The sad state of mental health

I was asked to do a report in our ethics class regarding the topic on Mental Health and I think what I have find out is worth sharing in this blog. So let me just place here some parts of my presentation and let everyone reflect on the sad situation of mentally ill patients for no one will surely talk about their rights except us who are still capable of thinking.

Mental health – has been defined variously by scholars from different cultures.
Concepts of Mental health include the following:Subjective well-being, Perceived self-efficacy, Autonomy, Competence, Self-actualization of one’s intellectual and emotional potential.From cross-cultural perspective, it is nearly impossible to define mental health comprehensively.The World Health Organization defines mental health as a state of well-being that allows a person to realize his or her own abilities to cope with the normal stresses of life.

Mental health has been recognize by WHO since its origin and is reflected by the definition of health in the WHO constitution as “not merely the absence of disease or infirmity” but rather “ a state of complete physical, mental and social well-being”Mental Health Situationer

Global perspective:

Based from WHO Report 2001, Mental and behavioral disorders are estimated to account for 12% of the global burdens of disease while mental health budgets of the majority of countries constitute less than 1% of their total health expenditures.

More than 40% of countries have no mental health policy and over 30% have no mental health programme.Over 90% of countries have no mental health policy that includes children and adolescents. Mental health plan frequently do not cover mental and behavioral disorders at the same time level as other illnesses.

In the Philippines, up to one in five adult Filipinos have “psychiatric disorders" and more people are developing mental disorders due to “extreme life experiences". According to Dr Lourdes Ladrido-Ignacio, a former president of the Philippine Psychiatric Association, said between 17 to 20 percent of the country’s adult population have psychiatric disorders.About 10 to 15 percent of children aged 5 to 15 are believed to have mental problems.Ladrido-Ignacio also noted that in remote barrios without doctors, 50 percent of adults who consult at rural health centers were diagnosed to have some form of psychological illness.

The National Statistics Office’s 2000 disability ranked mental illness as the third most common form of morbidity, or type of disease, after visual and hearing impairments among Filipinos.The same survey showed that 88 Filipinos out of every 100,000 population with mental problems.The region with the highest prevalence rate of mental illness is Southern Tagalog at 132.9 cases per 100,000 population,
NCR at 130.8 per 100,000 population and Central Luzon at 88.2 per 100,000 population.

In 2004, a DOH-commissioned Social Weather Stations survey found that 0.7 percent of total Filipino households have a family member who has a psychological disorder such as depression, schizophrenia, epilepsy, and substance abuse.Oliveros said addressing mental illness as a public health concern remains as a challenge since there are only 400 licensed psychiatrists practicing in the country.

This detrimental scenario in mental health both global and local shows us why there are still so many mentally ill patients who were walking in the streets and remains unattended and neglected. However, because of their mental conditions they cannot demand for services for even some of their relatives already considered them outcast. Based on the study of WHO, one problem that needs to be address with regards to mental health is the concept of stigma which can be defined as a mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society. The WHO identified that stigma, discrimination and neglect have prevented care and management from reaching persons with mental disorders. Actually, stigma is more on personal level since many of us who lack knowledge about mental health will eventually just think that those who are suffering from this kind of illness should be isolated without even knowing that there are many people with mental disorder who are still functional but because of their high status in society they remained to be highly respected.

According to WHO there are so much things that needs to be done in order to address mental health concerns which includes the following recommendation:

1. Formulating policies designed to improve the mental health of populations

2. Assuring universal access to appropriate and cost-effective services, including mental health promotion and prevention services

3. Ensuring adequate care and protection of human rights for institutionalized patients with most severe mental disorders.

4. Assessment and monitoring of the mental health of communities, including vulnerable populations such as children, women and the elderly

5. Promoting healthy lifestyles and reducing risk factors for mental and behavioral disorders such as unstable family environments, abuse and civil unrest

6. Supporting stable family life, social cohesion and human development

7. Enhancing research into the causes of mental and behavioral disorders, the development of effective treatments, and the monitoring and evaluation of mental health system

Our very own DOH also come up with the following strategic thrust for 2005-2010

1. Strengthen advocacy and public information campaign on mental health

2. Establish database and information system preventive, family-focused and community oriented

3. Integration of mental health into the provision of other public health services nationwide

4. Develop model programs for prevention of substance abuse and risk reduction for mental illness

5. Develop a financial package

6. Advocate for positive health-seeking behavior

Actually, there are so many policies identified but what is crucial is the implementation. Since, the main subject of the discussion are mentally ill patients then they are not mentally capable of asking for what is right and due to them. I hope normal people like us especially those policy makers will do something. For me, those who are in mental institution were more helpless and disadvantaged but worse than the deaf and mute they cannot speak up for themselves.

I remember our tour last 2002 to Elsie Gaches village, Hospicio de San Jose and Malaya Center. My students and me witnessed how many clients were put into cage because of their worsen mental health condition because if they are allowed to get out, they will cause harm to others. If we feel pity to an animal who were in the cage, how much more for humans like them? Some clients also do not have families in Malaya center so it is assume that some of them will live and stay there forever. According to the social worker their families do not visit them.

I know that there are so many human rights issues that needs our focused but isn't it mental health is a human rights concern? I hope we will ponder on this.

References:

A Public Mental Approach to Mental Health – The WHO Report 2001 Mental Health: New Understanding, New Hope
World Mental Health, 1995 – Rober Desjalais et. Al.
Ethics in Psychology and the Mental Health Professions Gerald P. Koocher access at http://books.google.com/
4.http://www2.doh.gov.ph/noh2007/NOHWeb32/NOHperSubj/Chap4/MentalHMD.pdf