In the central part of the Philippines lies Region VIII or the Eastern Visayas region with a population of over 4 million people. When Typhoon Haiyan devastated the Philippines in 2013, this region was one of the hardest hit areas, as it faces the Pacific Ocean. The typhoon left in its wake lives lost, homes destroyed and livelihoods damaged. Haiyan also had an impact on the mental health of those who survived the disaster.
“In the aftermath of that typhoon, there were many realizations and one of them was the need for us to fill the gap on mental health services,” explained Winnie Dorego, the regional mental health program manager of the Department of Health Regional Office VIII.
As in many areas in the Philippines, there’s a mix of urban and rural communities in this region making it difficult to provide equitable health services, including for mental health.
“Our region only has two hospitals that provide basic mental health services. Imagine the effort that it would entail for them to seek professional help in those two health facilities,” added Dorego
Winnie Dorego (front right) leads the discussion with mental health service users and their carers. WHO Western Pacific mental health technical lead Martin Vandendyck and WHO Philippines mental health technical officer Dr Jasmine Vergara joins the discussion to provide technical support to the team. Photo: WHO
Right after Typhoon Haiyan, the World Health Organization (WHO) and Philippine Department of Health (DOH) began to introduce the Mental Health Gap Action Programme (mhGAP) to scale up mental health and neurological services in the Philippines. The programme provides assessment, management and follow-up of people with mental health conditions at the heart of the community, within the primary care health centre.
City and municipal health doctors, nurses, and other health workers were trained with the mhGAP modules across the country. Health centres with mhGAP-trained health workers were also allocated with medication by the DOH to treat mental health disorders such as depression and schizophrenia.
“As of 2018, 100% of our health facilities have trained mhGAP personnel and it really helped them a lot because the patients are now being seen in their own communities,” said Dorego.
In Northern Samar, 1 of the 6 provinces in Eastern Visayas with a 1:690,000 psychiatrist to population ratio, they have seen positive changes in this community-based approach.
“We were able to access the medicines at the National Center for Mental Health at the national level. We were also able to have an active case finding for our mentally-challenged patients which started from 214 in 2014 and it rose to 384 in 2017,” explained Dr Mary Ann Avalon, Northern Samar provincial health officer.
“The changes were life-changing for us health workers, the patients and their families,” shared Dr Myrna Trongcoso, municipal health officer in Catarman, Northern Samar. “Initially, our barangay health workers were informed that they have to refer community members in need of support at the nearest health office. On our first month of program implementation, I got already had five patients. The support provided had a positive outcome on these patients who have become productive, helpful and functional to their families and communities they live in.”
Catarman municipal health officer Dr Myrna Trongcoso (right) talks with her mental health patient. Photo: WHO/J. Vergara
With the Mental Health Act passed in 2018 and ready to be implemented in 2019, community-based mental health services will be further improved. The law mandates the establishment of community-based mental health care facilities in the provinces, cities and cluster of municipalities in the Philippines based on the needs of the population, to provide appropriate mental health care services and enhance the rights-based approach to mental health care.
“We see a great future for mhGAP for the region and the whole Philippines,” said Dorego. “We can truly say that we are providing accessible and quality health service for all our citizens.”
“In the aftermath of that typhoon, there were many realizations and one of them was the need for us to fill the gap on mental health services,” explained Winnie Dorego, the regional mental health program manager of the Department of Health Regional Office VIII.
As in many areas in the Philippines, there’s a mix of urban and rural communities in this region making it difficult to provide equitable health services, including for mental health.
“Our region only has two hospitals that provide basic mental health services. Imagine the effort that it would entail for them to seek professional help in those two health facilities,” added Dorego
Winnie Dorego (front right) leads the discussion with mental health service users and their carers. WHO Western Pacific mental health technical lead Martin Vandendyck and WHO Philippines mental health technical officer Dr Jasmine Vergara joins the discussion to provide technical support to the team. Photo: WHO
Right after Typhoon Haiyan, the World Health Organization (WHO) and Philippine Department of Health (DOH) began to introduce the Mental Health Gap Action Programme (mhGAP) to scale up mental health and neurological services in the Philippines. The programme provides assessment, management and follow-up of people with mental health conditions at the heart of the community, within the primary care health centre.
City and municipal health doctors, nurses, and other health workers were trained with the mhGAP modules across the country. Health centres with mhGAP-trained health workers were also allocated with medication by the DOH to treat mental health disorders such as depression and schizophrenia.
“As of 2018, 100% of our health facilities have trained mhGAP personnel and it really helped them a lot because the patients are now being seen in their own communities,” said Dorego.
In Northern Samar, 1 of the 6 provinces in Eastern Visayas with a 1:690,000 psychiatrist to population ratio, they have seen positive changes in this community-based approach.
“We were able to access the medicines at the National Center for Mental Health at the national level. We were also able to have an active case finding for our mentally-challenged patients which started from 214 in 2014 and it rose to 384 in 2017,” explained Dr Mary Ann Avalon, Northern Samar provincial health officer.
“The changes were life-changing for us health workers, the patients and their families,” shared Dr Myrna Trongcoso, municipal health officer in Catarman, Northern Samar. “Initially, our barangay health workers were informed that they have to refer community members in need of support at the nearest health office. On our first month of program implementation, I got already had five patients. The support provided had a positive outcome on these patients who have become productive, helpful and functional to their families and communities they live in.”
Catarman municipal health officer Dr Myrna Trongcoso (right) talks with her mental health patient. Photo: WHO/J. Vergara
With the Mental Health Act passed in 2018 and ready to be implemented in 2019, community-based mental health services will be further improved. The law mandates the establishment of community-based mental health care facilities in the provinces, cities and cluster of municipalities in the Philippines based on the needs of the population, to provide appropriate mental health care services and enhance the rights-based approach to mental health care.
“We see a great future for mhGAP for the region and the whole Philippines,” said Dorego. “We can truly say that we are providing accessible and quality health service for all our citizens.”