module 2 handout 23-24

MENTAL HEALTH ACT

• Republic Act No. 11036Prepared by: Glenrose Lao Fernando, RN, MN

AN ACT ESTABLISHING A NATIONAL MENTAL HEALTH POLICY

• Purpose: Enhance the delivery of integrated mental health services.

• Commitment of the State:

• Valuing and protecting mental health.

• Treating and preventing mental health conditions.

• Ensuring accessible, timely, high-quality mental health care.

• Accountability of mental health services and rights protection of users.

OBJECTIVES OF THE MENTAL HEALTH ACT

• Strengthen leadership and governance in mental health:

  • Develop and implement national policies and regulations.

• Establish a comprehensive mental health care system for the Filipino people.

• Protect the rights of individuals with mental health needs.

• Enhance mental health information systems and research.

• Integrate mental health into basic healthcare services.

• Promote mental health in education, workplaces, and communities.

VISION AND MISSION

• Vision: Mental health and wellbeing for all Filipinos.

• Mission:

  • Protect and promote the right to mental health.

  • Provide accessible and quality mental health programs and services.

GOALS

• Value and protect mental health and wellbeing.

• Identify, treat, and prevent mental health conditions.

• Ensure the rights of persons with mental health conditions are upheld.

COMMUNITY-BASED MENTAL HEALTH PROGRAMS

Updates on Establishment

• DOH's role:

  • Develop sustainable community-based mental health programs.

  • Technical assistance from WHO ongoing.

  • Support for LGUs (Local Government Units) is being provided.

TECHNICAL ASSISTANCE FOR LGUs

• Training primary healthcare providers on mhGAP.

• 48% of LGUs trained in primary care, aim for 100% by 2023.

• Integration into primary care service packages.

NATIONAL SPECIALTY AND BASIC COMPREHENSIVE CENTERS

Specialty Centers (Advanced Comprehensive)

• NCR: National Center for Mental Health

• Other regions have designated mental health facilities.

Basic Comprehensive Centers

• Include various medical centers across regions.

mhGAP (Mental Health Gap Action Programme)

• Definition: A state of well-being where individuals realize their abilities and can cope with life stresses while contributing to their communities (WHO definition).

BACKGROUND ON MENTAL HEALTH

• Depression and suicide statistics:

  • Depression is a major disability cause.

  • Suicide is the 2nd leading cause of death among ages 15-29.

• Availability of mental health professionals:

  • 1 psychiatrist per 100,000 people in the Philippines.

  • Approximately 6 million Filipinos with depression and anxiety.

• Funding for mental health:

  • 3-5% of total health budget is allocated.

GLOBAL BURDEN OF DISEASE

• 14% of worldwide disease burden is mental health disorders.

• 75% of affected individuals in low-income countries lack access to treatment.

mhGAP PROGRAM OBJECTIVES

• Increase government and organizational commitment to allocate resources for mental health.

• Aim for higher coverage of interventions in low and middle-income countries.

mhGAP INTERVENTION GUIDE

• Aiming to facilitate delivery of evidence-based guidelines in non-specialized settings.

• Focus areas include prioritizing conditions like depression, psychosis, and substance use disorders.

MODULES OF mhGAP

1. Moderate-Severe Depression

2. Psychosis

3. Bipolar Disorder

4. Epilepsy/Seizures

5. Developmental Disorders

6. Behavioral Disorders

7. Dementia

8. Alcohol Use Disorders

9. Drug Use Disorders

10. Self-harm/Suicide.

11. Other Emotional Complaints

FREUD'S PSYCHOANALYTIC THEORY

• Key Concepts:

  • All behavior has causes, often rooted in childhood traumas.

  • Stressors lead to behavioral symptoms (hysteria, neurosis).

• Personality Components:

  • Id: Basic instincts, pleasure-seeking.

  • Superego: Moral standards.

  • Ego: Balances id and superego.

FREUD'S LEVELS OF AWARENESS

• Conscious: Current awareness.

• Preconscious: Thoughts accessible but not currently in awareness.

• Unconscious: Repressed thoughts influencing behavior.

EGO DEFENSE MECHANISMS

• Methods to protect self from anxiety.

• Key types include denial, repression, and rationalization.

FIVE STAGES OF PSYCHOSEXUAL DEVELOPMENT

1. Oral (0-18 months): Focus on mouth.

2. Anal (18-36 months): Focus on bowel control.

3. Phallic (3-5 years): Focus on genitals, complexes arise.

4. Latency (5-11 years): Sexual feelings dormant.

5. Genital (puberty onwards): Mature sexual interests, intimacy.

ERIKSON’S PSYCHOSOCIAL STAGES OF DEVELOPMENT

1. Trust vs. Mistrust

2. Autonomy vs. Shame

3. Initiative vs. Guilt

4. Industry vs. Inferiority

5. Identity vs. Role Confusion

6. Intimacy vs. Isolation

7. Generativity vs. Stagnation

8. Ego Integrity vs. Despair

COGNITIVE THERAPIES

• Cognitive Therapy (Beck): Focuses on immediate thoughts and interpretations affecting emotions.

• Rational Emotive Therapy (Ellis): Identifies irrational beliefs impacting happiness.

SELY'S STRESS-ADAPTATION MODEL

• Stress: General wear and tear of the body; stressors lead to physical and psychosocial reactions.

• General Adaptation Syndrome involves 3 stages: Alarm, Resistance, Exhaustion.

LAZARUS'S INTERACTIONAL MODEL

• Stress is the relationship between person and environment and includes three appraisals: primary, secondary, and reappraisal.

DSM-IV AND DSM-5

• DSM-IV: Multi-axial classification system assessing psychiatric disorders, medical conditions, and psychosocial problems.

• DSM-5: Standardized nomenclature for mental disorders, with revised diagnostic criteria eliminating the multiaxial system.

• Categories include various disorders, e.g., anxiety disorders, mood disorders, and more.