State of the mind

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‘Mental health care should be delivered as an integral part of our primary health0-care system amid the growing number of mental illnesses that are left untreated due to lack of mental facilities and of physicians who are sufficiently trained to handle and treat mental conditions,” Sen. Loren B. Legarda said in a recent press statement.

The lady senator was so happy that the Senate approved on third and final reading the Mental Health Bill under Senate Bill 1354, which seeks to provide affordable and accessible mental health services to Filipinos with mental disabilities.

Legarda, coauthor of the proposed bill, said the enactment of the said measure would usher in a new chapter in mental health-care policy and service delivery in the country as it would integrate mental health in all health services and policy initiatives.

Let’s take a closer look at the statistics in the Philippines. According to the Department of Health (DOH), one in five Filipino adults has some form of mental illness, topped by schizophrenia, depression and anxiety.

Unknowingly, depression is hard to detect among Filipinos.  “People confuse depression for normal sadness,” Dr. Randy Dellosa, a psychiatrist, was quoted as saying.

“Depression is a devastating illness that affects the total being—physically, emotionally, and spiritually,” wrote Frank B. Minirth and Paul D. Meier in their book, Happiness Is a Choice.  “The emotional pain of depression is more severe than the physical pain of a broken leg.”  “After anxiety, depression is the most common mental health disorder,” noted The Merck Manual of Medical Information.  Statistics show that 10 percent of people who see their doctors for what they think is a physical problem are actually experiencing depression.

“People who become depressed typically do so in their 20s, 30s, or 40s, although depression can begin at almost any age,” the Merck Manual pointed out.  “Depression affects a number of children and adolescents.”

An episode of depression typically lasts about six months if untreated, but sometimes it lasts for two years or more. “Episodes generally tend to recur several times over a lifetime,” the Merck Manual notes.

Medical experts say that about a third of people with depression don’t know they have it.  And two-thirds don’t seek treatment at all.  “With proper treatment, most people with serious depression improve, often within weeks, and can return to their normal daily activities,” the Mayo Clinic said.

Based on a survey conducted in 2000 by the National Statistics Office, mental illness is the third most common form of disability in the country—after visual and hearing impairments.  For every 100,000 Filipinos, about 88 of them suffer from mental illness due to heredity, psychosocial development and substance abuse.

It is not surprising why suicide cases in the country have been growing over a period of 20 years.  The Geneva-based World Health Organization (WHO) reported the Philippines has suicide rates (per 100,000) of 2.5 for men and 1.7 for women as of 1993.

“Further adding to the woes of those afflicted with mental health illnesses is the shortage in qualified mental-health professionals,” Legarda pointed out.

At present, there are only an estimated 490 psychiatrists and 1,000 nurses working in psychiatric care, and even less general practitioners trained in early assessment and management of common mental- health problem in the community.

“The number of addiction specialists, psychologists, occupational therapists, guidance counselors and social workers are extremely inadequate to meet the mental- health needs of 100 million Filipinos,” Legarda deplored.

According to Legarda, there are only two mental hospitals, 46 outpatient facilities, four-day treatment facilities, 19 community-based psychiatric inpatient facilities and 15 community residential (custodial home-care) facilities in the entire country.

Most of these facilities are not in the countryside.  “Almost all mental-health facilities are in major cities,” Legarda said.  In the National Capital Region the only mental hospital houses only 4,200 beds.

Dr. Mary Joselle D. Villafuerte, a medical doctor who once studied psychology at the St. Paul University Manila, considered mental health as a vital part of a person’s total health. “The problems on mental health contain not just the traditional mental-health disorders but the issues of target populations susceptible to psychological risks caused by extreme life experiences such as disasters, near-death experiences, heinous and violent crimes, internal displacement brought about by religious and civil unrests, as well as the psychosocial matters of daily living, like preserving a sense of well-being in these complicated times,” she said.

Under Senate Bill 1354, the Philippine Council for Mental Health shall be established as an attached agency under the health department, to provide for a coherent, rational and unified response to mental-health problems, concerns and efforts through the formulation and implementation of the National Mental Health Care Delivery System.

Legarda said the system shall constitute a quality mental health- care program, through the development of efficient and effective structures, systems and mechanisms that will ensure equitable, accessible, affordable, appropriate, efficient and effective delivery of mental health care to all its stakeholders by qualified, competent, compassionate and ethical mental- health professionals and mental-health workers.

“Many of the health problems we encounter arise from mental conditions. Our physicians see a significant proportion of common symptoms, such as fatigue, abdominal pain, and back pain for which they don’t find a cause. If we will be able to identify patients’ psychosocial stressors and common mental and behavioral conditions, such as depression, anxiety and substance use, we can understand more about what drive these symptoms and be able to give appropriate care and treatment,” Legarda said.

In Davao City, Mary Joselle Villafuerte—who is a councilor of the third district—has filed an ordinance, entitled “Mental Health Code of 2016”.  She explained the policy will “uphold the right of the people to mental health and encourage mental health consciousness among them”.

The ordinance has eight objectives.  The first four are: promote a shift from a hospital-based system to a strengthened community-based mental health care delivery system; reorient and modernize the existing mental-health facilities; integrate mental health care in the general health care delivery system; and promote, prevent and manage mental health at all levels and treat and rehabilitate persons with mental disability.

The remaining four objectives are as follows: provide access to comprehensive health care and treatment to ensure a well-balanced mental-health program in the community and hospital; establish a multisectoral joint network of mental illness or disability and the management of mental-health problems among vulnerable groups; protect and promote the mental health of the people through a multidisciplinary approach; and provide adequate support and follow-up mechanisms for the discharged.

American President Abraham Lincoln once said, “Most people are about as happy as they choose to be.”  He knew better.  He went through much anguish in his life —the death of his fiancée, lost elections, the Civil War and other major disappointments.

At one period of his life he was so depressed he considered suicide.  But Lincoln chose to overcome his depression.  He chose to be happy and obtained inner joy and peace in those last years before he was assassinated by a mentally disturbed man.