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Challenges to
Mental Health in
the Philippines
LEARNING
FACILITATOR
Milagros V. Enog,RGC
GUIDANCE COUNSELOR II – Ong Che Tee-BHS
Learning Objectives

Explain the Mental Health


Status in the Philippines

Discuss Challenges of
Present Mental Health
Services

Self-Awareness of Mental
Health
The Philippines has recently passed its first Mental
Health Act (Republic Act no. 11036). The Act seeks to
establish access to comprehensive and integrated
mental health services, while protecting the rights
of people with mental disorders and their family
members (Lally et al, 2019).
June 20, 2018
However, mental health remains poorly resourced:

• 3–5% of the total health budget is spent on mental health

•70% of this is spent on hospital care (WHO & Department of


Health, 2006).
The majority of mental healthcare is provided in hospital

settings and there are underdeveloped community mental

health services.
There are only two tertiary care psychiatric hospitals:
The National Center for Mental Health –
•4,200 beds located in Mandaluyong City

Mariveles Mental Hospital


•500 beds located in Bataan, Luzon
•There are 12 smaller satellite hospitals affiliated with the
National Center for Mental Health which are located
throughout the country.
Mental Health Services

- 1.08 mental health beds in general hospitals and

- 4.95 beds in psychiatric hospitals per 100 000 of the


population
Present situation in facilities
Overcrowding

poorly functioning units

chronic staff shortages and funding constraints particularly in


peripheral facilities.

There are no dedicated forensic hospitals although forensic beds


are located at the National Center for Mental Health.
Mental Health Staff
0.52 Psychiatrist (Isaac et al,2018) and 0.07 psychologist per
100 000

 There is a ratio of 3.21 psychiatrist / 100 000 general


population in mental health facilities
(WHO & Department of Health, 2012)
 500 psychiatrists in practice.
Mental Health Staff
 World Health Organization (WHO)-recommended
global target of 10 psychiatrists per 100 000
population
majority of psychiatrists work in for-profit services or
private practices and are mainly based in the major
urban areas, particularly in the capital region known as
Metro Manila.
Mental Disorders in the Philippines
 1.4 Million Filipinos with disabilities(mental disorders) 14% of the
population 3rd highest rate of mental health problems in the Western
Pacific Region

14.5% - diagnosis of depression

3.6M Filipinos early part of 2020 suffer from mental, neurological, and
substance use disorder.
Mental Disorders in the Philippines
•1984 and 2005, suicide in the Philippines have increased
from 0.23 to 3.59 per 100 000 in males, and from 0.12 to
1.09 per 100 000 in females (Redaniel et al, 2011).

•The most recent data from 2016 identified an overall


suicide rate of 3.2/100 000, with a higher rate in males
(4.3/100 000) than females (2.0/100 000) (WHO, 2018).
Mental Disorders in World

Depression - 300 million

Bipolar affective disorders – 60 million

Schizophrenia & other psychosis – 23 million

Dementia – 50 million
Mental Disorders in World
Mental, neurological and substance use disorders: 13% GBD

Depression: 4.3% GBD- largest single causes of disability


worldwide(11% of all years lived with disability globaly)
Anxiety Disorder – 284M 2017
Includes:
 Underinvestment
 lack of mental health
professionals
 underdeveloped community
mental health services.
Urgent:
Increased investment  psychiatrists
 nurses
improve the training and
 psychologists
recruitment of  social workers
 other multidisciplinary team
members
 Guidance Counselors
Existing public-health Challenges to delivery of
priorities and its mental health care in
Barriers influence on funding primary- care settings
include

Low numbers of Lack of mental health


those trained perspective in public-
mental healthcare health leadership
Aspects of Health

Physical Health- refers to the Mental Health-refers to a


condition which enables a person thinks of himself,
person to maintain a strong and control his emotions and adjust
healthy body to environment

Social Health – refers to ways a


person feels, think and act
towards everybody around him
Characteristics of a mentally
healthy person
He feels comfortable about himself, secure and
adequate. He accepts his shortcomings. He has self-
respect.
He feels right towards others, love them. He has
friendships that are satisfying and lasting, like and
trust others. He takes responsibility for his neighbors
and his fellow-men
 The mentally healthy person is able to meet the demands of life.

 He does something about the problems as they arise

 He is able to think for himself and to take his own decisions

 He sets reasonable goals for himself

 He shoulders his daily responsibilities

 He is not bowled over his own emotions of fear, anger, love or guilt
Warning Signs of Poor Mental
Health
You’re having feeling of sadness that last longer than two
weeks

You’re having extreme mood swings and don’t know why

Your worry & anxiety have gotten out of control

You’re started withdrawing from others or isolating yourself

You may noticed you’re having delusions or hallucinations


 You’re having more and more difficulty dealing with normal life
situations

 You’re sleeping too much or too little

 You’re started abusing

 You’re having extreme anger outbursts

 You’re started thinking of self-harm or suicide


Ability to recognize psychological distress

Knowledge and beliefs about causes


Components Knowledge and beliefs about self-help
of mental
Health Knowledge and beliefs about professional help
literacy
Attitudes that facilitate recognition and help
seeking
Knowledge of how to seek mental health
information
Needs of Man and Woman

The need for The need for The need for The need for
affection belonging independence achievement

The need for The need for The need for


recognition sense of self-
or approval personal worth actualization

These needs only differ in degree and qualitative importance at various ages
Challenge
+
Control
for future CHANGE in Mental Health
+
Commitment
The Philippine Council for Health Research and
Development

World Association for Psychosocial


Rehabilitation-Philippines

NATIONAL MENTAL HEALTH RESEARCH AGENDA IN THE


PHILIPPINES
2019-2022
After multiple consultation with various stakeholders and

focus group discussions with representatives from service

providers, service users, the academe, policy makers, and

other government and non-government organizations, the

following priority topics for mental health research were finally


identified
The National Mental Health Research Agenda Framework

1
Improved national mental health
information system

Risk factors and


Prevalence and of
determinants known and
disease assessed understood
The National Mental Health Research Agenda Framework

2 Improved national mental health


governance

Digital
Community Integration Institutional Increased
technologies
based mental into capacities investments
embraced
health primary and in mental
and
facilities healthcare competence health
harnessed
The National Mental Health Research Agenda Framework

3 Accessible,affordable,responsive and
rights-based mental health services
and core

Promotion of mental Treatment and care :


health and Patient-centered
prevention of mental Recovery –oriented
disorders holistic
The National Mental Health Research Agenda Framework
The mental health research agenda was defined in accordance
to the Philippine Mental Health act of 2017 as

 it aims to support the current local and global policy reforms


in the mental health

To fill in the information gap in this previously neglected field


of research

Integration of mental health care services in the primary


health care system
Priorities of the Helsinki Declaration
1964 & 2013
1. Foster awareness of the importance of mental well-being

2. Collectively tackle stigma, discrimination and inequality

3. Support people with mental health problems and their families to be


actively engaged in treatment process

4. Design and implement comprehensive, integrated and efficient


mental health systems (promotion, prevention, treatment and
rehabilitation

5. Address the need for a competent workforce, effective in all settings


and areas
References

•Conde B. (2004) Philippines mental health country profile. International Review of Psychiatry, 16, 159–
166. [PubMed] [Google Scholar]
•Department of Health (DOH) (2005) National Objectives for Health, 2005–2010. Department of
Health. [Google Scholar]
•Philippines Statistics Authority (2010). Highlights of the Philippine Population 2010 Census of
Population. Philippines Statistics Authority. [Google Scholar]
•Redaniel M. T., Lebanan-Dalida M. A. & Gunnell D. (2011) Suicide in the Philippines: time trend analysis
(1974-2005) and literature review. BMC Public Health, 11, 536. [PMC free article] [PubMed] [Google
Scholar]
•Tuliao A. P. (2014) Mental health help seeking among Filipinos: a review of the literature. Asia Pacific
Journal of Counselling and Psychotherapy, 5, 124–136. [Google Scholar
•World Health Organization (WHO) (2014) Global Health Observatory Data Repository: Human
Resources Data by country. World Health Organization. [Google Scholar]
•World Health Organization (WHO) (2018) Global Health Estimates 2016: Deaths by Cause, Age, Sex, by
Country and by Region, 2000-2016. World Health Organization. [Google Scholar
“ Challenges are
What makes life
interesting and
overcoming
them is what
makes life meaningful”
Joshua J. Marine
STAY SAFE EVERYONE!!

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