National Mental Health Program (DOH)

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National Mental Health Program of DOH



Paula Nicole Anne R. Marin National Mental Health Program I. Rationale:

Background of the Program Vision: Mission: Goal: Objective: Better Quality of Life through Total Health Care for all Filipinos. A Rational and Unified Response to Mental Health. Quality Mental Health Care. Implementation of a Mental Health Program strategy

The National Mental Health Policy shall be pursued through a Mental Health Program strategy prioritizing the promotion of mental health, protection of the rights and freedoms of persons with mental diseases and the reduction of the burden and consequences of mental ill-health, mental and brain disorders and disabilities.

State International Support and Policies, Mandates

Stakeholders: To ensure the sustainability and effectiveness of the National Mental Health Program, certain committees and teams were organized. 1. National Program Management Committee (NPMC)

The NPMC is chaired by the Undersecretary of Health of the Policy and Standards Development Team for Service Delivery and co-chaired by the Director IV of the National Center for Disease Prevention and Control (NCDPC). Its functions are as follows:
    

Oversee the development of mental health measures for sub-programs and components; Integrate the various programs, project and activities from the various program development and management groups for each sub-program; Manage the various sub-programs and components of the National Mental Health Program; Oversee the implementation of prevention and control measures for mental health issues and concerns; and Recommended to the Secretary of Health a master plan for mental health aligned with the mandates and thrusts of various government agencies. Program Development and Management Teams (PDMT)


Under the NPMC, PDMT shall be established corresponding to the four sub-programs of the National Mental Health Program. A PDMT shall oversee the operations of a sub-program of the National Mental Health Program. The functions of PDMT are:
   

Formulate and recommend policies, standards, guidelines approaches on each specifics sub-programs on mental health; Develop a plan of action for each specific sub-program in consultation with mental health advocates and stakeholders Develop operating guidelines, procedures, protocols for the mental health subprogram. Ensure the implementation of the program among all stakeholders; and Provide technical assistance to other mental health teams according to subprograms thrusts.

3. Regional Mental Health Teams (RMHT) To ensure an efficient and effective multi-sectoral implementation of the National Mental Health Program at the regional level, a RMHT shall be established in each of the Centers for Health Development (CHD). The functions are as follows:
     

Oversee the planning and operation of the National Mental Health Program at the regional level; Provide technical assistance on the issues and concerns pertaining to the implementation of the different subprograms of the National Mental Health Program; Strengthen technical and managerial capability at the local level to ensure LGU participation on the implementation of the National Mental Health Program; Ensure establishment of LGU teams for mental health; Ensure the conduct of monitoring and evaluation of the implementation of the National Mental Health Program at the regional level; and Regularly update the PDMT on the status of the regional implementation of the National Mental Health Program. Local Government Unit Mental Health Teams (LGUMHT)


The suggested members of the LGUMHT are the local health board members, technical health staff, civil society groups, non-government organizations and other stakeholders. Primarily, the LGUMHT enacts necessary legislative issuances and promotes and advocates the implementation of Community-based Mental Health Program among their respective localities and constituents. 5. Other Partners and Stakeholders

Other stakeholders who may or may not belong to the above-mentioned committees or teams may contribute to the implementation of the National Mental Health Program by:

Ensuring the availability of competent, efficient, culturally and gender-sensitive health care professionals who provide mental health services;

 

Identifying mental health needs of the population and refer findings to the appropriate mental care provider; and Promoting and advocating for the implementation of the program within their respective areas of responsibility.


Scenario Global Situation:

Many people with mental health conditions, as well as their families and caregiver, experience the consequences of vulnerability on a daily basis. Stigma, abuse, and exclusion are all-toocommon. Although their vulnerability is not inevitable, but rather brought about their social environments, over time it leads to a range of adverse outcomes, including poverty, poor health, and premature death. Because they are highly vulnerable and are barely noticed- expert to be stigmatized and deprive of their rights- it is crucial that people with mental health conditions are recognized and targeted for development interventions. The case for their inclusion is compelling. People with mental health conditions meet vulnerability criteria: they experience severe stigma and discrimination; they are more likely to be subjected to abuse and violence than the general population; they encounter barriers to exercising their civil and political rights, and participating fully in society; they lack access to health and social services, and services during emergencies; they encounter restriction to education; and they excluded from income-generating and employment opportunities. As a cumulative result of these factors, people with mental conditions are at heightened risk for premature death and disability. Mental health conditions also are highly prevalent among people living in poverty, prisoners, people living with HIV/AIDS, people in emergency settings, and other vulnerable groups. Attention from development stakeholders is needed urgently so that the down-ward-spiral of even-greater vulnerability and marginalization is stopped, and instead, people with mental health conditions can contribute meaningfully to their countries’ development. As a starting point, development stakeholders can consider carefully the general principles for action outlined in this report, and decided how best to incorporate them into their specific areas of work. Targeted policies, strategies, and interventions for reaching people with mental conditions then should be developed, and mental health interventions should be mainstreamed into broader national development and poverty reduction policies, strategies, and interventions. To make implementation a reality, adequate funds must be dedicated to mental health interventions, and recipients of development aid should be encouraged to address the needs of people with mental health conditions as a part of their development work. At country level, people with mental health conditions should be sought and supported to participate in development opportunities in their communities. Specific areas for action address the social and economic factors leading to vulnerability. Mental health services should be provided in primary care settings and integrated with general health services. To that end, mental health issues should be mainstreamed on countries’ broader health policies, plans, and human resource development, as well as recognized as an important issue to consider in global and multisectoral efforts, such as the International Health

Partnership, the Gloring Health Workforce Alliance, and the Health Metrics Network. During and after emergencies, development stakeholders should promote the (re)construction of community-based mental health services, which can serve the population long beyond the immediate aftermath of the emergency. Development strategies and plans should encourage strong links between health/mental health services, housing, and other social services. Access to education for people with mental conditions, as well as early childhood programmes for vulnerable groups should be supported by development stakeholders in order to achieve better development outcomes. People with mental health conditions should be included in employment and income generating programmes to assist with poverty alleviation, improve autonomy and mental health. Throughout their different areas of work, development stakeholders can and should support human rights protections for people with mental conditions and built their capacity to participate in public affairs. This report provides a number of recommendation and specifics areas of action that need to be integrated into policy, planning, and implementation by development stakeholders according to their role and strategic advantage. To achieve this aim development stakeholders need to recognize people with mental health conditions as a vulnerable group requiring support from development programmes. (World Health Organization and Mental Health and Poverty Project, 2010)

Local Situation

In a local baseline survey in 1964-67 in Sta. Cruz, Lubao, Pampanga, Manapsal of the DOH Division of Mental Hygiene, Bureau of Disease Control, found that the prevalence of mental health was 36% per 1,000 adults, children and adolescents. The 1980 WHO Collaborative Studies for Extending Mental Health Care in General Health Care Services (involving seven countries) showed that 17% for adults and 16% of children who consulted at three health centers in Sampaloc, Manila have mental disorders. Depressive reactions in adults and adaptation reaction in children were most frequently found. In Sapang Palay, San Jose Del Monte, Bulacan, the prevalence of adult schizophrenia was 12 cases per 1,000 population in 1988-1989 (Manalang et al). In Region 6 (Iloilo, Negros Occidental and Antique), Perlas et al. im 1993-94 showed that the prevalence of the following mental illness in the adult population were: psychosis (4.3%), anxiety (14.3%), panic (5.6%). For the children and adolescent, the top five most prevalent psychiatric conditions were: enuresis (9.3%), speech and language disorder (3.9%), mental subnormality (3.7%), adaption reaction (2.4%) and neurotic disorder (1.1%). The current DOH bed capacity for mental disorder is 5,465. Of these, 4,200 beds are in the NCR (at the National Center for Mental Health). The rest of the country share the remaining 1,265 beds (CAR-40 beds, Region 2-200 beds, Region3-500 beds, Region 11-200 beds). Regions 1,4,10,12, CARAGA and ARMM do not have inpatient psychiatric facilities. Only 27 DOH medical centers and regional hospitals have mental health services. Cavite is the only province with a psychiatric facility. These situations have hampered the delivery of basic services, aborted the national development, and reduced quality of life of the Filipino. Life has become severely stressful to most, whether rich or poor, young or old. The resiliency of the Filipino people to adapt to his present life situation is being stretched too far. Warning signs of restlessness abound such as

increasing reports of suicides and substance abuse. Decline in the socio-economic condition may translate into mental-ill health and therefore mental health disorders and mental disabilities. However, the provision of mental health services in the country, has remained illness-oriented, institution-based, fragmented, inadequate, inequitable, inaccessible, prohibitive, and neglected. The Department of Health (DOH), the national lead agency for health recognizes the magnitude of the mental health problem as contained in the National Objectives for Health (NOH) 19992004. Among the objectives are set the following: life. Reduction of morbidity, mortality, disability and complications from mental disorder Promotion of healthy lifestyle through the promotion of mental health and less stressful

However, the DOH has constraints in attaining these objectives given the limited government resources. Within the health sector, mental health has to compare for resources against other equally important health objectives. Concomitant reforms are therefore being pursued in hospitals, public health, local health systems, regulation as well as financing with the end-view of improving the health of all Filipinos as embodied in the Health Sector Reform Agenda.

Statistics/Local data about the disease program Disorder Specific Phobias Alcohol Abuse Depression Number of Cases 93 31 14 % 19 6 3 95% CI 15.98, 23.1 4.56, 8.96 1.74, 4.8

Number of Diagnosis One Diagnosis Multiple Diagnosis 2 Diagnoses 3 Diagnoses >/=4 Diagnoses Total

No. of Respondents 56 66 32 7 27 122

% 12 15


*Department of Health (DOH) and Field Epidemiology Training Program Alumni Foundation Incorporated (FETPAFI)


Interventions/ Strategies employed or implemented by DOH

The National Mental Health Program has the following program strategies: 1. Health Promotion and Advocacy

Enrichment of advocacy and multimedia information, education and community (IEC) strategies targeting the general public, mental health patients and their families, and service providers shall be done through the promulgation of observances issued by the Office of the President. 2. Service Provision

Enhancement of service delivery at the national and local levels will enable the early recognition and treatment of mental health problems. To ensure continuity of care, mental health services for people with persistent disabilities shall be established close to home and the workplace. 3. Policy and Legislation

The formulation and institutionalization of national legislation, policies, program standards and guidelines shall emphasize the development of efficient and effective structures, systems, and mechanisms that will ensure equitable, accessible, affordable and appropriate health services for the mentally ill patients, victims of disaster, and other vulnerable groups. 4. Encouraging the development of a research culture and capacity

The program shall support researches and studies relevant to mental health, with focus on the following areas: clinical behavior, epidemiology, public health treatment options, and knowledge management. It aims to acquire evidence-based information that will contribute to the public health information and education, policy formulation, planning, and implementation. 5. Capability Building

The capability of national, regional and local health workers in delivering efficient, effective and appropriate mental health services shall be strengthen. Training shall be conducted on psychosocial care, the detection and management of specific psychiatric morbidity, and the establishment of mental health facilities. 6. Public-Private Partnership

Inter-sectoral approaches and networking with other government agencies, non-government organizations, academe and private service providers and other stakeholders at the locals, regional and national levels shall be pursued to develop partnership and expand the involvement of stakeholders in: a.) advocacy, promotion and provision of mental health services; b.) conduct of relevant studies, researches and surveys; c.) training of mental health workers; d.) sharing of researches, data and other information on mental issues and concerns; and e.) sharing of resources. 7. Establishment of data base and information system

This is needed to determine the magnitude of the problem, its epidemiological characteristics and knowledge and practices to serve as basis for shifting the program for being institutional and treatment focused to being preventive, family focused and community oriented. 8. Development of model programs

Best practices/models for prevention of substance abuse and risk reduction for mental illness can be replicated in different LGUs in coordination with other agencies involved in mental health and substance abuse prevention programs. 9. Monitoring and Evaluation

A regular review process shall be conducted. Results of program monitoring and evaluation shall be used in formulating and modifying policies, program objectives and action plans to sustain the mental health initiatives and ensure continuing improvement in the delivery of mental health care.

Program Direction

Micro Point of View

Major Activities/Celebrations: Celebration Autism Consciousness Week National Mental Retardation Week National Epilepsy Awareness Week National Mental Health Week National Attention Deficit/Hyperactivity Disorder Awareness Week Substance Abuse Prevention & Control Week Date Every 3 Week of January February 14 to 19 Every 1st Week of September Every 2nd Week of October Every 3rd Week of October Every 3rd Week of

November V. Future Plan/ Action 2 Batches of Training on Promotion Mental Health in the Communities 1 Batch of Training on Psychosocial Intervention Series of lecture on Suicide prevention in different Schools & Colleges Mental Health Summit in celebration of World Mental Health Day

Partner Organizations/Agencies: The following organizations/agencies partake in achieving the vision of the program:

Philippine Psychiatric Association (PPA) Suite 1007, 10th flr. Medical Plaza Ortigas Condominium San Miguel Ave. Ortigas Center Pasig City # (632) 635-98-58.

- Dr. Constantine Della President Contact no. 0922-8537949 Email Add.: [email protected]

- Dr. Romeo Enriquez Vice President Contact no. 0933-5794140/ 0920-9053041 Email add: [email protected]

National Center for Mental Health (NCMH) Nuevo de Pebrero St. Mauway, Madaluyong City # (632) 531-90-01 -Dr. Bernardino Vicente Medical Center Chief

Philippine Mental Health Association (PMHA) No. 18 East Avenue, Quezon City 1100 # (632) 921-49-58; (632) 921-49-59 -Ms. Regina De Jesus National Executive Director

Christoffel Blindenmission (CBM) Unit 604, Alabang Business Tower 1216 Acacia Avenue, Madrigal Business Park Alabang, Muntinlupa City 178 # (632) 807-85-86; (632) 807-85-87

-Mr. Willy Reyes Contact no. 0905-4142608

Program Managers: Mr. Melson Mendoza Email: [email protected]

Ms. Remedios Guerrero

Email: [email protected]

Ms. Ditas Purisima Raymundo Email: [email protected] Department of Health-Non Communicable Disease Office (DOH-NCDO) Contact Number: 651-78-00 local 1750-1752

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