School Based Mental Health and Psychosocial Wellness :

IN THE PHILIPPINES

there is inadequate attention to & awareness of problems regarding the mental health of the population

WORLDWIDE
Mental disorders affect nearly 12% of the world's

population About 450 million people suffer from mental and behavioural disorders worldwide. One person in four will develop one or more of these disorders during their lifetime. Mental & behavioural disorders represented 11% of the total disease burden in 1990; this is predicted to increase to 15% by 2020

WORLD WIDE CENSUS

On average, about 800 000 people commit suicide

every year, 86% of them in low- and middle-income countries. 50% aged between 15 and 44 present a person dies from suicide every 40 seconds.

Mental health problems are prevalent and troubling, with about 3 in 10 Filipinos affected by mental illness that is serious enough to affect functioning.

TEN PROJECTED LEADING CAUSES of DALYs WORLDWIDE in 2020

Murray, C.J.L. & Lopez, A.D. (1997). The Lancet. 349: 1498-1504. RANK
1 2

DISEASE or INJURY
Ischaemic heart disease Major depression

% of TOTAL DALYs
5.9 5.7

3
4 5

Road traffic accidents

Cerebrovascular disease COPD Lower respiratory infections Tuberculosis War injuries Diarrhoeal diseases HIV

5.1
4.4 4.1

6
7 8 9 10

3.1
3.1 3.0 2.7 2.6

DALYs: sum of years of life lost because of premature mortality & years of life lived with disability

IN THE PHILIPPINES:
Studies on mental health in general health care: 17-20% of adults and 10- 15% children (5-15 years) consulting primary health care clinics have psychiatric disorders (Ignacio et al, 1981) Doctorless barrios: 50% of adults consulting rural health clinics have psychological morbidity, ( unpublished report)

PHILIPPINES (CONT)
Studies among survivors of disaster: Consistently show that psychosocial consequences of disaster are significant

REGIONAL BASELINE SURVEY on MENTAL ILLNESS in the PHILIPPINES

Conducted in Region VI (Antique, Iloilo, Negros

Occidental) N=5219

n=3042 adults n=2167 children & adolescents 32% of adults 22.6% of children and adolescents

Prevalence rate of mental illness

Perlas, A. (1995). PGH Research Journal. 1(1): 26-27.

 Prevalence of mental health problem in primary

health centers:
1.

Urban primary health center in Sampaloc, Manila as part of a seven nation study of the WHO;

17% of adults has psychiatric disorders 10% of children has psychiatric disorders Recognition rate of 5% by health staffs

2. Rural health center, 3 towns in Bulacan (Plaridel, Guiguinto and Malolos)-34% of adults has psychological morbidity.

The prevalence of mental health problems (DOH-NEC 2006), among 327 government employees from 20 government agencies in Metro Manila
32% had experienced a mental health problem at least once in their lifetime 15% had specific phobias 10% had alcohol abuse 6% with depression

OVERSEAS FILIPINO WORKERS

April to September 2007 was registered at 1.75 M

male (50.9%); females (49.1%)

More than half (55.2%) were below 35 years old Largest number in age group 25 to 29 years

One out of three (35.0%) were laborers & unskilled

workers, service workers & shop & market sales workers

MENTAL HEALTH PROBLEMS of OVERSEAS FILIPINO WORKERS

ranks 13th of 20 ailments Depression is another common problem

Anxiety

TRIGGER FACTORS FOR DEPRESSION AMONG OVERSEAS FILIPINO WORKERS, 2003

Home s icknes s , boredom, anxiety F atique,work pres s ure, overworked P roblems -pers onal, family, financial P hys ical pain/illnes s Maltreatment-verbal/phys ical abus e, s exual harras ment C ulture s hock, racial dis crimination 3% 2% 2% 18% 46%

29%

STREET CHILDREN
About 1.5 M street children with 75,000 in Metro

Manila alone More boys than girls Metro Manila, ratio is 7:3 Most belong to 11 14 age bracket although age ranges from 6 to 17

 The Department of Social Work and Welfare

(DSWD) claims that the annual average increase of prostituted children is 3,266. It also reports a more than 100 percent increase in cases of sexually abused and exploited children. Of these cases, 36% were rape cases. Child prostitution and pedophilia accounted for 12 percent.

MENTAL HEALTH RESOURCES

FINANCING:

5% of the health care expenditures by the

government health department are directed towards mental health. Of all expenditures on mental health, 95% are spent on the operation, maintenance and salary of the personnel of mental hospitals. The percentage of the population that has free access to psychotropic medication is unknown.

HUMAN RESOURCES FOR MENTAL HEALTH CARE

# of MHW per 100,000 pop

Psychiatrists* Nurses Psychologists

412 769 119

0.42 0.91 0.14

Social Workers
Occupational Therapists Others

74
72 1,372

0.08
0.08 1.62

*237 (58%) of the Psychiatrists practice in the NCR

*WHO AIMS Philippines 2007

MENTAL HEALTH SERVICE DELIVERY

Current government capacity for mental disorder 6,305 beds
4,775 beds (75%) are in NCR 1,530 beds (24%) spread out in different regions

Mental health units within General Hospitals/ Medical Centers

Provide out and in patient consultation liaison and forensic services Only 10 regions have psychiatric inpatient facilities

MENTAL HEALTH Services is not INTEGRATED in the HEALTH DELIVERY SYSTEM

DEFINITIONS

Healtha state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
(WHO,2001b,p.1)

mental health is an integral part of health

mental health is more than the absence of mental illness

mental health is intimately connected with physical health and behaviour.

MENTAL HEALTH
Integral part of Health
Mental health and mental illness are determined by multiple and interacting social, psychological and biological factors Association between poverty and mental disorders appears to be universal, occurring in all societies.

Substance abuse, violence and abuses of women and children on the one hand, and health problems such as heart disease, depression and anxiety on the other, are more prevalent and more difficult to cope with in conditions of high unemployment, low income, limited education, stressful work conditions, gender discrimination, unhealthy lifestyle and human rights violations (Desjarlais et al., 1995, p. 6).

MENTAL HEALTH
is an athlete who is temporarily disabled with a fractured ankle healthy or unhealthy? Is an asymptomatic person with a history of bipolar affective disorder healthy or unhealthy? Is a DOH staff taking maintenance anti-diabetes medication not following healthy dietary advice healthy or unhealthy?

MENTAL HEALTH

More than the absence of mental illness

implies fitness rather than freedom from illness
Average mental health is not the same as healthy, for averaging always includes mixing in with the healthy the prevailing amount of psychopathology

MENTAL HEALTH
Intimate connection with physical health and behaviour
Many studies since the 1950s support the idea that medically ill patients with negative attitudes have worse outcomes than those with more positive attitudes
Now studies demonstrate that healthy people who are optimistic have lower death rates from heart disease than those who are pessimistic, even taking other risk factors into account (Giltay et al., 2004) The importance of short-term mental stress as a trigger for the development of myocardial infarction and sudden death in people with heart disease is no longer questioned

MENTAL HEALTH
Intimate connection with physical health and behaviour
Malnutrition in infants can increase the risks of cognitive and motor deficits Heart disease and cancer can increase the risk of depression (Blane et al., 1996; Marmot & Wilkinson, 1999) Persistent pain is linked with suffering and lost productivity around the world. Those with persistent pain were over four times more likely to have an anxiety or depressive disorder than those without pain (Gureje et al., 1998).

DEFINITIONS

Mental health
a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her Community (WHO, 2001d, p.1).

DEPRESSION
Single largest contributor to non-fatal burden and is responsible for a high number of lost DALYs worldwide Fourth leading cause of disease burden (in DALYs) globally and is projected to increase to second leading cause in 2030 Lifetime estimate of prevalence for either major depressive disorder or dysthymia is 4.217% (weighted mean 12.1%)

DEPRESSION AND OTHER DISEASES

A risk factor for suicide and many noncommunicable diseases such as stroke, coronary heart disease, and type 2 diabetes Comorbid depression is a predictor of adverse outcome e.g. increased mortality after myocardial infarction Infection with HIV-1 is associated with increased occurrence of depression; adherence to antiretroviral therapy is adversely affected by comorbid depression. Adherence to antiretroviral therapy has been shown to improve when comorbid depression is treated

DEPRESSION AND OTHER DISEASES

Comorbid depression also affects adherence to treatment for other health conditions such as diabetes and tuberculosis Postpartum depression has negative consequences for the early relationship between mother and infant and for the childs psychological development. Maternal depression is a risk factor for infant stunting. Mothers suffering from depression may delay seeking help for their child with potentially serious illnesses.

SUICIDE AND OTHER SECTORS

Childhood adversities including physical, emotional, and sexual abuse are associated with high risk for suicide
Suicide results from many complex sociocultural factors and is most likely to occur during situations of socioeconomic, family, and individual crisis (e.g. loss of a loved one, loss of employment, partner abuse, or domestic violence)

Easy access to lethal means such as pesticides is related to high rates of suicide

REFERENCES
Mental Health Gap Action Programme: Scaling up care for Mental, Neurological and Substance Disorders WHO, 2008

Promotion of Mental Health :Concepts; Emerging Evidence; Practice A Report of the WHO, Dept. of Mental Health & Substance Abuse in collaboration with the Victorian Health Promotion Foundation & University of Melbourne (Helen Hermann, Shakhar Saxena, Rob Modie ,editors)

Preventing Mental Illness: Mental Health Promotion in Primary Health Care

-Rachel Jenkins & T. Berdihan Ustun (editors) 1998

-Published by John Wiley & Sons

 Coping with depression

The

most common way of coping with depression are talking to a friend (42.3%) 29.2% admit to not doing anything about the symptoms 6.8% consult a doctor about it 2.2% go on leave 19.5% have other ways of coping

 Children left behind by migrant workers

1. visible and yet invisible concealed within the benefits of the material gains of the OFW parents. 2. Vaguely show up in the statistical studies.

A child of a migrant worker is no different from other children. Children survival and development depend on the quality of care and commitment provided by the adults who have responsibility on them.

 The benefits gained from overseas work tend to

provide the basic needs of the children.

Risk factors: 1.increasing number of absentee parents,

2.Feminization of labor migration 3.Breakdown of traditional family structures i.e. long distance parenting 4.Changing values i.e. materialistic world view

ACTIVITIES TO IMPROVE HEALTH

Promotion of Mental Health

general coping skills, and mental health of nonclinical population Reducing Risk for Mental Disorders
Risk reduction approaches

Treatment and Rehabilitation

Risk Factors Potentially Influencing The Development of Mental Health Problems and Mental Disorders In Individuals (Particularly Children)

Individual Factors
Prenatal brain damage Prematurity Brain Injury

Family/Social Factors
Having a teenage mother Having a single parent

Life Events/Situations
Physical, sexual and emotional abuse School transitions Bullying

School Context

Community & Cultural

Socioeconomic disadvantage Social and cultural discrimination Isolation

Peer rejections Poor attachment in schools Divorce and family break up

Absence of a father during childhood Large family size

Low Birth weight & complications

Economic security Physical and intellectual disability Antisocial role models Poor health in infancy Family violence and disharmony Insecure attachment in infant and child Low intelligence Difficult temperament Problem solving skill Internal locus of control Social skills Good coping style Optimism Moral beliefs Responsibility within the family (for child and adult) Supportive relationship with other adults Marital discord in parents Poor monitoring and supervision of children Death of a family member Physical illness and impairment Unemployment and homelessness Incarcerations Good physical health

Inadequate behaviour management

Independence and helpfulness

Strong cultural identity and ethnic pride

Access to support services

Opportunities for some success and recognition of achievement School norms against violence

Community cultural norms against violence Neighborhood violence and crimes

Deviant peer group School failure Population density and cultural conditions Lack of support services including transport, shopping and recreational facilities

Low prenatal involvement in childs activity

More than two years between siblings

Poverty and economic insecurity Job insecurity Unsatisfactory workplace relationship Work accident/injury

Strong family norms and morality

Values Neglect in childhood Positive self related cognitions Living in poverty Chronic illness Unemployment Poor social skills Criminality in parent Low self esteem Parental substance misuse Alienation

Parental mental disorder

Impulsitivity

PREVENTION OF MENTAL ILLNESS

INTERVENTIONS ACCORDING TO THE LEVELS OF RISK OF ILLNESS

Universal - Targeted to whole populations or general public - Effects are widely beneficial with no marked negative effects.
Examples:
1. High quality prenatal care 2. Healthy lifestyle

3. Stress management (in the workplace )

PREVENTION OF MENTAL ILLNESS

INTERVENTIONS ACCORDING TO THE LEVELS OF RISK OF ILLNESS

Selected

-Targeted to subgroups of the population whose risk is

significantly above average -Anticipated benefits outweigh increased costs, efforts and risk
Example: 1. Nurse visiting program for young, poor first

pregnancy mothers
2. Psychosocial intervention for individuals having adverse life experience

PREVENTION OF MENTAL ILLNESS

INTERVENTIONS ACCORDING TO THE LEVELS OF RISK OF ILLNESS

Indicated

-Targeted at high risk individuals who display minimal but

detectable symptom.s - Expected costs are high, but anticipated benefits far outweigh costs.
Example: 1. Screening and early referral for treatment of symptoms of depression and early dementia 2. Psychosocial intervention for individuals in extreme life experience

TREATMENT OF MENTAL ILLNESS

Treatment

Case identification
Standard for known disorders

Maintenance reduction in relapse and recurrence aftercare (including rehabilitation )

Mental disorder prevention

Mental ill-health refers to mental health problems, symptoms and disorders, including mental health strain and symptoms related to temporary or persistent distress.
Preventive interventions work by focusing on reducing risk factors and enhancing protective factors associated with mental ill-health.

Public health definition of mental disorder prevention Mental disorder prevention aims at reducing incidence, prevalence, recurrence of mental disorders, the time spent with symptoms, or the risk condition for a mental illness, preventing or delaying recurrences and also decreasing the impact of illness in the affected person, their families and the society (Mrazek & Haggerty, 1994)----------The approach to mental disorder prevention lies in the concept of public health, defined as the process of mobilizing local, state, national and international resources to solve the major health problems affecting communities

MENTAL HEALTH INTERVENTION SPECTRUM FOR MENTAL DISORDERS

MRAZEK & HAGGERTY 1994, BY PERMISSION OF THE NATIONAL ACADEMY PRESS

HISTORICAL LANDMARKS
1986 People Power Revolution - The first real effort to comprehensively address the growing mental health problems in the country including the need to reform the mental health care delivery system. Project Team on Mental Health (Task Force on Mental Health) created, composed mainly of faculty members from universities & MH professionals from psychiatric departments of different hospitals. They worked closely with the staff of the National Mental Hospital. In 1988-90, a multi-sectoral consultation led to the organization of the National Program for Mental Health (NPMH) at the DOH. The NPMH in recognition of the prevailing social conditions and their mental health implications identified five priority areas of concerns . These were patients with mental

disorders, victims of disasters and violence, street children and child victims of abuse, substance abusers, overseas workers .

HISTORICAL LANDMARKS
1999 - The administration implemented the reengineering of the Dept of Health and almost reduced the NMHP to nonexistence in a corner of one of the government hospital in Quezon City. Administrative Order No. 8 - National Mental Health Policy was signed on April 5, 2001 by Sec. Manuel Dayrit 2002 - The current National Mental Health Program was reactivated. It has been placed under the administrative authority of the Undersecretary for Health Program Development Cluster and lodged at Degenerative Disease Office NCDPC.

NATIONAL MENTAL HEALTH POLICY (ADMINISTRATIVE ORDER #8 S2001)

Vision: Better quality of life through total health care for all Filipinos
A rational and unified response to mental health Quality Mental health care

Mission:

Goal:

NATIONAL MENTAL HEALTH POLICY

(ADMINISTRATIVE ORDER #8 S2001)
Policy Statements: A. Leadership: the

B.

C.

local governments as embodied in the Local Government Code of 1991 shall ensure the delivery of basic mental health services. Collaboration and Partnership: the DOH shall ensure the creation of an enabling environment for collaboration and partnership among (a) sectors (b) disciplines (c) levels of government Empowerment and Participation : (a) person at risk to develop, (b) persons w/ mental illnesses, (c) their families in effective treatment and management of mental health problems & disorders, shall be involved in the planning and decision making on matters that concern and pertain to them.

NATIONAL MENTAL HEALTH POLICY

(ADMINISTRATIVE ORDER #8 S2001)

Policy Statements:
D. Equity mobilization, allocation and utilization of resources from all sectors in all regions, provinces, cities and municipalities shall be created E. Standard for Quality Mental Health F. Human Resource Development the curriculum and trng for mental health care providers shall be responsive to national and local culture and human development goals G. Health Service Delivery System the integration into the general health care programs, services and systems of hospitals, health centers and other health units of government and private sectors ..

OPERATIONAL FRAMEWORK FOR THE SUSTAINABLE ESTABLISHMENT OF A MENTAL HEALTH PROGRAM

(ADMINISTRATIVE ORDER 2007-0009)

It sets forth strategies for national reform from an institutionally based mental health system to one that is consumer focused with an emphasis on supporting the individual in their community

General Guidelines
A. NOH and F1 encompasses mental health & applies to the promotion of mental health as follows:
1. The goals of the mental health program are to reduce mental health prevalence; reduce mortality from suicide and intentional harm, and reduce the risk for mental disorder through the promotion of mental health in the general population and improvement in the quality of life for those suffering from such condition;

2. Service Delivery
a) Integrate mental health services into the existing health programs in the DOH retained hospitals, LGU health facilities, NGOs and other concerned agencies; b) Increase the number of DOH retained hospitals/medical centers and LGU health facilities capable of providing mental health services by 10% every year; c) Improve the competencies of health service providers on Mental Health Program; d) Develop a technical assistance package for national agencies, local government units, private sector and NGOs relating to Mental Health policies and programs by end 2008; e) Strengthening school and workplace mental health programs

3. Financing
a. Mobilize resources for Mental Health from private sector & funding agencies b. Facilitate the expansion of the Philippine Health Insurance benefits package for Mental Health by 2008

4. Regulation:
a. Regulate custodial home care and clinics providing mental health services in coordination with the Bureau of Health Facilities Services.

5. Governance
a. Establish a coordinating mechanism for the successful implementation, monitoring and evaluation of the National Mental Health Program which necessitates institutionalization of a functional management structure. b. Establish and implement a Mental Health research, monitoring and evaluating system by the end of 2008.

General Guidelines
A. NOH and F1 encompasses mental health & applies to the promotion of mental health as follows: B. The National Mental Health Program focuses on four priority sub-programs;

ADMINISTRATIVE ORDER 2007-0009

FOUR PRIORITY SUB-PROGRAMS

1. Wellness of Daily Living Focuses on attaining and maintaining the wellbeing of person/s across the life cycle through the promotion of healthy lifestyle with emphasis on coping with stress and other psychosocial issues .

ADMINISTRATIVE ORDER 2007-0009

FOUR PRIORITY SUB-PROGRAMS

2. Extreme Life Experience
Focuses on addressing the psychosocial consequences and maintaining mental health of person/s who experiences incidents that are out of the ordinary, such as disaster, epidemic, trauma, etc., which threatens personal equilibrium

ADMINISTRATIVE ORDER 2007-0009

FOUR PRIORITY SUB-PROGRAMS

3. Substance Abuse and other forms of addiction.
Focuses on the promotion of protective factors and prevention against the development of substance abuse and other forms of addiction in the following key settings

(Family, School, Workplace, Community, Health Care Setting, Industry) through existing DOH programs and
responsible agencies

ADMINISTRATIVE ORDER 2007-0009

FOUR PRIORITY SUB-PROGRAMS

4. Mental Disorder
Focuses on the promotion of mental health and prevention of mental illness, such as clinically behavioral or psychological syndromes, characterized by the presence of distressing symptoms or significant impairment of functioning, across the lifespan of an individual.

General Guidelines
A. NOH and F1 encompasses mental health & applies to the promotion of mental health as follows: B. The National Mental Health Program focuses on four priority sub-programs; C. Mental Health Programs adopts the following key approaches and strategies

Key Approaches & Strategies

1.Health Promotion & Advocacy 2. Service provision 3.Policy & Legislation 4. Research Culture 5. Capability Building 6.Public-Private partnership 7. Data base & Information System 8. Development of model programs 9. Monitoring & Evaluation

Implementing Mechanism
A. Management Structure

NPMC - National PDMT RMHT - Regional LGUMHT - Provincial/Municipal

NATIONAL PROGRAM MANAGEMENT COMMITTEE

Ensure the development of mental health measures for subprograms and components; Integrate the various programs, projects 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; Recommend to the Secretary of Health a Master Plan for Mental Mealth aligned with mandates and thrust of various government agencies.

PROGRAM DEVELOPMENT & MANAGEMENT TEAMS

Formulate and recommend policies, standards, guidelines approaches on each specific 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 sub-programs. Ensure the implementation of the program among all stakeholders
Provide technical assistance to other mental health teams according to sub-program thrusts

REGIONAL MENTAL HEALTH TEAMS

Regional Mental Health Team (RMHT) shall be established in each of the Centers for Health Development (CHD).
Members of the RMHT shall be composed of mental health advocates from government agencies, nongovernment organizations, civil societies, academe, specialty societies or associations, and representatives from the local government units.

The RMHT shall be chaired by the Director of the CHD. A Vice-chairperson shall be nominated by members of the Regional Mental Health Team. A secretariat shall be created to support the team

REGIONAL MENTAL HEALTH TEAMS

To ensure the dedication of the members, bilateral agreements shall be developed between the Center for Health Development and members of the team; A Regional Coordinator for the National Mental Health Program shall be designated by the CHD Director. The coordinator shall be responsible for the technical and administrative concerns of the program within the region.

The RMHT shall:

Oversee the planning and operation of 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 NMHP Strengthen technical and managerial capability at the local level to ensure LGU participation on the implementation of the NMHP; Ensure establishment of LGU teams for mental health; Ensure the conduct of monitoring and evaluation of regional activities on the implementation of the NMHP at the regional level Regularly update the Program Development Management Team on the status of the regional implementation of the NMHP.

a. Composition The suggested members of the LGUTMH Mental Health Team shall be composed of the local executives, local health boards, technical health staff, civil society groups, non-government organizations and other stakeholders b. Suggested functions of the LGU Team for Mental Health are the following: Enact necessary legislative issuances (e.g. ordinances, resolutions, etc.) in support of National Objectives for Health, Fourmula One for Health, RA 9165, RA 9211, AO 8 s. 2001, and the National Mental Health Program; Promote and advocate the implementation of the Community-based Mental Health Program among their respective localities and constituents

LOCAL GOVERNMENT UNIT TEAMS FOR MENTAL HEALTH (LGUTMH)

Administrative Order 2007-0009 (Functional Management Structure)

National Program Management Committee

DDO Secretariat
PDMT for the Substance Abuse & other forms of addiction

PDMT
For the Wellness of Daily Living

PDMT for the Extreme Life Experience

PDMT for the Mental Disorder

RMHT

17 Regions

79 provinces, 115 cities, 1,495 municipalities 41,956 barangays

LGUTMH

Overall Strategic Vision

Better Quality of Life through Total Health Care for All Filipinos

Overall Strategic Mission

A Rational and Unified Response to Mental Health

Overall Strategic Goal

Quality Mental Health Care

KEY SETTING -Family -School -Workplace -Community -Health Care Setting -Industry

Strategic Approach

Population Base Approach

Guiding Principle

Evidenced Based Practice

Partnership and Shared Responsibility

Integration

Target Population

Strategic Pillar

Governance

Health Regulation

Health Service Delivery

Health care Financing/Resource Mobilization

Human Resource Development

Information Management System

Area of Emphasis

Wellness of Daily Living

Extreme Life Experience

Mental Disorder

Substance Abuse and Other Form of Addiction

The National Mental Health Program

Wellness of daily Living Extreme Life Experience Mental Disorder Person with Disability

Substance Abuse

Wellness/Normal

High Risk

Mental Disorder

Rehab

Stress

Distress

Disease

Disability

Spectrum of Health
Advocacy, Service Provision, Research, Policy & Legislation, Capability Building, Public-Private Partnership, Data Base information, Development of Model Program, Monitoring and evaluation

Health Education Counseling Stress Management Consultation Socialization

Counseling Stress Management Psychosocial Support Consultation/risk screening

Case Finding Treatment & Rehab CPGs Development of Mid level MDs & other HW Development and Strengthening of referral system

Registration Health Education Development of Livelihood project

Healthy Lifestyle
Sports Festival

Support Group Building

Emergency Management

* Substance Abuse

Integrated Community-based Health Services

National Mental Health Program

Overall Goal: Mental Health is promoted in the general population, the risks and prevalence of mental disorders are reduced, and the quality of life of those who are suffering from such conditions is improved.

STRATEGIES FOR 2011-16

Conduct nationwide awareness on mental health, mental disorder (e.g. Depression and suicide) prevention and control through schools, community & government offices. Training of health workers in early detection, and proper referral system. management of new cases/relapse cases

Community diagnosis on mental health (knowledge, risk factors.

attitude and practices) and its

Policy & Directions

(Jan June)

Capacity Building
(July December)

Provision of Services
(2012)

National
Establishment of Hospital Mental Health Leader & Coordinator
Re-organization of NPMC & PDMT (Experts Group)

Regional /Local
Orientation on Mental Health Program Provision of Drugs & Medicines/Referral System

Community/Local
Wellness of Daily Living Counseling/PSI

Organization of Regional & Local Mental Health Team

Operationalization of HPP Finalization & Reproduction of Training Manuals on..

* Community MH * Stress Management * Psychosocial Intervention * Mgt. of Specific Psychiatric

Training on the Promotion of Community Mental Health

Extreme Life Experience Psychosocial Intervention Diagnostics/Treatments Referrals

Morbidities Development of CPGs for Mental Disorder MOP for Mental Health Program

Stress Management Training Training on Psychosocial Care in Crisis Management Training on Identification & Mgt. of Psychosocial Problems and Specific Psychiatric Morbidity

Mental Disorder
Diagnostics/Treatments at Secondary & Primary Referrals Substance Abuse

Reproduction of Community MH manual & Flyers Baseline Survey on Major Mental Disorder Registry on Mental disorder Mental Health Act

Annual Celebration - Mental Health Week

- Suicide Prevention Day

Health Educ/Promotion Campaigns

Referrals

Community-based Mental Health

Health Educ/Promotion Campaigns

= Community Mental Health

Packages:
GOs I/NGOs POs Religious Sector other Stakeholder Trainings Logistic Support Ordinances Budget Service Provision

Services:
Primary Secondary Tertiary

OF PEOPLE LIVING WITH MENTAL DISORDERS

Push for Legislation of Mental Health Act Link with other sectors to strengthen community-based mental health programs Develop training manuals for psychiatrists, psychiatric nurses, psychologists and psychiatric social workers Educate the public by providing IEC Materials regarding promotion of promotion mental health and prevention of mental disorder to the consumers and the community. Provide trainings and/or seminars to the community regarding mental health to minimize stigma and acceptance that mental disorders is just like any other illnesses.

VIABLE SOLUTIONS TO IMPROVE THE LIVES OF PEOPLE LIVING WITH MENTAL DISORDERS
Strengthen family education regarding signs of impending relapse of the patient Provide technical assistance to projects that would integrate mental health care in general hospital, i.e., Acute Psychiatric Units Strengthen the community outreach service of mental hospitals through effective networking with non-government organizations and local government units. Institute cost effective management of common mental health disorder in PHC through capability building of community based health workers using:

o locally relevant training materials o refresher training course to primary care physicians Provide community care services in coordination / collaboration with local government units and other organizations.

THANK YOU
It was once said that the moral test of Government is how that Government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the (mentally) sick, the (emotionally) needy, and the (mentally) handicapped.
-Hubert Humphrey 38th VP, USA

Thank You

Mabuhay!