NATIONAL MENTAL HEALTH

PROGRAM

Background and Milestones

19th Century - Clergy
1904 - Insane Department of San Lazaro
Hospital
1925 - Insular Psychopathic Hospital
1928 - renamed National Mental Hospital
1960s- NMH still the only government
institution
1970s- Baguio and Cebu Units integrated
as department of psychiatry in
respective regional hospitals

Background and Milestones

1986 People Power Revolution
- Project Team on Mental Health (Task Force
on Mental Health) was created to reform the
mental health care delivery system.
In 1988-90, a multi-sectoral consultation led to
the organization of the National Program for
Mental Health (NPMH) at the DOH.
1999 - The administration implemented the reengineering of the Dept of Health and streamline
the bureaucracy and almost reduced the NMHP to
non-existence.

Background and Milestones

Administrative Order No. 8 , otherwise known as
the National Mental Health Policy was signed on
April 5, 2001 by Sec. Manuel Dayrit
2002 - The current National Mental Health
Program
(NMHP) was reactivated. It has been placed
under the administrative authority of the
Undersecretary for Health Program
Development Cluster and lodged at the
Degenerative Disease Office NCDPC.

Background and Milestones

2002 The Dangerous Drug Act of 2002 was
passed. Initiatives from the stakeholders to
create Bureau of Mental Health and Substance
Abuse was considered but situational analysis
disclosed factors that made it difficult to institute
BOMHSA
Initial Draft of AO for the Implementing
Guidelines was formulated after series of
consultative meetings.
Consultation with experts was done on
November 23, 2006, came up with the specific
objectives and activities for the respective subprograms

Background and Milestones

Finalization & Approval of AO No. 2007- 0009
June 28, 2007 the newly created NPMC &
PDMT was convened

Mental health service delivery in

the Philippines is described as
illness-centered,
institution-based,
fragmented,
inadequate and
inequitably distributed.

Situationer
International Studies
1% of population have severe
mental & neurological disorder
4-5% mild- moderate neurological
problems alcohol & drug abuse

Situationer
Local studies:
36/1000 adults, children &
adolescents-Pampanga
17 % adults & 16 % of children
-Sampaloc Manila Depressive
reactions & adaptation reaction.
12 cases / 1000 population adult
with schizoprenia - Bulacan

Situationer
DOH Mental Health resources:
Total Bed Capacity 5,465
NCR- 4,200 beds
CAR-40
Region 2- 200
Region 3- 500
Region 11- 200
Regions 1,4,10,12,Caraga, ARMM- none
27- DOH medical centers- mental health facilty
Cavite - only province with mental health
facility.
Need to train health manpower

Mental Health
A state of well being where a
person can realize his or her own
abilities, to cope with normal
stresses of life and work
productively.

Mental ill Health

Disturbance in a persons
thoughts , feelings and behavior.
It affects and is affected by a
persons interaction with others,
ones environment and even
ones own self esteem.

Mental Disorder
Medically diagnosable illness
that results in significant
impairment of ones cognitive,
affective or relational abilities
and is equivalent to mental
illness.

Four Facets of Mental

Health Problems
Defined Burden- Burden
currently affecting persons with
mental disorders and is
measured in terms of prevalence
and other indicators such as the
quality of life indicators and
disability adjusted life years
( DALY).

Four Facets of Mental

Health Problems
Undefined Burden- Burden related to the
impact of mental health problems to persons
other than the individual directly affected.
Felt heavily by the families & communities both
human & economic loss
Mental ill health affects the persons functioning ,
thinking process, diminishes the persons social
role and productivity to the community.
Tremendous burden on emotional &
socioeconomic capabilities of relatives who care
for the patient .

Four Facets of Mental

Health Problems
Hidden burden - Refers to the
stigma & violations of human rights.
A mark of shame , disgrace or
disapproval that results in a person
being shunned or rejected by others.
Generally increases as his behavior
differs from that of the norm.

Four Facets of Mental

Health Problems
Future burden burden in the
future resulting from the aging of
the population , increasing social
problems and unrest inherited
from the existing problem.

Mental Health in the

Different Stages of Life
18th week fetus reacts to various stimuli
passing the amniotic sac such as sound,
(music, noise) substances (drugs, alcohol)
Infancy- the psychosocial & cognitive
development is affected by the absence of
the care taker, mother.
First Crisis -Trust vs mistrust
Consistent mothering is important
Mothers living in conditions of stress and
adversity

Mental Health in the

Different Stages of Life
Toddler stage greatly affected by motor
and intellectual development .
Child learns to master locomotion and
impulses.
Crisis- asserting independence against
shame and doubt.
The need for control & firmness on the part
of the caretaker
Negative exposure & punishment may cause
shame & develop self doubt on the child.

Mental Health in the

Different Stages of Life
Pre school age the child can express complex
emotions : love, unhappiness, jealousy and envy
which are influenced by hunger & tiredness .
Aware of their bodies, genitalia & gender differences .
Concept of what they want & need- leads to choices
between desire, the need to grow outside the homes
& what parents restrict turning parental values into
self regulating mechanism ( obedience, guidance &
punishment)
Milestone- development of conscience

Mental Health in the

Different Stages of Life
School age Education plays a big role in
facilitating the childs well being & healthy
social & emotional growth.
They should be taught skills to improve
their psychosocial competence.
Problem solving, critical thinking,
communication, interpersonal skills ,
empathy and coping with emotions.
Children & adolescent develop a sound &
positive mental health.

Mental Health in the

Different Stages of Life
Adolescence- psychosocial concerns :
acceleration of cognitive development ,
consolidation of personality formation
and development of morals.
Adulthood:
Very productive age
Mental health concern- work related
problems
Emphasis- aspects of work process that
promote mental health.

Mental Health in the

Different Stages of Life
Elderly- Aging population is a result
of increased life expectancy as a
result of improved quality of life
Must be able to live their lifes full
potential.
Healthy older person is a resource
for the family, community and
economy.

Concerns of Daily Living

Psychological consequences & suffering brought
about by :
Migration
Urbanization
Industrialization
Economic policies
Political confusion
Poverty & abuses
Victims of disaster
Violence & armed conflict
OFWs & children in difficult circumstances are exposed
to depressive circumstances

National Mental
Health Policy
(AO No. 8 s. 2001)

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

(AO# 2007 0009)

Operational
Framework for the
Sustainable
Establishment of a
Mental Health
Program

Operational Framework for the

Sustainable Establishment of a Mental
Health Program
(Administrative Order 2007-0009)

It sets forth strategies for

national reform from an
institutionally-based mental
health system to one that is
consumer-focused with an
emphasis on supporting the
individual in their community

(AO# 2007 0009)

Wellness of Daily Living Focuses on
attaining and maintaining the wellbeing of person/s across the life
cycle through the promotion of
healthy lifestyle with emphasis on
coping with stress and other
psychosocial issues.

(AO# 2007 0009)

Extreme Life Experience Focuses on
addressing the psychosocial
consequence and maintaining
mental health of person/s that
experiences incidents that are out
of the ordinary such as disasters,
epidemic, trauma etc., which
threatens personal equilibrium.

(AO# 2007 0009)

Substance Abuse and other forms of
addiction Focuses on the
promotion of protective factors and
prevention against the development
of substance abuse and other forms of
addiction in the following key settings
(family, school, workplace, community,
health care setting, industry) through
existing DOH programs and
responsible agencies

(AO# 2007 0009)

Mental Disorder Focuses on the
promotion of mental health and
prevention of mental illness, such as
clinically behavioral or psychological
syndromes, across lifespan of an
individual (i.e. children, adolescents,
adults, elderly, special populations,
such as the military, OFW, refugees,
and PWDs)

(AO# 2007 0009)

Functional Management Structure

National Program Management Committee
DDO Secretariat

PDMT
For the
Wellness of
Daily Living

PDMT
for the
Extreme Life
Experience

RMHT

79 provinces, 115 cities, 1,495

LGUTMH
municipalities 41,956 barangays

PDMT
for the
Substance
Abuse & other
forms of
addiction

17 Regions

PDMT
for the
Mental
Disorder

Implementing
Mechanisms
National Program Management Committee
Ensure the development of mental health
measures for sub-programs and components;
Integrate the various programs, projects and
activities from the various program development
and management groups for each sub-program;
Manage the various sub-programs and components
of the National Mental Health Program;
Oversee the implementation of prevention and
control measures for mental health issues and
concerns;
Recommend to the Secretary of health a Master
Plan for mental health aligned with mandates and
thrust of various government agencies.

Program Development &

Management Teams

The functions of the PDMT are following:

Formulate and recommend policies, standards,
guidelines approaches on each specific subprograms on mental health;
Develop a plan of action for each specific subprogram in consultation with mental health
advocates and stakeholders
Develop operating guidelines, procedures,
protocols for the mental health sub-programs.
Ensure the implementation of the program
among all stakeholders
Provide technical assistance to other mental
health teams according to sub-program thrusts

Regional Mental Health Teams

RMHT shall be established in each of

the CHD with the Director of the
CHD as the Chairperson. A vicechairperson shall be nominated by
the members of the RMHT.
Function of the RMHT is to oversee
the planning and operation of the
National Mental Health Program at
the regional level.

Local Government Unit Teams for Mental

Health

An LGU Team for Mental Health

(LGUTMH) shall be established by
respective local government
executives.
Suggested functions of the LGUTMH:
To enact necessary legislative
issuances and promote & advocate
the implementation of community
based Mental Health Program
among their constituents in their
respective localities.

Other Partners and

Stakeholders
may contribute to the implementation of
the National Mental Health Program by:

Ensuring the availability of competent,

efficient, culturally and gender-sensitive
health care professionals who provide mental
health services
Identifying mental health needs of the
population and refer findings to the
appropriate mental health care provider
Promoting and advocating for the
implementation of the program within their
respective areas of responsibility

Expected Changes
Decentralization of capabilities and
services
More research initiatives
Development of relevant policies
Institutionalization of
programs/services

Governance

Establish a coordinating mechanism

for successful implementation,
monitoring and evaluation of the
NMHP which necessitates
institutionalization of a functional
management structure

Establish and implement a mental

health research, monitoring and
evaluating system

Health Financing

Expansion of the Philippine Health

Insurance benefits package for
Mental Health

Mobilize resources for MH from the

private sector and funding
agencies

Service Delivery
Integrate mental health services into the existing
health programs in the DOH retained hospitals,
LGU health facilities, NGOs and other concerned
agencies
Increase the number of DOH retained
hospitals/medical centers and LGU health facilities
capable of providing mental health services by
10% every year
Improve the competencies of health service
providers on Mental Health Program
Develop a technical assistance package for
national agencies, local government units, private
sector and NGOs relating to Mental Health policies
and programs

Regulation

Regulate custodial home care and

clinics providing mental health
services

The National Mental Health Program

Wellness of daily Living

Extreme Life Experience

Mental Disorder
Substance Abuse

Person with Disability

Wellness/Normal

High Risk

Mental Disorder

Rehab

Stress

Distress

Disease

Disability

Spectrum of Health
Advocacy, Service Provision, Research, Policy & Legislation, Capability Building, Public-Private
Partnership, Data Base information, Development of Model Program, Monitoring and evaluation

Case Finding
Counseling

Treatment & Rehab

Stress Mgt

CPGs

Psychosocial
Support

Development of Mid
level MDs & other HW

Socialization

Consultation/risk
screening

Healthy Lifestyle

Support Grp Bldg

Development and
Strengthening of
referral system

Sports Festival

Emergency Mgt

Health Education
Counseling
Stress Mgt
Consultation

Re-entry to family and

community

Substance Abuse

Integrated Community-based Health Services

Registration
Health
Education
Development
of Livelihood
project
Re-entry to
family and
community

NEXT STEPS
Push for Legislation of Mental Health
Act
Link with other sectors to strengthen
community-based mental health
programs
Develop training manuals for
psychiatrists, psychiatric nurses,
psychologists and psychiatric social
workers
Educate the public by providing IEC
Materials regarding promotion of
promotion mental health and
prevention of mental disorder to the
consumers and the community.

NEXT STEPS
Strengthen family education regarding signs
of impending relapse of the patient
Provide technical assistance to projects that
would integrate mental health care in general
hospital, i.e., Acute Psychiatric Units
Strengthen the community outreach service
of mental hospitals through effective
networking with non-government
organizations and local government units.
Institute cost effective management of
common mental health disorder in PHC
through capability building of community
based health workers using:
locally relevant training materials
refresher training course to primary care
physicians