Health Undersecretary Beverly Ho (Photo from Facebook account of the Department of Health)
MANILA, Philippines — There are only three mental healthcare professionals for every 100,000 Filipinos, and in a situation where mental health disorders are underreported, the Department of Health (DOH) is training local health workers to be proficient in this discipline to address the shortage.
Health Undersecretary Beverly Ho, speaking at this year’s National Mental Health Summit held in Taguig City, said the “goal is to begin democratizing mental health services… meaning, we don’t have to be specialist-oriented.”
“We don’t have enough [mental health workers]. But we don’t want to rely on specialists. Within the health-care sector, we want primary care providers to be able to screen for mental health,” said Ho, who is also the officer in charge of the DOH’s public health services team.
She emphasized that frontline health workers, down to the barangay level, should be able to provide counseling or refer mental health patients to the appropriate health facility or doctor.
For years, the DOH has maintained that for every 100,000 Filipinos, there are only about three mental health professionals such as psychiatrists, psychologists and psychiatric nurses. The health agency aims to double this number in five years.
But Ho said increasing the number of mental health workers would also mean establishing a “specialist-oriented system,” which is not among the current priorities of the DOH.
According to the DOH, at least 3.6 million Filipinos suffered from some form of mental health illness in 2020, the first year of the Covid-19 pandemic. The other mental health issues were depressive disorder, bipolar disorder, schizophrenia, alcohol and drug use disorders, epilepsy and suicide.
But the health department said these numbers may be underreported because the data tackled only a few conditions, and there is still stigma attached to mental health illness.
One in three COVID-19 patients also developed “various adverse neurological and psychiatric outcomes” such as anxiety, mood and substance use disorders, about six months after contracting the virus, the DOH said.
Most common cases
The DOH figure is far from the estimates of the World Health Organization (WHO) which said the two most common mental health conditions among Filipinos are anxiety and depression; 15.3 million are suffering from substance use disorder and another one million from schizophrenia.
Reported suicide rates in the Philippines have been increasing over the past several decades, particularly among young people, with 2015 estimates indicating 17 percent of young people age 13–15 had attempted suicide, the WHO added.
A 2021 study by the University of the Philippines Population Institute found that one out of five Filipinos age 15 to 24 had thought about ending their lives; 7 percent considered suicide “more than once.”
It found that “family problems” was the top reason for the youth’s behaviors.
“The question is how do we better equip parents to help their kids,” Ho told reporters on the sidelines of the event.
“They need to create an open space at home to talk about [their mental health]… We have to normalize talking about this,” she said.
2,000 trained
The DOH has adopted the WHO Mental Health Gap Action Program in training health-care workers to address mental health patients at the primary care level that entails preventing suicide and helping those with mental health problems to lead normal lives by providing proper care, psychosocial assistance and medication.
Ho said that more than 50 percent of health-care workers, or about 2,000 assigned at rural health units nationwide, have already finished training under this program. The DOH aims to cover all health-care workers by next year.
The health official pointed out that the country is losing mental health professionals to other lucrative jobs due to the lack of a “sustainable career path” for them, adding that the government and the private sector must invest in them.
Career path
For Yuri Marshall, CEO of Mind You, a technology system for mental health intervention, said the country needs to improve the training and continuing professional development of mental health-care workers.
“A sustainable career path needs to involve a mental health professional feeling like they are also growing in their career. So [there is a need] to improve their skill sets and their ability to operate in a community so they can speak and connect to other psychologists, psychiatrists, guidance counselors and social workers,” he said.
Ho said another way to “scale up” resources for mental health intervention is to partner with the private sector, schools and communities.
“It’s not merely a health sector issue… In our waking days, what are the chances you’ll go to the hospital as opposed to you being in your home, workplace, schools and communities,” said Ho.
“The interventions have to be in those areas and the caretakers of those areas have to own this problem,” she added.
She said the DOH has also partnered with the Department of Education to help teachers with mental health interventions in schools.
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