MENTAL HEALTH

RACHEL H. SANTOS- BUCAY, RM, RN, LPT, MAN

CLINICAL INSTRUCTOR
 What is Health?

complete state of
physical, mental and social
wellbeing and not merely the
absence of diseases or
infirmity.
 MENTAL HEALTh

Individual

 As a state of social well-being in which

every individual realizes his or her own Social

potential, can cope with the normal stresses

of life, can work productively and Environmental
fruitfully, and is able to make a
contribution to her or his community.
 What is Mental Health Problem?

Risk factors
disrupts a person’s thinking, feeling,
mood, ability to relate to others and Increases the likelihood of having
daily functioning mental health problem
 RISK FACTORS

 Stressful life events

 Difficult family background
 Heredity
 Brain diseases
 Brain trauma
 Medical illness/ Problems
 Substance Abuse
What do you think about people with
mental illness?
 What are the daily challenges for persons with mental,
neurological and substance use disorders?

 Employment?

 Education?
 Marriage?
 Social life?
 Abuse?
4 facets of Public health burden

1. Defined/ direct burden

2. Undefined or indirect burden
3. Hidden burden
4. Future or health burden
 MENTAL ILLNESS
(mental disorder)
> Is any illness experienced by a person that interferes with his or her thinking, feeling, or
social activities and even daily functioning. It produces a negative effect on one’s life or the
lives of the family. A mental health problem, on the other hand, does not hamper functioning
and is temporarily experienced as a reaction to life stressors. It is less severe and shorter in
duration, but it may develop into mental disorders.
 Common Mental Health Problems

 Depression  Behavioral
 Psychosis  Dementia
 Bipolar  Alcohol use Disorder
 Epilepsy/ Seizures  Drug use disorder
 Developmental  Self-harm/ Suicide
 Depression
What is Depression?
 Makes a person experience
depressed mood, loss of interest
and enjoyment, reduce energy
leading to diminished activity for
at least 2 weeks.
 May suffer from anxiety
symptoms and medically
unexplained somatic symptoms.
Common Presentation
 Low energy; fatigue; sleep or appetite
problems
 Persistent sad or anxious mood;
irritability
 Low interest or pleasure in activities
that used to be interesting or enjoyable
 Multiple symptoms with no clear
physical cause (e.g. aches and pains,
palpitations, numbness)
 Difficulties in carrying out usual work,
school, domestic or social activities
 Psychosis
What is Psychosis?
 Characterized by distortions of thinking and
perception, as well as inappropriate or
narrowed range of emotions.
 
People with psychosis are at high risk of
exposure to human rights violations.
Common Presentation
 Abnormal or disorganized behaviour (e.g.
incoherent or irrelevant speech, unusual
appearance, self-neglect, unkempt appearance)
Delusions (a false firmly held belief or
suspicion)
 Hallucinations (hearing voices or seeing things
that are not there)
 Neglecting usual responsibilities related to
work, school, domestic or social activities
 Manic symptoms (several days of being
abnormally happy, too energetic, too talkative,
very irritable, not sleeping, reckless behaviour)
 Bipolar Disorder
What is Bipolar Disorder? Common Presentation

 characterized by episodes in which the  Elevated, expansive or irritable mood

person’s mood and activity levels are  Increased activity, restlessness, excitement
significantly disturbed.
 Increased talkativeness
 This disturbance consists on some
occasions of an elevation of mood and  Loss of normal social inhibitions
increased energy and activity (mania), and  Decreased need for sleep
on others of a lowering of mood and
 Inflated self-esteem
decreased energy and activity (depression).
 Distractibility
 Elevated sexual energy or sexual
indiscretion
 Epilepsy/ Seizures
What is Epilepsy/ Seizures?
 chronic condition, characterized by
recurrent unprovoked seizures
 It has several causes; it may be genetic or
may occur in people who have a past
history of birth trauma, brain infections or
head injury
Common Presentation
 convulsive movement or fits / seizures
 During the convulsion:
– loss of consciousness or impaired
consciousness
– stiffness, rigidity
– tongue bite, injury, incontinence of urine
or faeces
 After the convulsion: fatigue, drowsiness,
sleepiness, confusion, abnormal behaviour,
headache, muscle aches, or weakness on one
side of the body
 Developmental disorder
What is Developmental disorders? Common Presentation

 covering  Delayed development: much slower

disorders such as intellectual
disability / mental retardation as well learning than other children of same age
in activities such as: smiling, sitting,
as pervasive developmental disorders
standing, walking, talking /
including autism. communicating and other areas of
development, such as reading and writing
Intellectual Disability
 Abnormalities in communication;
impairment of skills across multiple developmental areas (i.e.,
cognitive, language, motor and social) during the developmental restricted, repetitive behaviour
period.
 Difficulties in carrying out everyday
Pervasive Development Disorder (Autism) activities normal for that age
impaired social behaviour, communication and language, and a
narrow range of interests and activities.
 Behavioral Disorder
What is Behavioral disorders?
 umbrella term for children and
adolescents with a moderate to
severe degree of psychological,
social, educational or
occupational impairment in
multiple settings. This can
persists into adulthood.
Common Presentation
 Excessive inattention and absent-
mindedness, repeatedly stopping tasks
before completion and switching to
other activities
 Excessive over-activity: excessive
running around, extreme difficulties
remaining seated, excessive talking or
fidgeting
 Excessive impulsivity: frequently
doing things without forethought
 Behavioral Disorder
Common Presentation

 Repeated and continued behaviour that disturbs others (e.g. unusually

frequent and severe temper tantrums, cruel behaviour, persistent and
severe disobedience, stealing)
 Sudden changes in behaviour or peer relations, including withdrawal
and anger
 Dementia
What is Dementia?
 syndrome due to illness of the brain, which is
usually chronic and progressive in nature. This
can cause changes on person’s mental ability,
personality and behaviour.
 commonly experience problems with memory
and the skills needed to carry out everyday
activities.
 Not part of normal ageing and can occur at any
age. However, it’s more common in older
people.
Common Presentation
 Decline or problems with memory (severe
forgetfulness) and
 orientation (awareness of time, place and
person)
 Mood or behavioural problems such as
apathy (appearing uninterested) or
irritability
 Loss of emotional control – easily upset,
irritable or tearful
 Difficulties in carrying out usual work,
domestic or social activities
 Alcohol Use Disorder
What is Alcohol Use disorder? Common Presentation

 Conditions resulting from  Appearing to be under the influence of

different patterns of alcohol alcohol (e.g. smell of alcohol, looks
consumption include acute intoxicated, hangover)
alcohol intoxication, harmful  Presenting with an injury
alcohol use, the alcohol
 Somatic symptoms associated with alcohol
dependence syndrome, and the
alcohol withdrawal state. use (e.g. insomnia, fatigue, anorexia,
nausea, vomiting, indigestion, diarrhoea,
headaches)
 Difficulties in carrying out usual work,
school, domestic or social activities
Screening for Alcohol Abuse Disorder

CAGE Screening Test

Answer yes or no to the following questions:

Have you ever felt you should . . . . . Cut down on your drinking?
Have people . . . . . . . . . . . . . . . . . . . Annoyed you by criticizing your drinking?
Have you ever felt bad or . . . . . . . . . Guilty about your drinking?
Have you ever had an . . . . . . . . . . . . Eye-opener (a drink first thing in the morning to steady your nerves or get rid of a hangover)?

One “yes” response suggests a possible alcohol problem. If you answered yes to more than one question, it is highly likely
that a problem exists. In either case, it is important that you see your physician or other health care provider right away to
discuss your responses to these questions.

http://www.integration.samhsa.gov/health-wellness/wellness-strategies/wellness.pdf
 Drug Use Disorder
What it is?
 Conditions resulting from different patterns
of drug use include acute sedative overdose,
acute stimulant intoxication or overdose,
harmful or hazardous drug use, cannabis
dependence, opioid dependence, stimulant
dependence, benzodiazepine dependence,
and their corresponding withdrawal states.
Common Presentation
 Appearing drug-affected (e.g. low energy,
agitated, fidgeting, slurred speech)
 Signs of drug use (injection marks, skin
infection, unkempt appearance)
 Requesting prescriptions for sedative
medication (sleeping tablets, opioids)
 Financial difficulties or crime-related
legal problems
 Difficulties in carrying out usual work,
domestic or social activities
 Self-harm /Suicide
What is Self-Harm?
Suicide is the act of deliberately killing
oneself.
Self-harm is a broader term referring to
intentional self-inflicted poisoning or injury,
which may or may not have a fatal intent or
outcome.
Common Presentation
 Current thoughts, plan or act of self-harm or
suicide
 History of thoughts, plan or act of self-harm
or suicide
Any person over 10 years of age experiencing any
of the following conditions should be asked about
thoughts or plans of self-harm in the last month and
about acts of self-harm in the last year:
 » any of the other priority conditions
 » chronic pain;
 » acute emotional distress.
 MENTAL HEALTH
PROGRAM
 Is a plan of action aims to accomplish clear objectives.
 Through a comprehensive mental health program that includes a wide range of promotive,
preventive, treatment and rehabilitative services; that is for all individuals across the life course
especially those at risk of and suffering from MNS disorders; integrated in various treatment
settings from community to facility that is implemented from the national to the barangay
level; and backed with institutional support mechanisms from different government agencies.
 We hope to attain the highest possible level of health for the nation because there is no
Universal Health Care without mental health.
 MENTAL HEALTH
PROGRAM
Vision Mission
A society that promotes the well-being of To promote over-all wellness of all Filipinos,
all Filipinos, supported by transformative prevent mental, psychosocial, and neurologic
multi-sectoral partnerships, comprehensive disorders, substance abuse and other forms of
mental health policies and programs, and a addiction, and reduce burden of disease by
responsive service delivery network improving access to quality care and recovery in
order to attain the highest possible level of health
to participate fully in society.
 MENTAL HEALTH
PROGRAM
Objectives
 To promote participatory governance and leadership in mental health
 To strengthen coverage of mental health services through multi-sectoral partnership to provide
high quality service aiming at best patient experience in a responsive service delivery network
 To harness capacities of LGUs and organized groups to implement promotive and preventive
interventions on mental health
 To leverage quality data and research evidence for mental health
 To set standards for compliance in different aspects of services
 REPUBLIC ACT No. 11036
“Mental Health Act”

 Is an Act Establishing a National Mental Health Policy for the Purpose of

Enhancing the Delivery of Integrated Mental Health Services, Promoting and
Protecting the Rights of Persons Utilizing Psychosocial Health Services in the
Philippines.
 Specifically, the law calls for the
implementation of the following:
 Mental health services at the community level for all LGUs down to the barangay.
 Community resilience and psychosocial wellbeing training in all barangays, including
the availability of mental health and psychosocial support services during and after
natural disasters and other calamities.
 Training and capacity- building programs for local mental health workers in
coordination with mental facilities and departments of psychiatry in general or
university hospitals.
 Support services for families and co- workers of mental health services; and
 Dissemination of mental health information and promotion of mental health
awareness among the general population.
Section 42. Creation of the DOH Mental Health Division. - There shall be created in the
DOH, a Mental Health Division, under the Disease Prevention and Control Bureau, staffed by
qualified mental health specialists and supported with an adequate yearly budget. It shall
implement the National Mental Health Program and, in addition, shall also serve as the
secretariat of the Council.
 Mental Health Resources
in the Philippines - Manpower

Total psychiatric beds per/100,000 4.486

population
Psychiatrists per 100,000 population 0.38
Psychiatric nurses per 100,000 0.72
population
Neurologists per 100,000 population 2
Neurosurgeons per 100,000 population 0.11-1
Psychologists working in mental health 0.22
per 100,000 population
Social workers working in mental health 0.02
per 100,000 population
Fact 9: There are 5 key barriers to increasing mental health
services availability

 absence of mental health from

the public health
 current organization of mental
health services
 lack of integration within
primary care
 inadequate human resources
for mental health
 lack of public mental health
leadership
Mental health needs
1-3% severe mental
disorders

5—10% moderate to
mild: depression,
anxiety, alcohol abuse

10-20% Subclinical
distress

100% MH prevention,
protection and
promotion
 Training in mental health for primary care staff
 4-5% of training time devoted to mental health
 1% of doctors, 2% of nurses and 6% of other PHC workers have
received training related to mental health
 Almost no assessment and treatment protocol for key mental health
conditions
 Limited prescription of psychotropics
 Mental health services are largely facility-based.
Fact 10: Financial resources to increase services are relatively
modest

 Governments, donors and

groups representing mental
health service users and their
families need to work together
to increase mental health
services.
On financing cost of care

 Five percent of health care expenditures by the DOH are directed

towards mental health, 98% of which are spent on the operation,
maintenance and salary of personnel of mental hospitals.

 Mental health services are primarily shouldered by individuals

themselves. The Philippine Health Insurance Corporation
recently covered mental illness but limited only to patients with
severe mental disorders confined for short duration.

Mental Health Systems in the Philippines (DOH-WHO, 2007)

What are the things needed to be done at
the community level?
Advocate for the rights of people
with mental illness and their
families

Integrate mental health services at

the primary health care

Coordinate support services for

people with mental illness and their
family carer.
 Key Messages
 There is no health without mental health.
 Mental health is influenced by individual, social and
environmental factors.
 Toimprove mental health, risk factors should be reduced and
protective factors should be promoted.
 Mentalhealth problems are common in the community/school
and can be identified by Teachers/Guidance Counselors.
Calendar of Activities

September 10 - World Suicide Prevention Day

October 10 -World Mental Health Day

2nd Week of October - National Mental Week

 “There is
NO health
without
mental health.”
Thank you for listening!!!