FILE PHOTO: Members line up at the counters of the Philippine Health Insurance Corporation or PhilHealth. INQUIRER FILES
Philippine Health Insurance Corp. (PhilHealth) will introduce this year a new benefit package for Filipinos with mental health illnesses requiring interventions at the primary care level, amid calls from advocacy groups and lawmakers for more access to these kinds of services.
Citing a World Health Organization 2018 study that found about 6 million Filipinos are living with depression or anxiety, Rey Baleña, acting PhilHealth vice president of corporate affairs, said the new outpatient program would help make treatment and management of mental health “much more accessible.”
Guidelines for this new package will soon be issued through a circular, Baleña said in an online forum on Friday.
According to Baleña, the new mental health package and the following benefits also set to be launched this year would be funded by regular contributions from members: outpatient therapeutic care for severe acute malnutrition for kids below 5 years old; rationalized COVID-19 packages; and expanded Konsulta packages.
The Konsulta package is the agency’s primary health-care services, such as consultation, laboratory tests and medicines.
PhilHealth will also cover up to P270,000 for renal patients on peritoneal dialysis. Those needing kidney transplant will be provided up to P600,000 coverage.
The said benefits will be funded by contributions from the Philippine Amusement and Gaming Corp. and Philippine Charity Sweepstakes Office, both of which are mandated to remit a portion of their revenues to the state insurer.
More coverage
Also in the PhilHealth pipeline for this year are enhanced treatment coverage for patients needing hemodialysis, peritoneal dialysis, kidney transplant, orthopedic implants and open heart surgeries for children, as well as treatment services for patients of breast, cervical and prostate cancers.
For Stage 5 patients of chronic kidney disease, outpatient hemodialysis will be raised to 156 sessions based on standards for an “adequate dialysis” that requires three 4-hour sessions per week.
At present, PhilHealth only covers up to P7,800 for patients hospitalized for certain mental health conditions, namely dementia, bipolar and anxiety disorders and schizophrenia.
According to Israel Pargas, PhilHealth senior vice president, the state health insurer is currently conducting field tests for the design of about three sets of the mental health outpatient packages planned for rollout.
As of Dec. 31 last year, 10,102 facilities and 47,251 health-care professionals are accredited with PhilHealth. Recognizing the lack of mental health care professionals in the country, Pargas said PhilHealth is looking to tap trained and in-training practitioners of the Department of Health (DOH) and nongovernmental organizations to render services under the benefit packages.
“This package… would need trained people to look after patients with mental health [conditions]. That’s why at the community level, we will set requirements and standards for trained people who will handle the packages,” Pargas said at a press briefing this week celebrating PhilHealth’s 28th anniversary.
The Philippines only has three mental health care practitioners, such as psychiatrists, psychologists and psychiatric nurses, for every 100,000 individuals. To address the shortage, the DOH aims to “democratize” mental health services by training local health workers instead of relying merely on specialists.
Mental health issues among students had been the subject of numerous congressional hearings in recent weeks, in which Department of Education officials reported receiving complaints of bullying and cases of suicide in schools during the pandemic. Education officials noted that 404 students ended their lives while 2,147 more tried to commit suicide.
This prompted calls for the DOH, DepEd and Department of Social Welfare and Development to come up with proactive measures as health experts pointed out that incidents of bullying had been proven to result in adolescent depression or suicidal tendencies.
In October last year, Health Assistant Secretary Beverly 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 for mental health interventions.