Mental Health

According to the World Health Organization, health is a complete state of physical,  not just the absence
of illness or infirmity, but also physical, mental, and social wellbeing.  This definition places a strong
emphasis on health as a happy state of wellbeing. Persons in a state of mental, physical, and social
health carry out daily obligations, successfully navigate daily life and are content with their interpersonal
themselves and their relationships.  There isn't a single, agreed-upon definition of mental wellness. In
most cases, a person's behavior can give hints about their mental wellness because of each
individual distinct perspective or perception of conduct. The assessment of mental health may be
challenging depending on values and views.

In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by
satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and
emotional stability. Mental health has many components, and a wide variety of factors influence it.
These factors interact; thus, a person’s mental health is a dynamic, or ever-changing, state. Factors
influencing a person’s mental health can be categorized as individual, interpersonal, and social/cultural.
Individual, or personal, factors include a person’s biologic makeup, autonomy and independence, self-
esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness,
sense of belonging, reality orientation, and coping or stress management abilities.

Interpersonal, or relationship, factors include effective communication, ability to help others, intimacy,
and a balance of separateness and connectedness. Social/cultural, or environmental, factors include a
sense of community, access to adequate resources, intolerance of violence, support of diversity among
people, mastery of the environment, and a positive, yet realistic, view of one’s world.

MENTAL HEALTH SERVICES IN THE PH

The Philippines has recently passed its first Mental Health Act (Republic Act no. 11036). The Act seeks to
establish access to comprehensive and integrated mental health services, while protecting the rights of
people with mental disorders and their family members (Lally et al, 2019). However, mental health
remains poorly resourced: only 3–5% of the total health budget is spent on mental health, and 70% of
this is spent on hospital care (WHO & Department of Health).

Accordingly, the majority of mental healthcare is provided in hospital settings and there are
underdeveloped community mental health services. The National Center for Mental Health was
previously estimated to account for 67% of the available psychiatric beds nationally (Conde). More
recent data indicate that there are 1.08 mental health beds in general hospitals and 4.95 beds in
psychiatric hospitals per 100 000 of the population (WHO, 2014). There are 46 out-patient facilities
(0.05/100 000 population) and 4 community residential facilities (0.02/100 000) (WHO, 2014). There are
only two tertiary care psychiatric hospitals: the National Center for Mental Health in Mandaluyong City,
Metro Manila (4200 beds) and the Mariveles Mental Hospital in Bataan, Luzon (500 beds). There are 12
smaller satellite hospitals affiliated with the National Center for Mental Health which are located
throughout the country. Overcrowding, poorly functioning units, chronic staff shortages and funding
constraints are ongoing problems, particularly in peripheral facilities. There are no dedicated forensic
hospitals, although forensic beds are located at the National Center for Mental Health.
MENTAL HEALTH STAFF

There is 1 doctor for every 80 000 Filipinos (WHO & Department of Health, 2012; the emigration of
trained specialists to other countries, particularly English-speaking countries, contributes to this scarcity.
This shortage is magnified in psychiatry where, nationally, there are a little over 500 psychiatrists in
practice. The ratio of mental health workers per population in the Philippines is low, at 2–3 per 100 000
population (WHO & Department of Health). This ratio is lower than in other Western Pacific Rim
countries with similar economic status, for example Malaysia (4.9 mental health workers per 100 000
population) and Indonesia (3.1 per 100 000 population). Data indicate that there are 0.52 psychiatrists
(Isaac et al, 2018) and 0.07 psychologists per 100 000 inhabitants, and 0.49 mental health nurses per
100 000 of the population (a reduction from 0.72 per 100 000 in 2011) (WHO).

Together, these figures equate to a severe shortage of mental health specialists in the Philippines. This is
further illuminated when compared with the World Health Organization (WHO)-recommended global
target of 10 psychiatrists per 100 000 population. Further, the majority of psychiatrists work in for-profit
services or private practices and are mainly based in the major urban areas, particularly in the capital
region known as Metro Manila.

According to a report done by the World Health Organization, access to mental health institutions in the
Philippines favors those near the National Capital Region. Most of the psychiatrists in the country also
work in private practice rather than in government facilities.

NATIONAL MENTAL HEALTH PROGRAM

 A National Mental Health Program or Mental Health Policy exists in the Philippines
(Administrative Order #8. 2001), which was authorized by Manuel Dayrit, the Department of
Health's then-secretary.
 The Philippine Psychiatric Association (PPA), the National Center for Mental Health (NCMH), the
Philippine Mental Health Association, and Christoffel Blindenmission (CBM)
 Mental Health Awareness and Mental Health Awareness Month
 Mental Health Law and Mental Health Act : Philippine Mental Health Law or Republic Act 11036
 National Program Management Committee and the Program Development and Management.

IMPORTANCE AND IMPACT OF MENTAL HEALTH SERVICE

To supervise and manage the program's development and to define the protocols for the particular
policies that were put into place, the National Program Management Committee and the Program
Development and Management teams were established. The incidence, prevalence, and prognosis of
mental diseases are significantly correlated with factors at the community level. Other stakeholders or
partners in this initiative include the Philippine. It is possible to improve accessibility, acceptability, cost,
and scalability of services, as well as treatment adherence and the likelihood of successful clinical
outcomes, by making mental health treatments available and integrating them into local communities.
Community services can also be extremely helpful in raising public awareness of mental illness,
minimizing stigma and prejudice, fostering recovery and social inclusion, and preventing mental
illnesses.
International action plans and recommendations thus place a strong emphasis on community mental
health services. The provision of comprehensive, integrated mental health and social care is mandated
by the World Health Organization's Mental Health Action Plan for 2013-2020, which also calls for the
inclusion of promotion and prevention programs in local communities that incorporate the perspectives
and involvement of service users and families. Community-based, recovery-focused services must be
established, according to the WHO Quality Rights Toolkit. According to Article 19 of the UN Convention
on the Rights of Persons with Disabilities, people with disabilities including psychosocial impairments
should be given assistance so they can live independently in their communities. Due to the challenges, it
is vital to determine how to effectively work in communities and with community-based service
providers for mental health care delivery in low-resource settings.