Lack of awareness hinders mental health services for kids among LGUs

The lack of awareness among local government units (LGUs) on national policies and plans in mental health and psychosocial services for children was identified as a “significant barrier” to implementing those programs, according to a new study.

In a report published this month and conducted by the United Nations Children’s Fund (Unicef), the Research Institute for Mindanao Culture and Burnet Institute, together with representatives of various sectors, said many LGUs were unaware of relevant policies and their specific roles in delivering mental health services to children and adolescents.

“This was seen as particularly critical, given that LGUs have responsibility for implementation and resource allocation but may not prioritize mental health,” the study said.

“At the local level, LGUs have responsibility for financing and implementation of the mental health program, although with a focus on actions in relation to responsive care,” it added.

‘Capacity and support’

The report noted that the mental health of children and teenagers up to 18 years old was one of the “most neglected issues globally.”

In the Philippines, survey data and published studies of their mental health needs showed that anxiety and depression as well as behavioral problems impacting learning were among the most common issues.

Under Republic Act No. 11036 or the Mental Health Act, LGUs are mandated to formulate and implement effective mental health care and wellness policies and ordinances.

They are also required to develop training programs that would enhance the capacity of care providers at the local level and “establish, reorient and modernize” mental health care facilities in their areas.

But according to the study, “stakeholders noted the lack of awareness or prioritization of mental health by LGU authorities and poor coordination across sectors as barriers impacting [policy] implementation at the local level.”

Few practitioners

“To overcome these challenges, stakeholders recommended that a special coordinating body be established to build awareness, capacity and support for LGUs to formulate mental health ordinances,” the report said.

It also cited the National Mental Health Strategy requiring the establishment of mental health councils in all 16 regions by 2023 to augment local planning efforts and program implementation.

“It was also recommended that each LGU be required to allocate a nominated amount in each budget to support the…program, …similar to the Gender and Development program that requires a 5-percent share of the total budget allocation,” the report said.

The limited number of trained practitioners was also seen as a major challenge, as this resulted in heavy caseloads and referral bottlenecks that delayed access to health care.

“There are an estimated 2,051 professionals working in government and nongovernment settings. Of the 567 registered psychiatrists, 60 are child psychiatrists,” the report said, citing data from the World Health Organization’s Mental Health Atlas in 2017.

The majority of these professionals are situated in urban areas and tertiary hospital facilities, resulting in limited access to specialists in rural areas, it added.

A health sector representative who took part in the study said the country lacks neuro-developmental and behavioral pediatricians.

“Very few applied [because] the income earned outside the country is very high. In fact, we’ve been offering new doctors that will come to us and send for training, but still no applicants,” the interviewee said.

Barangay health workers

To address the problem of limited workforce, the report recommended the improvement of training primary health care providers to deliver mental health care, as it underscored that “children and adolescents can be effectively managed at the primary care level.”

It noted that barangay health workers could also play a role in providing such services.

“Stakeholders suggested to improve training and supervision of barangay health workers… who are developed especially to support child and adolescent mental health and well-being,” the study said.

“This could involve more junior health workers with a primary focus on children and adolescents, for whom MHPSS (mental health and psychosocial support services) could be integrated into their role,” it added.