 Palawan does not have a rehabilitation facility for psychiatric patients

Most Palaweños with mental illness are diagnosed with schizophrenia and any

related psychosis, it is characterized by distortions in thinking, perception, emotions,

language, sense of self and behavior. Schizophrenia is associated with considerable

disability and may affect educational and occupational performance. People with

schizophrenia are 2 - 3 times more likely to die early than the general population1. This is

often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.

More than 69 percent of people with schizophrenia are not receiving appropriate care2.

Ninety percent of people with untreated schizophrenia live in low- and middle- income

countries. Lack of access to mental health services is an important issue. Furthermore,

people with schizophrenia are less likely to seek care than the general population.3

Schizophrenia is treatable. Treatment with medicines and psychosocial support is

effective. However, most people with chronic schizophrenia lack access to treatment.

There is clear evidence that old-style mental hospitals are not effective in providing the

treatment that people with mental disorders need and violate basic human rights of

persons with mental disorders3.

1
Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annual Review of Clinical
Psychology, 2014;10, 425-438.
2
Lora A et al.. Service availability and utilization and treatment gap for schizophrenic disorders: a survey in 50 low-
and middle-income countries. Bulletin World Health Organization; 2012: 10.2471/BLT.11.089284.
3
https://www.who.int/news-room/fact-sheets/detail/schizophrenia,
 400

343
350

300

250

200

150

100
62 59
52 43
50 39

0
schizophrenia/ depression developmental seizure disorder behavioral other mental
psychosis disorder disability disorders

Table 1.8 Schizophrenia and psychosis as the leading mental disorders in Palawan4

schizophrenia 3 20 22

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Placebo effect Drug effect Psychosocial effect

Table 1.9 Treatment effects on schizophrenia and any related psychosis5

4
Table 1.4 Provincial Health Office “No Health without Mental health” program report, 2018, pg. 10
5
https://www.who.int/mental_health/media/investing_mnh.pdf, pg. 32
 Projection of psychiatric patients
400

350
339
329
319
300 309
297 290 299
276 281
250

200 207

150

100

50

0
2015 2016 2018 2019 2020 2021 2022 2023 2024 2025

Table 1.10 Projected number of psychiatric patients that need rehabilitation services (3.2
percent (0.032) annual growth rate6)

Existing Mental Health Services for Standard/ ideal treatment needed for

Psychiatric patients of Palawan (Drop- in Psychiatric patients

Center, PPC)

1. Drug effect 1. Drug effect

 Oral Medication  Oral Medication

 Parentheral Medication  Parentheral Medication

2. Placebo effect 2. Admission to a Psychiatric/ Rehabilitation

 Counseling facility (average duration of stay 6 months)

3. Psychosocial Effect 3. Psychosocial Rehabilitation

 None 

6
HHDC accomplishment report, numbers of psychiatric patients brought- in to the facility, Table 1.5 pg. 12
 4. Safekeeping of psychiatric patients (15 days

or 2 weeks)

Stigma, discrimination and violation of human rights of people with schizophrenia is

common.

Halfway house/ Drop- in Center alone, cannot provide the different needs of the patients,

Halfway House/ Drop- in center can only accommodate 15 patients at a time with 2 weeks

stay at the facility for safekeeping. But due to the large numbers of patients being admitted

to the facility, the tendency of overcrowding and early release of safekept patients is

inevitable. This may lead to the patients with chronic mental disorder to receive lesser

psychiatric care intervention and monitoring. In year 2013 and 2014, there are 185 reports

of psychiatric patients brought back to the halfway house/ Drop- in Center because of

relapse or the recurrence of their mental disorders7. Relapses usually happens to patients

after the discontinuation of his/her medication.

According to NBCI, only 10-20% of psychiatric patients don’t experience relapse.

Relapse have 52% rate and usually happens 6.3 (ranging from 0.5 to 24 months) months

after treatment.8 All patients suffering from severe and persistent mental illness requires

7
Halfway House Annual Report 2013- 2019 Table 1.3
8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599855/
 rehabilitation. The goal of psychiatric rehabilitation is to help the disabled individuals to

develop the emotional, social and intellectual skills needed to live, learn and work in the

community with the least amount of professional support. The overall philosophy of

psychiatric rehabilitation comprises two intervention strategies. The first strategy is

individual-centered and aims at developing the patient's skills in interacting with a stressful

environment. The second strategy is ecological and directed towards developing

environmental resources to reduce potential stressors9.

Projection of psychiatric patients

400

350
339
329
319
300 309
297 290 299
276 281
250

200 207

150

100

50

0
2015 2016 2018 2019 2020 2021 2022 2023 2024 2025

Graph 1.3 Projection of psychiatric patients with 3.2 percent (0.032) annual growth rate10

9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1636112/
10
HHDC accomplishment report, numbers of psychiatric patients brought- in to the facility, Table 1.3
 Percentage of mental illness

5%4% Others
6%
Psychosis
6%
46% Depression
Seizure Disorder

33% Developmental Disorder

Behavioral Disability

Chart 1.1 Percentage of mental illnesses out 1029 reported cases in 201811

Graph 1.4 Percentage of treatments and effects in different mental disorder (WHO, 2003)12

Fig. 1.3 Halfway House/ Drop- in Center (Services for mentally ill) left- side and rear view

2013 2014 2015 2016 2017 2018 2019

11
PHO Annual Report on Mental Health, 2018 Table 1.2
12
Investing in Mental Health WHO, 2003 https://www.who.int/mental_health/media/investing_mnh.pdf
 Total no. of 482 650 276 297 N/A 207 281
Patients
brought- in to
the facility

Safekept 276 334 240 191 N/A N/A 160

Patients

Violent Patients 84 108 240 255 N/A 85 173

Psychotic 15 12 15 18 N/A 12 10
vagrants

Relapse/ 77 108 N/A N/A N/A N/A N/A

recurrence

Table 1.5 Halfway House/ Drop- in center for mentally ill annual report 2013- 201913
Research has not identified one single factor. It is thought that an interaction between genes
and a range of environmental factors may cause schizophrenia. Psychosocial factors may also
contribute

 Insufficient number of Psychiatric beds in Palawan

Existing number of Psychiatric beds in Standard number of Psychiatric beds

Palawan (50 per 100, 000 of the population14)

13
Halfway House Drop In Center, Accomplishment Reports, 2013- 2019
14
https://www.treatmentadvocacycenter.org/storage/documents/backgrounders/how-many-psychiatric-beds-
does-america-need.pdf
Municipali Total Psycho Behaviou Depressi Develop Seizure others
ty/ city number sis ral on mental disorder
of disability disorder
patients
PHO clinic 53 46 1 6 1
(bipolar)
Coron 45 27 1 3 13
Cuyo 69 22 3 12 15 12 5
(alcohol
& drug
use,
dementi
a)
Araceli 23 13 7 3
Taytay 85 66 1 16 2
Narra 89 35 11 25 4 2 12
(alcohol
& drug
use,
dementi
a)
PPC 88 57 1 4 2 24(bipol
ar)
Roxas 87
Linapacan 12
Aborlan 61
El Nido 73
Balabac 1
Quezon 28
Bataraza 89
Magsaysa 47 22 24 1 (drug
y use)
Agutaya 4 1 1 1 1
Cagayanci 2 2
llo
Dumaran 7 6 1
Brooke’s 65 47 15 3
Point
Sofronio 14 14
Espaṅola
Busuanga 14 7 1 1 5
San NO DATA
Vicente
Culion NO DATA
Kalayaan NO DATA
TOTAL 957 343 39 62 52 59