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.
Priority Conditions addressed by
mhGAP
• Depression
• Psychoses
• Suicidal ideation
• Epilepsy
• Dementia
• Disorders due to use of alcohol and psychoactive
substances
• Mental and behavioural disorders in children and other
conditions including medically unexplained somatic
complaints and emotional, physical or behavioural
problems after exposure to an extreme stressor.
 “The essence of
mhGAP is building
partnerships for
collective action.”
MENTAL HEALTH BURDEN

• Mental illness is the 3rd most common disability

among Filipinos (14 % of the population)
• 3rd highest rate of mental health problems in the
Western Pacific Region
• 3.6 million Filipinos suffer from one kind of mental,
neurologic and substance use disorder (WHO, 2020)
• Depression and anxiety is the most common
condition
• Suicide rate is 5.4 per 100, 000 but is increasing
through the years (pandemic)
MENTAL HEALTH BURDEN

• Mental illness remains stigmatized in the country

➢ people with mental health conditions have little
chance of recovery
➢ people with mental health conditions will be looked
down on
➢ it would be embarrassing to go out with a relative
with such condition
➢ preferred not to tell others if they had a mental illness
➢ mental illness is often attributed to curse or evil
spirits in rural areas
RESOURCES FOR MENTAL HEALTH

• mental health represents an estimated 2.65 % of the

health budget (mental hospitals)
• 4 mental hospitals, 46 psychiatric inpatient units, and
29 outpatient mental health facilities
• 548 psychiatrists (0.5 per 100,000)
• 516 psychiatric nurses (0.5 per 100,000)
• 133 psychologists (0.1 per 100,000)
• mental health professionals are mostly in Metro
Manila
Mental Health Patient’s Bill of
Rights
• To be informed about benefits, qualifications of all
providers, available treatment options, appeals and
grievance procedures.

• Least restrictive environment to meet needs.

• Confidentiality

• Choice of providers
Mental Health Patient’s Bill of
Rights
• Treatment determined by professionals, not third-
party payers.

• Nondiscrimination

• All benefits within scope of benefit plan.

Mental Health Patient’s Bill of
Rights
• Treatment that affords greatest protection and
benefit.

• Fair and valid treatment review processes.

• Treating professionals and payers held accountable

for any injury caused by gross incompetence,
negligence, or clinically unjustified decision.
Involuntary Hospitalization

• Most clients are admitted to inpatient settings on a

voluntary basis.

• Some clients, however, do not wish to be hospitalized

and treated.

• HCP respect these wishes unless clients are dangers

to themselves or others.
Release from the Hospital

• Clients admitted to the hospital voluntarily have the

right to leave, provided they do not represent a
danger to themselves or others.
Conservatorship and Guardianship

• People who are gravely disabled, are found to be

incompetent, cannot provide food, clothing and
shelter for themselves even when resources exist,
and cannot act in their own best interests may
require appointment of a conservator or legal
guardian.

• The client with a guardian loses the right to enter into

legal contracts or agreement.
Least Restrictive Environment

• Client does not have to be hospitalized if he or she can be

treated in an outpatient setting.

• Client must be free of restraint or seclusion unless it is

necessary.

• Short-term use of restraint or seclusion is permitted only

when the client is imminently aggressive and dangerous
to himself or herself or to others, and all other means of
calming the client have been unsuccessful.
Restraint
- the direct application of physical force to a person
without his or her permission to restrict his or her
freedom of movement.

- May be human restraint, mechanical or chemical

restraint
Seclusion
- The involuntary confinement of a person in a
specially constructed, locked room equipped with a
security window or camera for direct visual
monitoring.
Least Restrictive Environment

• For adult clients, use of restraint and seclusion

requires a face-to-face evaluation within 1 hour and
every 8 hours thereafter; a physician’s order every 4
hours, documented assessment by the nurse every 1-
2 hours and close supervision of the client.

• For children, the physician’s order must be renewed

every 2 hours with a face-to-face evaluation every 4
hours.
Least Restrictive Environment

• Restraint is a restorative, not a punitive procedure.

• A debriefing session is required within 24 hours

following release from seclusion or restraint.
Nursing Liability

Tort
- A wrongful act that results in injury, loss or damage.

- May be either
➢ unintentional
✓ negligence
✓ malpractice
➢ intentional
✓ assault
✓ battery
✓ false imprisonment
Negligence
- An unintentional tort that involves causing harm by
failing to do what a reasonable and prudent person
would do in similar circumstances.
Malpractice
- A type of negligence that refers specifically to
professionals such as nurses and physicians.

- Four elements that must be proven:

➢ duty
➢ breach of duty
➢ injury or damage
➢ causation
Assault
- Involves any action that causes a person to fear
being touched in a way that is offensive, insulting or
physically injurious without consent or authority.

Battery
- Involves harmful or unwarranted contact with a client
False imprisonment
- Unjustifiable detention of a client, such as the
inappropriate use of restraint or seclusion.
Three Elements to Prove Intentional
Tort
1. The act was wilful and voluntary on the part of the
defendant (nurse).

2. The nurse intend to bring about consequences or

injury to the person (client).

3. The act was a substantial factor in causing injury or

consequences.
Steps to Avoid Liability

• Practice within the scope of law and nurse practice

act.

• Collaborate with colleagues to determine the best

course of action.

• Use established practice standards to guide

decisions and actions.
Steps to Avoid Liability

• Always put the client’s rights and welfare first.

• Develop effective interpersonal relationships with

clients and families.

• Accurately and thoroughly document all assessment

data, treatments, interventions, and evaluations of
the client’s response to care.
REFLECTION ACTIVITY

In your own experience as a mental health psychiatric

student nurse, how would you evaluate the
implementation of the Mental Health Act? What
initiatives or programs for mental health are present in
your school or community?

https://padlet.com/deviannejanedaiz/reflection-activity-9xoun0ksks71fns4