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Department of Health
National Mental Health
Program
 2
Objectives
At the end of the discussion you will be able to:

• Understand the Philippine National Mental Health

Program.

• Identify programs that support the NMHP.

• Identify different conditions covered by the Medicine

Access Program for Mental Health.

• Enumerate the different psychotropic medications

included in the Department of Health Medicine Access
Program.

• Determine the steps on how to access psychotropic

medications to the DOH.
 INTRODUCTION 3
Mental, neurological, and substance use disorders are
common in all regions of the world, affecting every community and
age group across all income countries. While 14% of the global
burden of disease is attributed to these disorders, most of the people
affected - 75% in many low-income countries - do not have access to
the treatment they need.
The WHO Mental Health Gap Action Programme (mhGAP)
aims at scaling up services for mental, neurological and substance
use disorders for countries especially with low- and middle-income.
The programme asserts that with proper care, psychosocial
assistance and medication, tens of millions could be treated for
depression, schizophrenia, and epilepsy, prevented from suicide and
begin to lead normal lives– even where resources are scarce.- WHO
4
GOAL:
Quality Mental Health Care

OBJECTIVE:
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 freedom of
persons with mental diseases and the reduction
of the burden and consequences of mental ill-
health, mental and brain disorders and
disabilities.
 National Mental Health
Program
Vision: Better quality of life through total health
care for all Filipinos

Mission: A rational and unified response to

mental health.
 INTERVENTIONS / STRATEGIES
EMPLOYED/IMPLEMENTED BY DOH

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.

2. Service Provision
Enhancement of service delivery at the national and local
levels will enable the early recognition and treatment of
mental health problems.
 INTERVENTIONS / STRATEGIES
EMPLOYED/IMPLEMENTED BY DOH

3. Policy and legislation

The formulation and institutionalization of national legislations,
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 clinical behavior,
epidemiology, public health treatment options and
knowledge management.
 INTERVENTIONS / STRATEGIES
EMPLOYED/IMPLEMENTED BY DOH

5. Capacity building
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 shall be pursued to
develop partnership and expand the involvement of
stakeholders.
 INTERVENTIONS / STRATEGIES
EMPLOYED/IMPLEMENTED BY DOH

7. Establishment of database and information system

This is needed to determine the magnitude of the problem
to serve as basis for shifting the program for being
institutional and treatment focused on being preventive,
family focused and community oriented.
8. Development of model programs
Best practices 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.
 INTERVENTIONS / STRATEGIES
EMPLOYED/IMPLEMENTED BY DOH

9. Monitoring and evaluation

A regular review process shall be conducted.
 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 and colleges.
❑ Mental Health summit in celebration of World
Mental Health Day.
 13

Mental Health Gap Action

Programme (mhGAP)
AN OVERVIEW
 Leading causes of years of life lived with disability
(Global Health Estimates, 2012)

1 Unipolar depressive disorders 10.3%

2 Back and neck pain 7.3%

3 Iron deficiency anemia 5.9%

4 Chronic obstructive pulmonary disease 4.2%

5 Alcohol use disorders 3.8%

6 Anxiety disorders 3.7%

7 Diabetes mellitus 2.6%

8 Other hearing loss 3.0%

9 Falls 2.8%

10 Migraine 2.5%

“Mental, neurological and substance use disorders are a large and growing problem globally.”
PREDICTIONS FOR THE LEADING CAUSES OF
DISABILITY AND MORTALITY IN 2030
 VISION OF mhGAP

✓ One doctor and/or one nurse for every health

facility nationwide should be trained on
mhGAP
✓ OPS/APU included as requirement for
Philhealth accreditation of 3rd level facility
✓ BHWs to help in identification
mhGAP integrated in medical and nursing
curriculum
✓ Psychotropic medicines part of outpatient
benefit package
 MHGAP-IG CONDITIONS
✓ 1. Depression
✓ 2. Psychosis
✓ 3. Epilepsy
✓ 4. Child and Adolescent Mental and
Behavioral disorders
✓ 5. Dementia
✓ 6. Disorders due to Substance Use
✓ 7. Self-harm/Suicide
✓ 8. Other significant mental health complaints
 Recommended starter kit
(RHU)
✓ Good for 10 patients per month: 8 for
psychosis, 2 for depression

✓ Assumes that there will be one – three patients

needing rapid-acting anti psychotic

✓ Assumes that of the 8 patients with psychosis,

2 would be on long-acting drugs
Recommended starter kit
(RHU)
Chlorpromazine 100 mg tab x 28 per pack x 4 packs
Risperidone 2mg tab x 28 per pack x 2 packs
Haloperidol 5 mg tab x 60 tablets
Fluoxetine 20 mg cap x 28 per pack x 2 packs
Biperiden HCl 2mg tab x 60 tablets
Haloperidol 5 mg/ml amp x 3 ampules
Fluphenazine 25mg/ml injection x 2 amp
Recommended starter kit
(Hospitals)

Same as RHU but 6 instead of 3 Haloperidol 5 mg IM

Valproic Acid 250 mg cap x 60 per pack x 2 packs*
Carbamazepine 200 mg tablet x 60 per pack x 1 pack*
Starter kit given by Region 3
Carbamazepine 200 mg (360)
Sertraline (180)
Risperidone 2 mg (1080)
Chlorpromazine 100 mg (180)
Biperiden 2 mg (252)
Diphenhydramine 50 mg amp (3)
Valproic disodium and valproic acid (360)
Currently, the process takes 6 weeks to 3 months

Delivery of the medicines requested is shouldered

by the requesting party

Need to fill up forms requested by the MAP to re-

order medicines; no forms filled out means you can
not re-order.
 23

MEDICINE ACCESS PROGRAM

MENTAL FOR HEALTH

AN OVERVIEW
 Objectives of MAP-MH
PRIMARY GOAL: To attain and sustain universal
access of all Filipinos to medicines by 2015
Specifically, it aims:

-to improve supply and access to quality essential medicines;

-to ensure rational use of medicines by prescribers,
dispensers, and patients; and
-to institutionalize transparency and good governance in the
pricing and procurement of medicines.
 ELIGIBLE PATIENTS
✓ Diagnosed by his attending physician
with one or more of psychiatric
disorder(s);
✓ Prescribed with medicines included in
the list of essential psychotropic
medicines available for dispensing.
Flowchart on how to become an access site for MAP-MH
ACCESS SITES - LUZON  Cagayan Valley Regional Medical Center
 Ilocos Training and Regional Medical
Center
 Baguio General Hospital
 Bulacan: Municipal Health Office of Plaridel
City Health Office of Malolos
Emmaus House of Apostolate
 NATIONAL CENTER FOR MENTAL
HEALTH
• DOH – TRC Bicutan
• DSWD – Sanctuary Center
• DSWD – Jose Fabella Center
• DSWD – Elsie Gaches Village
• DSWD – Haven for the Elderely
• DSWD – GRACES
• Health Future Foundation Inc. (SAGIP SAMAR)
 Provincial Health Office, Catanduanes
 Gumaca District Hospital
 Bicol Medical Center
 Municipal Health Unit, Oriental
Mindoro
 ANTIPSYCHOTICS, per
orem
 Chlorpromazine 100 mg,
200 mg
 Haloperidol 20 mg
 Risperidone 1mg, 2mg, 4
mg
 Quetiapine 200 mg, 300 mg
 Olanzapine 10 mg
 Clozapine 25 mg, 100 mg
 Risperidone 2mg ODT

injectables
 Haloperidol 5 mg per mL
 Olanzapine 10 mg per vial
 Fluphenazine decanoate 25
mg/mL
 Fluphentixol decanoate 20
mg/mL
 ANTI-DEPRESSANTS ANTI-
 Escitalopram 10 mg PARKINSONISMS
 Flouxetine 20 mg  Biperiden HCl 2 mg
 Sertraline 50 mg  Diphenhydramine
HCl 50 mg per
• MOOD-STABILIZERS capsule
 Diphenhydramine
 Lithium carbonate 450 mg HCl 50 mg/mL

ANTI-CONVULSANTS
 Divalproex Na 250 mg
 Carbamazepine 200 mg
References:
 http://portal.doh.gov.ph/content/national-mental-health-program-0.html
 www.who.int/mental_health/mhgap/en/
 Thank You…
And God Bless