The Missing Half of Healthcare: Why It’s Time to Insure the Invisible

For decades, Nepal has told its citizens that health is a right. But for millions silently grappling with anxiety, depression, schizophrenia, and other mental health conditions, that promise has often rung hollow. Now, a landmark Supreme Court ruling is forcing the country to confront an uncomfortable truth: without real insurance coverage for mental health, the right to health is only half a right.

Nepal’s healthcare system has always carried an invisible divide — one that treats broken bones as emergencies, but broken minds as private struggles. And insurance? It follows the same fault lines. National health insurance schemes, proudly rolled out to great fanfare in 2015, barely scratch the surface of mental health needs. Therapy sessions, psychiatric consultations, psychiatric medication all remain luxuries out of reach for the majority.

The Supreme Court verdict strikes at the heart of this injustice. Health, it ruled, means physical, mental, and social well-being — not just the absence of disease. No government, it said, can plead budget constraints as an excuse. The court ordered the creation of mental health units in hospitals, integration of services at all levels, and specific budget allocations.

But money alone won’t fix the problem. What Nepal needs is something far more ambitious: a revolution in how health insurance itself is designed.

A Global Shift Nepal Must Not Miss

Around the world, countries are beginning to realize that mental health cannot be treated as an afterthought. Australia funds therapy through its Medicare system. India’s Mental Healthcare Act 2017 makes it illegal for insurers to discriminate between physical and mental health conditions. Even in resource-strapped settings, governments are experimenting with community-based insurance models that include psychological care.

Nepal cannot afford to lag behind as mental health is not just a public health issue; it is an economic one. Untreated mental illness drains productivity, drives up healthcare costs, and deepens poverty cycles across generations.

Insurance reform would not just mean better care; it would mean rewriting the social contract. True mental health insurance would cover outpatient consultations, therapy, medication, inpatient psychiatric care, and rehabilitation services — without hidden exclusions or impossible paperwork.

Integrating mental health into insurance schemes is not just about funding services; it’s about sending a message that mental suffering is just as real, just as urgent, and just as deserving of care as any physical injury. Nepal’s Supreme Court has done its part. Now the baton passes to policymakers and citizens alike.