DOH urges: Erase labels on persons with mental disorder

By Gina V. Rodriguez LEGAZPI CITY—-Changing the public perception on mental disorder will go a long way in engaging the community to help persons with the mental condition, according to mental health advocates at the Department of Health (DOH) in Bicol. Persons with mental disorder must be treated as “human beings with problems in the mind,” Dr. Evy Sarmiento, head of the Non-Communicable Disease Prevention and Control Cluster of DOH-Bicol, told a media forum on October 9. The forum tackled the observance of the second week of this month as National Mental Health Week and October 10 as World Mental Health Day. “Those with mental disorder should not be vilified and tagged with the various terms for the disease such as ‘kapay, boa or bariar’”--some of the Bicol terms for the mentally deranged, she said. Windalyn Baluis, coordinator of the mental health program of DOH-Bicol, said the challenge in promoting mental health awareness is to avoid the discrimination or stigma attached to the illness. She said mental disorder is a medical condition that can be treated with medication in the same way that diabetes and hypertension are being treated. “With maintenance medicine there is hope for persons with mental disability so they can become functional and lead productive lives,” she added. Over the last two years the regional mental health team has been training the rural health units or RHUs in Bicol to manage the “Mental Health Gap (mhGAP) Action Program” of the World Health Organization (WHO) at the provincial level. Mental health patients in the communities get access to proper care, psychosocial assistance and medication from public health doctors and health workers through the program. DOH-5 provides continuing technical assistance to the public health doctors and health workers in the region to enhance their assessment and management of the patients in their communities. “They are trained to recognize and assess the persons who manifest the symptoms of the condition,” said Baluis. Sarmiento said health centers can get the free medicines at sites identified in the provinces. Baluis however said not all patients require medicines as 80 percent of the cases require psycho-educational counseling wherein the family is also involved in taking care of the patient. Sarmiento noted “some progress” in giving attention to patients in far-flung communities through the creation of mhGAP teams at the provincial level. She said the institutionalization of the mhGAP program, that started in 2015, has helped raise awareness on mental health at the community level and gave access to “interventions” for the patients. Sarmiento said before it was common to find the patients unattended with a number locked up in their homes in the barrios. Baluis said what is important is to get the help of the people in the community, who should be vigilant in referring the patients to the RHUs. “The people in the community are of big help in the treatment of the patients,” she said. Baluis said the local government units, their provincial, municipal or city health offices can work together with the local social welfare and development offices in handling the referrals which is important so that the condition of the patients does not worsen. Data from WHO showed that more 300 million people suffer from depression, a medical mental disorder which is the leading cause of mental disability. Many of those with the disorder suffer from anxiety. WHO said that more women than men suffer from depression or one in every four women have the condition compared to one in every ten men. The burden of depression is on the rise globally and is seen by WHO to become a major public concern by 2030. In Bicol, DOH-run mental health facilities registered 15,277 patients which have mental disorder in 2017, said Sarmiento. She said at the Bicol Medical Center (BMC), which reported over 8,000 of these cases, the conditions include bipolar disorder and depression. But she added there has yet to be complete data on those with the problem because the mhGAP teams are still reaching out to those patients who have difficulty accessing the mental health services in their communities. Sarmiento said beginning next year there will be fully functional “acute psychiatric units or APUs” in health facilities in the six Bicol provinces which will serve as “halfway homes” for those with mental disorder. She said there is need for these APUs as there is only one mental health care facility serving patients in Bicol. This is the Don Susano J. Rodriguez Memorial Mental Hospital, which is located in Cadlan, Pili, Camarines Sur, and managed by BMC. The 32-hectare open psychiatric ward of the facility has a capacity of 200 beds that is insufficient to meet the big number of patients in the region. Sarmiento said the patients can stay at the APUs for two weeks at the most. Here a psychiatrist will visit them before their referral either to a regular mental health facility or be managed by their families and mental health teams in their communities. She said health facilities in Albay, Masbate and Sorsogon have committed five-bed capacity units in their hospital buildings to serve as APUs with those in in Camarines Norte and Catanduanes assuring they will set up similar APUs in their areas. “We want everyone in all stages of life to be given apt intervention,” Baluis said. But first she said everyone in the community must work together to erase the discrimination against persons with the mental disorder.