We’re all being encouraged to talk openly about mental health – and with good reason – but how would you feel if your openness was then used against you – to hike up the price of basic services such as travel insurance? It might sound ridiculous – if a little sinister – but that’s exactly what’s happening right now. 

According to The Money and Mental Health Policy Institute, there has been a sharp increase in the number of cases where people have found out that they are being quoted a four-fold increase in the cost of travel insurance – for the simple reason that they take or have taken commonly prescribed psychotropic medication such as Sertraline. 

Even a mild ‘depressive episode’ – followed by years of ‘stable mental health’ – can be used to increase an insurance quote. 

This sounds like discrimination. So let’s call a spade a spade – it is discrimination. We live in scary times if insurance companies have the power to define ‘mental illness’ or ‘mental health issues’, though let’s be clear here, there are no black and white definitions of what any of these terms mean. Many insurance companies use these terms indiscriminately, or use their own definitions, which is strange because contractual lawyers – who work for insurance companies – like clarity around ‘definitions’ especially when things get ‘legal’. 

In the first instance, we need to be really careful about how we use terms like ‘issues’ or ‘illness’? I see mental health as fluid and on a spectrum and I prefer not to pathologising it. But then I come from a psychotherapeutic background rather than a medical background. 

Doctors and GPs – who as a psychotherapist I work with in Lambeth NHS – ‘diagnose’. They generally see mental health from a medical model which means they talk about ‘disorders’. To do that they use the DSM – the Diagnostic and Statistical Manual of Mental Disorders. Psychotherapists use it too – but generally we hold the definitions lightly. Anyway, the DSM is a fascinating read – I’d recommend it – it kind of works on a tick box basis and you can even work out if you have ‘narcissistic personality disorder’. Though the thing is, you can’t really. The forward of the landmark 1980 DSM-III – acknowledged that the diagnostic system was imprecise – so imprecise that it should never be used for forensic or insurance purposes … fast forward to what is happening today … I say no more.

Since the 1980s, ‘pharma’ has become a multi-billion dollar business – no surprise then that insurance companies want a bite of that. 

So how would you feel about your mental health history being used like this by insurance companies to increase basic cover? Would it stop you from talking with your GP about your mental health in future? Would you think twice about asking for a medication prescription for a depressive or anxiety episode due to say a change of job?

A worrying outcome is that some people are taking the risk not to get travel insurance. Young people are most likely to go abroad without insurance and they’re the ones who may need it most. Even if they have insurance, if they haven’t disclosed their mental health status their insurance may be invalid. 

According to Helen Undy, director of the MMHPI, nearly half of those with mental health issues said they never disclosed their condition – risking their travel policy becoming invalid.

She’s recently gone on record to say: 

’Half of us will experience a mental health problem at some point in our lives, which could have a long-term impact on our access to insurance. If the mainstream travel insurance market doesn’t work for half of customers, then it’s really not working at all. The way insurance companies calculate risk, and set their prices, is determined behind closed doors. Only the regulator has the data needed to check if it’s truly fair.’

In response a spokeswoman for the Association of British Insurers (ABI) said: “Travel insurance is widely available for people with a range of long-term and serious conditions, including mental health conditions. As with pre-existing physical conditions, some insurers may consider them a risk factor and this can push up premiums because of the potentially high cost of treatment that is needed overseas. We are already working with the FCA and other industry and consumer bodies on how to improve signposting for customers with pre-existing medical conditions.”

The next chapter of mental health will be the fight back against big business using diagnosis for their own financial gain. It has to be stopped. And whilst we are at it we all need to be aware of what we all really mean about ‘mental health illness’ and ‘mental health issues’, what lens we are using when we talk about terms like this and how these terms have evolved over the past 30 years. 

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