If she has her way, Leslie Mangubat said she likes to bring the mental health program down to the barangays so that the barangay health workers are trained on early detection before the problem goes out of hand.
“The challenge is always in the early detection. The family and their immediate neighbors are the first to detect if the person is experiencing the early signs of mental problems like sudden changes in behavior,” she said. “If this is addressed early on, we could possibly save a person from getting a mental illness.”
“BHW are not yet trained to spot a potential mental health case in their barangay. They should be trained not only because we lack manpower but also because the BHW are the ones on the ground,” she said.
She said most of the patients that are referred to the rural health units are already in the advanced stage.
“What happens is nade-detect lang sila when the patient is already in a violent stage, kapag nakakasakit na sa iba saka lang humihingi ang family ng intervention,” she said. “Hindi umaabot sa time na kaya mo pang kausapin ang patient regarding his condition.”
Mangubat said mental health patients that are brought to the RHU are immediately referred to the facilities like EVMC and Schistosomiasis Hospital. Once they are diagnosed, the hospital sends the RHU an endorsement letter and they are included in the registry for the allocation of medicines.
The system, though, does not conform to the intention of mhGAP which is to address mental health issues right at the grassroots. This is worsened if the mhGAP-trained personnel, which usually is the municipal health officer, is saddled with all the administrative and program implementation tasks.
Like other DoH programs that are implemented in the RHU, the mental health program competes with other programs for the allocation of measly funds, especially in a fifth-class municipality with a scarce budget.
Mangubat said the LGUs must come up with an ordinance so that the program will have its budget and be able to implement activities on the ground.
DoH’s Dorego said the agency has been urging the LGUs to pass an ordinance for the mental health program but not one — province or municipality — has done. She said the best that has been done so far by an LGU in Eastern Visayas is an Executive Order issued by the governor of Northern Samar.
“We are batting for an ordinance or a local legislation so that there will be an allocation of funds and that it will not be subject to the priority of a local chief executive,” Dorego said.