Medical Aids that cover suicidal thoughts

A mind at war – The silent warning

Suicide is a national crisis in South Africa, with an alarming 23 suicides recorded each day and approximately 230 serious self-harm attempts. These figures highlight the urgent need for mental health awareness, early intervention before it gets worst, and accessible to mental support systems.

Factors such as depression, anxiety, financial stress, substance abuse, and societal pressures contribute to the increasing suicide rates. Despite the stigma surrounding mental health problems, it is crucial to spur on open conversations and ensure that individuals in need have access to professional help.

Is Suicidal Thoughts a mental condition?

Suicide itself is not a mental health condition. It is however strongly linked to mental health conditions such as depression, anxiety, bipolar disorder, schizophrenia, and substance use disorders.

Suicidal ideas and self-harm behaviours can be symptoms of these conditions, but they can also arise due to a person experiencing unmanageable stress, trauma, or difficult life circumstances.

It’s important to remember that help and assistance is freely available. Suicidal thoughts do not define a person. If you or someone you know is fighting this battle, reaching out to a mental health professional or crisis support service can make a difference to the person and save a lot of sorrowness for the people around the person. You’re not alone, and support is out there. JUST REACH OUT!

Mental Health Conditions that are covered under PMB:

Prescribed Minimum Benefits (PMB) make certain that medical schemes cover the costs associated with treating specific medical conditions, including certain mental health disorders. This means that if you are a member of a medical aid scheme, you are entitled to treatment for specific mental health conditions without concerns about the funds paying for this treatment.

PMB covers a variety of mental health conditions like:

• 💙 Major depressive disorder
• 💙 Bipolar mood disorder
• 💙 Schizophrenia and other psychotic disorders
• 💙 Anxiety disorders (e.g., panic disorder, OCD, PTSD)
• 💙 Substance use disorders (limited scope of coverage)
• 💙 And more…

What is Covered under PMB?

Under PMB, medical aid schemes will cover the following:

✔️ In-hospital treatment:

A person experiencing severe mental health confrontations, including serious suicidal thoughts or psychotic incidents, may benefit from inpatient treatment. This intensive level of care offers 24/7 support to the patient, close monitoring, and a range of therapeutic interventions to resolve the specific crisis. In-hospital treatment also assist the person to recovery.

✔️ Out of Hospital care for a patient:

Outpatient mental health care gives permission to individuals to receive treatment and care for mental health conditions without staying in a hospital. This involves a variety of services, including:

• Psychiatric care: Evaluation, diagnosis, and medication management by a psychiatrist.
• Psychological services: Therapy, psychological testing, and assessment provided by a psychologist.
• Therapy sessions: Individual, group, or family therapy with a licensed therapist or counselor.

✔️ Medication:

 Psychiatric medications are designed to help patients with their biological factors that contribute to mental health conditions.

Medications like antidepressants (for example Selective Serotonin Reuptake Inhibitors (SSRIs), antipsychotics, mood stabilizers, and anti-anxiety drugs, are prescribed and managed by a qualified psychiatrist.

The psychiatrist considers the individual’s specific diagnosis, symptoms, and medical history. The idea is to achieve the most effective medication and dosage to lessen distress and finding a balance to function normally.

✔️ Emergency mental health care:

When a person experiences a mental health emergency, such as a suicide attempt or serious psychotic incident, emergency services assist with critical support that focuses on stabilization and safety of the person. Crisis intervention teams work to de-escalate the situation and helps to ensure the person’s well-being. They also assist into clearing the way to access for the necessary treatment.

How to Access your Mental Health benefits:

Step 1:

You need to contact your medical aid directly to inquire about the classification of your condition in accordance with the Prescribed Minimum Benefits (PMBs). It is important to understand the amount of coverage you will receive from your medical aid for mental health care.

Step 2:

It is essential to have a clear and accurate diagnosis of your mental health condition. Your diagnosis should be obtained from a recognized healthcare professional like a psychiatrist, psychologist, or general practitioner. You can determine your medical aid benefits online, and to assist in ensuring you receive the correct treatment

Step 3:

Make certain that your treatment is covered and that you receive the correct health care. It is imperative to follow the treatment plan prescribed by your healthcare provider. This plan should be developed in accordance with the Medical Schemes Acts’ guidelines, emphasizing on evidence-based practices and the necessity of following the recommended interventions for your specific condition.

Step 4:

A member (as per instruction form the plan they selected) might need to make use of certain Designated Service Providers (DSPs) to benefit for the mental health coverage. DSPs are providers that your medical scheme has partnered with to deliver services within the terms of your plan.

📌📌📌 NOTE: If you or someone you know is experiencing suicidal thoughts in South Africa, it’s crucial to seek immediate help.

Resources available to provide support for suicidal thoughts

• South African Depression and Anxiety Group (SADAG):
  • ✅ Suicide Crisis Helpline: 0800 567 567 (available 24/7)
  • ✅ SMS Support: Send a message to 31393
  • ✅ Website: www.sadag.org

• Lifeline South Africa:
  • ✅ National Counselling Line: 0861 322 322 (available 24/7)
  • ✅ Website: www.lifelinesa.co.za

• Akeso Psychiatric Response Unit:
  • ✅ 24-Hour Helpline: 0861 435 787

Does Medical aid schemes cover self-harm?

✅ Yes, in South Africa, medical aid schemes do cover self-harm, but the extent of coverage depends on the specific medical aid plan and whether the treatment falls under Prescribed Minimum Benefits (PMB).

What is Covered?

• Emergency Treatment is covered if a member requires urgent medical attention due to self-inflicting actions. It can be wounds, overdoses, or other physical injuries. Most medical aids cover hospitalization and emergency care.

• Due to self-harm Psychiatric Hospitalization is covered for mental health conditions such as depression, bipolar disorder, or anxiety. Coverage typically includes psychiatric assessments, therapy, and medication.

• Out of hospital Mental Health Services is covered for some medical aid plans offer consultations with psychiatrists, psychologists, and therapists. Medication for underlying mental health conditions is normally included.

• Counselling & Therapy is covered depending on the scheme the person is on. Psychotherapy and counselling may also be covered to help address the causes of self-harm.

Factors to consider:

✅ Is it a PMB Conditions:

Self-harm may be covered if the situation is linked to a recognized mental health disorder that is listed on the PMB list.

✅ Use of Designated Service Providers (DSPs):

Some medical aid plans will require that a member must make use of specific hospitals or mental health clinics.

✅ Pre-authorization requirement:

Prior approval might be required before a member can benefit from psychiatric hospitalization or ongoing treatment.

Medical Aid Schemes mental health benefits

Below is two examples of Mental health care benefits. We recommend that you contact your medical scheme provider directly to find out more.

Discovery Health

The Mental Health Care Programme, in collaboration with your nominated Premier Plus GP, supports you in actively managing episodic depression. This programme provides both you and your GP with essential tools and benefits to monitor and manage your condition, ensuring high-quality, coordinated healthcare. The Mental Health Care Programme is available across all Discovery Health Medical Scheme plans.

Benefits available on the Mental Health Care Programme

If you are enrolled on the Mental Health Care Programme by your network psychologist, where applicable, or nominated Premier Plus GP, you have access to the following benefits (in addition to those covered by the Prescribed Minimum Benefits) while registered on the programme:

• ✅ Up to three consultations (virtual or face-to-face) with your enrolling nominated Premier Plus GP.

• ✅ If you are registered for a mental health condition under the Prescribed Minimum Benefits (PMB), psychotherapy sessions will be paid from your approved PMB basket of care first.

• ✅ Thereafter, you have access to individual psychotherapy sessions or group therapy sessions with a Mental Health Care Programme network psychologist. Psychotherapy sessions in the Mental Health Care Programme are paid up to a total cover amount of R3,479 per person per year.

• ✅ You can claim for psychotherapy sessions up to a maximum of 60-minutes per session until you reach the benefit limit.

• ✅ Members 18 years and older also have access to one internet-based Cognitive Behavioural Therapy (iCBT) course through the Discovery Health app when referred by your enrolling Premier Plus GP or network psychologist. iCBT will be paid up to the Discovery Health Rate, from the psychotherapy consultation cover amount stated above.

📌 Download the: Discovery Health Mental health care programme

Bestmed

Bestmed recognizes the importance of actively managing mental health. Bestmed understand the strong connection between your physical and mental well-being and believe that achieving balance in both is essential for living your best life.

The Bestmed Tempo Wellness Programme is designed to support you on your journey to better health while helping you experience the benefits of overall well-being. Bestmed equip its members with the tools to navigate life’s challenges and provide practical tips to manage them effectively.

Bestmed’s Tempo Talks offer a platform where the focus extends beyond physical fitness to include mental resilience and coping strategies for everyday stress. These informative sessions are led by qualified professionals, ensuring that you receive expert guidance on maintaining both mental and physical wellness.

📌 Download the: Bestmed Emotional Wellness Journey Guide