Desirable insurance coverage for electronic mental health services: a qualitative study on perspectives and...

The increasing prevalence of mental disorders, especially among young adults, highlights the growing need for adequate insurance coverage for mental health services, including e-mental health services. Given the importance of patient preferences, the design of such insurance coverage requires consideration of the views of consumers and service providers, who can largely represent consumers. This study aimed to identify the desirable features of e-mental health insurance for students from the perspectives of students and mental health service providers in Hamadan, Iran.

This qualitative study used a content analysis approach. Data were collected through semi-structured in-depth interviews with 33 students and 15 mental health service providers in 2024. For students, stratified convenience sampling was used. Purposive sampling was applied for providers. Content analysis was used for data analysis, and the participants and researchers confirmed the trustworthiness of the data.

The mean ± standard deviation of age of providers and students was 41.8 ± 8.81 and 24.24 ± 4.13, respectively. The majority of participants in the study were female (32 persons). Data analysis led to the extraction of five main themes: financial support, credibility, prioritization, control and management of moral hazard, and appropriate process, and 11 sub-themes: the share of insurance coverage, the scope of insurance coverage, fulfilling financial obligations, how to buy insurance, provider competency and the trustworthiness of providers, observing economic equity and triage, preventing abuse by providers and preventing abuse by insured individuals and reducing bureaucratic barriers.

Providing e-mental health insurance for students requires policymakers and health insurance organizations to provide insurance coverage with premiums commensurate with students' ability to pay, financial support for vulnerable socio-economic groups, and attention to the needs and preferences of students regarding mental health services covered by insurance. Also, the development of transparent guidelines for the approval of competence and supervision of the behavior of providers is another important factor in the success of the implementation of e-mental health insurance.

Not applicable.