National Mental Health Program (DOH)

7/27/2019 National Mental Health Program (DOH)

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Paula Nicole Anne R. Marin

National Mental Health Program

I. Rationale:

Background of the Program

Vision: Better Quality of Life through Total Health Care for all Filipinos.

Mission: A Rational and Unified Response to Mental Health.

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 freedoms of persons withmental diseases and the reduction of the burden and consequences of mental ill-health, mentaland brain disorders and disabilities.

State International Support and Policies, Mandates

Stakeholders:

To ensure the sustainability and effectiveness of the National Mental Health Program, certaincommittees and teams were organized.

1. National Program Management Committee (NPMC)

The NPMC is chaired by the Undersecretary of Health of the Policy and StandardsDevelopment Team for Service Delivery and co-chaired by the Director IV of the NationalCenter for Disease Prevention and Control (NCDPC).

Its functions are as follows:

Oversee the development of mental health measures for sub-programs andcomponents;

Integrate the various programs, project and activities from the various programdevelopment and management groups for each sub-program;

Manage the various sub-programs and components of the National Mental HealthProgram;

Oversee the implementation of prevention and control measures for mental healthissues and concerns; and

Recommended to the Secretary of Health a master plan for mental health alignedwith the mandates and thrusts of various government agencies.

2. Program Development and Management Teams (PDMT)


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Under the NPMC, PDMT shall be established corresponding to the four sub-programs of theNational Mental Health Program. A PDMT shall oversee the operations of a sub-program of theNational Mental Health Program.

The functions of PDMT are:

Formulate and recommend policies, standards, guidelines approaches on eachspecifics sub-programs on mental health;

Develop a plan of action for each specific sub-program in consultation with mentalhealth advocates and stakeholders

Develop operating guidelines, procedures, protocols for the mental health sub-program. Ensure the implementation of the program among all stakeholders; and

Provide technical assistance to other mental health teams according to sub-programs thrusts.

3. Regional Mental Health Teams (RMHT)

To ensure an efficient and effective multi-sectoral implementation of the National Mental HealthProgram at the regional level, a RMHT shall be established in each of the Centers for HealthDevelopment (CHD).

The functions are as follows:

Oversee the planning and operation of the National Mental Health Program at theregional level;

Provide technical assistance on the issues and concerns pertaining to theimplementation of the different subprograms of the National Mental Health Program;

Strengthen technical and managerial capability at the local level to ensure LGUparticipation on the implementation of the National Mental Health Program;

Ensure establishment of LGU teams for mental health; Ensure the conduct of monitoring and evaluation of the implementation of the

National Mental Health Program at the regional level; and Regularly update the PDMT on the status of the regional implementation of the

National Mental Health Program.

4. Local Government Unit Mental Health Teams (LGUMHT)

The suggested members of the LGUMHT are the local health board members, technical healthstaff, civil society groups, non-government organizations and other stakeholders. Primarily, theLGUMHT enacts necessary legislative issuances and promotes and advocates theimplementation of Community-based Mental Health Program among their respective localities

and constituents.

5. Other Partners and Stakeholders

Other stakeholders who may or may not belong to the above-mentioned committees or teamsmay contribute to the implementation of the National Mental Health Program by:

Ensuring the availability of competent, efficient, culturally and gender-sensitivehealth care professionals who provide mental health services;


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Identifying mental health needs of the population and refer findings to theappropriate mental care provider; and

Promoting and advocating for the implementation of the program within theirrespective areas of responsibility.

II. Scenario

Global Situation:

Many people with mental health conditions, as well as their families and caregiver, experiencethe consequences of vulnerability on a daily basis. Stigma, abuse, and exclusion are all-too-common. Although their vulnerability is not inevitable, but rather brought about their socialenvironments, over time it leads to a range of adverse outcomes, including poverty, poor health,and premature death.

Because they are highly vulnerable and are barely noticed- expert to be stigmatized and depriveof their rights- it is crucial that people with mental health conditions are recognized and targetedfor development interventions. The case for their inclusion is compelling. People with mentalhealth conditions meet vulnerability criteria: they experience severe stigma and discrimination;they are more likely to be subjected to abuse and violence than the general population; theyencounter barriers to exercising their civil and political rights, and participating fully in society;they lack access to health and social services, and services during emergencies; theyencounter restriction to education; and they excluded from income-generating and employmentopportunities. As a cumulative result of these factors, people with mental conditions are atheightened risk for premature death and disability. Mental health conditions also are highlyprevalent among people living in poverty, prisoners, people living with HIV/AIDS, people inemergency settings, and other vulnerable groups.

Attention from development stakeholders is needed urgently so that the down-ward-spiral ofeven-greater vulnerability and marginalization is stopped, and instead, people with mentalhealth conditions can contribute meaningfully to their countries development.

As a starting point, development stakeholders can consider carefully the general principles foraction outlined in this report, and decided how best to incorporate them into their specific areasof work. Targeted policies, strategies, and interventions for reaching people with mentalconditions then should be developed, and mental health interventions should be mainstreamedinto broader national development and poverty reduction policies, strategies, and interventions.To make implementation a reality, adequate funds must be dedicated to mental healthinterventions, and recipients of development aid should be encouraged to address the needs of

people with mental health conditions as a part of their development work. At country level,people with mental health conditions should be sought and supported to participate indevelopment opportunities in their communities.

Specific areas for action address the social and economic factors leading to vulnerability. Mentalhealth services should be provided in primary care settings and integrated with general healthservices. To that end, mental health issues should be mainstreamed on countries broaderhealth policies, plans, and human resource development, as well as recognized as an importantissue to consider in global and multisectoral efforts, such as the International Health


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Partnership, the Gloring Health Workforce Alliance, and the Health Metrics Network. During andafter emergencies, development stakeholders should promote the (re)construction ofcommunity-based mental health services, which can serve the population long beyond theimmediate aftermath of the emergency. Development strategies and plans should encouragestrong links between health/mental health services, housing, and other social services. Accessto education for people with mental conditions, as well as early childhood programmes for

vulnerable groups should be supported by development stakeholders in order to achieve betterdevelopment outcomes. People with mental health conditions should be included in employmentand income generating programmes to assist with poverty alleviation, improve autonomy andmental health. Throughout their different areas of work, development stakeholders can andshould support human rights protections for people with mental conditions and built theircapacity to participate in public affairs.

This report provides a number of recommendation and specifics areas of action that need to beintegrated into policy, planning, and implementation by development stakeholders according totheir role and strategic advantage. To achieve this aim development stakeholders need torecognize people with mental health conditions as a vulnerable group requiring support fromdevelopment programmes.

(World Health Organization and Mental Health and Poverty Project, 2010)

Local Situation

In a local baseline survey in 1964-67 in Sta. Cruz, Lubao, Pampanga, Manapsal of the DOHDivision of Mental Hygiene, Bureau of Disease Control, found that the prevalence of mentalhealth was 36% per 1,000 adults, children and adolescents. The 1980 WHO CollaborativeStudies for Extending Mental Health Care in General Health Care Services (involving sevencountries) showed that 17% for adults and 16% of children who consulted at three healthcenters in Sampaloc, Manila have mental disorders. Depressive reactions in adults andadaptation reaction in children were most frequently found. In Sapang Palay, San Jose DelMonte, Bulacan, the prevalence of adult schizophrenia was 12 cases per 1,000 population in1988-1989 (Manalang et al).

In Region 6 (Iloilo, Negros Occidental and Antique), Perlas et al. im 1993-94 showed that theprevalence of the following mental illness in the adult population were: psychosis (4.3%),anxiety (14.3%), panic (5.6%). For the children and adolescent, the top five most prevalentpsychiatric conditions were: enuresis (9.3%), speech and language disorder (3.9%), mentalsubnormality (3.7%), adaption reaction (2.4%) and neurotic disorder (1.1%).

The current DOH bed capacity for mental disorder is 5,465. Of these, 4,200 beds are in theNCR (at the National Center for Mental Health). The rest of the country share the remaining

1,265 beds (CAR-40 beds, Region 2-200 beds, Region3-500 beds, Region 11-200 beds).Regions 1,4,10,12, CARAGA and ARMM do not have inpatient psychiatric facilities. Only 27DOH medical centers and regional hospitals have mental health services. Cavite is the onlyprovince with a psychiatric facility.

These situations have hampered the delivery of basic services, aborted the nationaldevelopment, and reduced quality of life of the Filipino. Life has become severely stressful tomost, whether rich or poor, young or old. The resiliency of the Filipino people to adapt to hispresent life situation is being stretched too far. Warning signs of restlessness abound such as


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increasing reports of suicides and substance abuse. Decline in the socio-economic conditionmay translate into mental-ill health and therefore mental health disorders and mental disabilities.

However, the provision of mental health services in the country, has remained illness-oriented,institution-based, fragmented, inadequate, inequitable, inaccessible, prohibitive, and neglected.

The Department of Health (DOH), the national lead agency for health recognizes the magnitudeof the mental health problem as contained in the National Objectives for Health (NOH) 1999-2004. Among the objectives are set the following:

- Reduction of morbidity, mortality, disability and complications from mental disorder

- Promotion of healthy lifestyle through the promotion of mental health and less stressfullife.

However, the DOH has constraints in attaining these objectives given the limited governmentresources. Within the health sector, mental health has to compare for resources against other

equally important health objectives. Concomitant reforms are therefore being pursued inhospitals, public health, local health systems, regulation as well as financing with the end-viewof improving the health of all Filipinos as embodied in the Health Sector Reform Agenda.

Statistics/Local data about the disease program

Disorder Number of Cases % 95% CI

Specific Phobias 93 19 15.98, 23.1

Alcohol Abuse 31 6 4.56, 8.96

Depression 14 3 1.74, 4.8

Number of Diagnosis No. of Respondents %

One Diagnosis 56 12

Multiple Diagnosis 66 15

2 Diagnoses 32

3 Diagnoses 7

>/=4 Diagnoses 27

Total 122 27

*Department of Health (DOH) and Field Epidemiology Training Program AlumniFoundation Incorporated (FETPAFI)

III. Interventions/ Strategies employed or implemented by DOH


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The National Mental Health Program has the following program strategies:

1. Health Promotion and Advocacy

Enrichment of advocacy and multimedia information, education and community (IEC) strategiestargeting the general public, mental health patients and their families, and service providersshall be done through the promulgation of observances issued by the Office of the President.

2. Service Provision

Enhancement of service delivery at the national and local levels will enable the early recognitionand treatment of mental health problems. To ensure continuity of care, mental health servicesfor people with persistent disabilities shall be established close to home and the workplace.

3. Policy and Legislation

The formulation and institutionalization of national legislation, policies, program standards and

guidelines shall emphasize the development of efficient and effective structures, systems, andmechanisms that will ensure equitable, accessible, affordable and appropriate health servicesfor 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 thefollowing areas: clinical behavior, epidemiology, public health treatment options, and knowledgemanagement. It aims to acquire evidence-based information that will contribute to the publichealth information and education, policy formulation, planning, and implementation.

5. Capability Building

The capability of national, regional and local health workers in delivering efficient, effective andappropriate mental health services shall be strengthen. Training shall be conducted onpsychosocial care, the detection and management of specific psychiatric morbidity, and theestablishment of mental health facilities.

6. Public-Private Partnership

Inter-sectoral approaches and networking with other government agencies, non-governmentorganizations, academe and private service providers and other stakeholders at the locals,regional and national levels shall be pursued to develop partnership and expand theinvolvement of stakeholders in: a.) advocacy, promotion and provision of mental health services;

b.) conduct of relevant studies, researches and surveys; c.) training of mental health workers;d.) sharing of researches, data and other information on mental issues and concerns; and e.)sharing of resources.

7. Establishment of data base and information system


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National Center for Mental Health (NCMH)

Nuevo de Pebrero St. Mauway, Madaluyong City

# (632) 531-90-01

-Dr. Bernardino Vicente

Medical Center Chief

Philippine Mental Health Association (PMHA)

No. 18 East Avenue, Quezon City 1100# (632) 921-49-58; (632) 921-49-59

-Ms. Regina De Jesus

National Executive Director

Christoffel Blindenmission (CBM)

Unit 604, Alabang Business Tower

1216 Acacia Avenue, Madrigal Business Park

Alabang, Muntinlupa City 178

# (632) 807-85-86; (632) 807-85-87

-Mr. Willy Reyes

Contact no. 0905-4142608

Program Managers:

Mr. Melson Mendoza

Email:[email protected]

Ms. Remedios Guerrero
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Ms. Ditas Purisima Raymundo


Department of Health-Non Communicable Disease Office (DOH-NCDO)

Contact Number: 651-78-00 local 1750-1752
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]

National Mental Health Program (DOH)

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