged India’s growing mental health burden, signalling intent to strengthen mental healthcare infrastructure and expand institutional capacity with a second NIMHANS in north India.
Proposals to bolster national mental health institutions suggest a recognition of the scale of the crisis. Public facilities face staff shortages and long waiting times, causing many patients to discontinue treatment. Expanding the national mental health institutional framework is significant not only for patient care, but also for training professionals and decentralising expertise.
For individuals struggling to afford weekly therapy sessions, public investment in just one part of the country does little to ease immediate financial pressure. Without insurance-backed outpatient support, the burden of care continues to rest squarely on individuals, reinforcing the gap between policy intent and access.
Dropping out of therapy due to cost
The result is a dropout crisis. Poulomee Shaw, counselling and mental health specialist at AM Medical, said financial strain is one of the biggest reasons people discontinue therapy.
“Psychological treatment is expensive. I saw many cases stop treatment just because they are not financially strong enough to continue,” she said. Shaw stressed that including mental health treatment under insurance would reduce the burden of long-term care, improve access, reduce stigma and enhance overall productivity and well-being.
“When insurance is priced beyond ordinary lives, it quietly announces who care is meant for. Mental health coverage becomes a privilege, not a safeguard. A system that insures wealth but not distress is managing exclusion, not health,” said Ratnaboli Ray, clinical psychologist and mental health activist.
Coverage that collapses in real life
Many insured individuals remain unaware that mental health hospitalisation is covered or that OPD care requires additional riders.
“It’s confusing, and lack of awareness is a key issue with insurance overall,” said Pranaadhika Sinha Devburman, trustee, One Million Against Abuse Foundation. She added that excluding OPD therapy reflects a fundamental misunderstanding of mental healthcare, which is primarily outpatient and long-term.
“I did not know mental healthcare was covered by health insurance and we could opt for riders for OPD care,” said Shibani Banerjee, a resident of Behala. “For someone who goes for therapy every week and pays Rs 2,000, an insurance policy would have helped. Instead, fixing my mental health is financially draining.”
“Until therapy and counselling become core insurance benefits rather than optional add-ons, mental health insurance in India will continue to exist more in law than in lived reality,” Banerjee concluded.