Ed114-MentalHealth-Part1.pdf

ED 114 S pecial Topics in E d u ca t i o n Mrs. Lariel M. Mendoza “Ma’am Elle”  Proposed more than 3 years ago, the Philippine Mental Health...

ED 114 S pecial Topics in E d u ca t i o n Mrs. Lariel M. Mendoza “Ma’am Elle”  Proposed more than 3 years ago, the Philippine Mental Health Act was passed in the congress and senate in 2017 (Senate Bill No. 1354, 2017) and signed into law on 21 June 2018. Prior to this bill, the Philippines were one of a minority of https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646 countries with no mental health 847/#:~:text=Under%20its%20provisions%2C%20the% 20Philippine,informed%20about%20psychosocial%20a nd%20clinical legislation.  Clinicians lacked guidance on legal and ethical aspects of their practice, and patients' rights were not clearly defined – for example, the usual practice was for patients who lacked capacity to be ‘signed in’ by a next of kin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646 847/#:~:text=Under%20its%20provisions%2C%20the% 20Philippine,informed%20about%20psychosocial%20a nd%20clinical  The passing of this bill is a major milestone in the history of psychiatry in the Philippines. The bill, the first in the country's history, provides a rights-based mental health legislation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646 847/#:~:text=Under%20its%20provisions%2C%20the% 20Philippine,informed%20about%20psychosocial%20a nd%20clinical  It mandates for the provision of psychiatric, psychosocial and neurological services in all hospitals, and basic mental health services in community settings. Compulsory treatment is limited to hospital settings, and the Act does not provide for https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646 compulsory community 847/#:~:text=Under%20its%20provisions%2C%20the% 20Philippine,informed%20about%20psychosocial%20a nd%20clinical treatment.  Under its provisions, the Philippine Mental Health Act protects the rights of patients as follows: ‘a right to freedom from discrimination, right to protection from torture, cruel, inhumane, and degrading treatment; right to aftercare and rehabilitation; right to be adequately informed about psychosocial and clinical assessments; right to participate in the treatment plan to be implemented; right to evidence-based or informed consent; right to confidentiality; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646 847/#:~:text=Under%20its%20provisions%2C%20the% and right to counsel, among others’. 20Philippine,informed%20about%20psychosocial%20a nd%20clinical  The Act also incorporates rights for ‘concerned individuals’, incorporating patient relatives and mental health professionals. In this context, a mental health professional refers to a medical doctor, psychologist, nurse, social worker or any other appropriately-trained and qualified person with specific skills relevant to the provision of mental health services (section 4 of the Act). The Act highlights the need to provide psychosocial support to family members of the https://www.ncbi.nlm.nih.gov/pmc/articles patient if required and, with informed patient /PMC6646847/#:~:text=Under%20its%20pr ovisions%2C%20the%20Philippine,informed consent, to include them in the planning of treatment for the patient. %20about%20psychosocial%20and%20clinic al  It further recognizes the role of mental health professionals, protecting their right to participate in mental health planning and development of services, and ensuring that they have a safe working environment, access to continuing education and autonomy in their own practice. Additionally, and with some foresight, the Act seeks to integrate mental health into the educational system by promoting https://www.ncbi.nlm.nih.gov/pmc/articles /PMC6646847/#:~:text=Under%20its%20pr mental health programs in schools and ovisions%2C%20the%20Philippine,informed %20about%20psychosocial%20and%20clinic al other organizations.  Mental healthcare remains an under- resourced and neglected aspect of healthcare in the Philippines. Until now, the country has lacked a formal structure in which to enshrine the rights of those people with mental illness, their families, and the rights and responsibilities of mental health professionals and government in relation to mental health. https://www.ncbi.nlm.nih.gov/pmc/articles /PMC6646847/#:~:text=Under%20its%20pr ovisions%2C%20the%20Philippine,informed %20about%20psychosocial%20and%20clinic al  The Philippine Mental Health Act of 2017 has created an environment for the organization and provision of hospital- and community-based mental healthcare in the Philippines, while providing specific legislative checks to ensure the rights of patients receiving mental healthcare and treatment are protected. https://www.ncbi.nlm.nih.gov/pmc/articles /PMC6646847/#:~:text=Under%20its%20pr ovisions%2C%20the%20Philippine,informed %20about%20psychosocial%20and%20clinic al  The Philippine Mental Health Act of 2017 is therefore a major step forward for mental health in the Philippines and a milestone for psychiatry in the country. Significant logistical challenges remain in the successful implementation of this legislation, but the Act is a significant step with the provision to comprehensively address, at a national and local level, the https://www.ncbi.nlm.nih.gov/pmc/articles /PMC6646847/#:~:text=Under%20its%20pr mental health needs of the population. ovisions%2C%20the%20Philippine,informed %20about%20psychosocial%20and%20clinic al Key facts about Mental Disorders https://www.who.int/ news-room/fact- 1 in every 8 people in the world live with a sheets/detail/mental- disorders mental disorder Mental disorders involve significant disturbances in thinking, emotional regulation, or behaviour There are many different types of mental disorders Effective prevention and treatment options exist Most people do not have access to effective care  Mental Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders A mental disorder is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour. It is usually associated with distress or impairment in important areas of functioning. There are many different types of mental disorders. Mental disorders may also be referred to as mental health conditions. The latter is a broader term covering mental disorders, psychosocial disabilities and (other) mental states associated with significant distress, impairment in functioning, or risk of self-harm.  Mental Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- In 2019, 1 in every 8 people, or 970 million people disorders around the world were living with a mental disorder, with anxiety and depressive disorders the most common. In 2020, the number of people living with anxiety and depressive disorders rose significantly because of the COVID-19 pandemic. Initial estimates show a 26% and 28% increase respectively for anxiety and major depressive disorders in just one year.  Anxiety Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- In 2019, 301 million people were living disorders with an anxiety disorder including 58 million children and adolescents. Anxiety disorders are characterized by excessive fear and worry and related behavioural disturbances. Symptoms are severe enough to result in significant distress or significant impairment in functioning.  Anxiety Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- There are several different kinds of anxiety disorders disorders, such as: generalised anxiety disorder (characterised by excessive worry), panic disorder (characterised by panic attacks), social anxiety disorder (characterised by excessive fear and worry in social situations), separation anxiety disorder (characterised by excessive fear or anxiety about separation from those individuals to whom the person has a deep emotional bond), and others. Effective psychological treatment exists, and depending on the age and severity, medication may also be considered.  Depression https://www.who.int/ news-room/fact- In 2019, 280 million people were living sheets/detail/mental- disorders with depression, including 23 million children and adolescents. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. During a depressive episode, the person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities, for most of the day, nearly every day, for at least two weeks.  Post-Traumatic Stress Disorder (PTSD) https://www.who.int/ news-room/fact- sheets/detail/mental- disorders The prevalence of PTSD and other mental disorders is high in conflict- affected settings. PTSD may develop following exposure to an extremely threatening or horrific event or series of events.  Post-Traumatic Stress Disorder (PTSD) https://www.who.int/ news-room/fact- sheets/detail/mental- It is characterised by all of the following: disorders 1) re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares); 2) avoidance of thoughts and memories of the event(s), or avoidance of activities, situations, or people reminiscent of the event(s); and 3) persistent perceptions of heightened current threat.  Post-Traumatic Stress Disorder (PTSD) https://www.who.int/ news-room/fact- sheets/detail/mental- disorders These symptoms persist for at least several weeks and cause significant impairment in functioning. Effective psychological treatment exists.  Schizophrenia https://www.who.int/ news-room/fact- sheets/detail/mental- Schizophrenia affects approximately 24 disorders million people or 1 in 300 people worldwide. People with schizophrenia have a life expectancy 10-20 years below that of the general population. Schizophrenia is characterized by significant impairments in perception and changes in behaviour.  Schizophrenia https://www.who.int/ news-room/fact- sheets/detail/mental- Symptoms may include persistent disorders delusions, hallucinations, disorganized thinking, highly disorganized behaviour, or extreme agitation. People with schizophrenia may experience persistent difficulties with their cognitive functioning. Yet, a range of effective treatment options exist, including medication, psychoeducation, family interventions, and psychosocial rehabilitation.  Eating Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- In 2019, 14 million people experienced eating disorders disorders including almost 3 million children and adolescents (1). Eating disorders, such as anorexia nervosa and bulimia nervosa, involve abnormal eating and preoccupation with food as well as prominent body weight and shape concerns. The symptoms or behaviours result in significant risk or damage to health, significant distress, or significant impairment of functioning.  Eating Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- Anorexia nervosa often has its onset disorders during adolescence or early adulthood and is associated with premature death due to medical complications or suicide. Individuals with bulimia nervosa are at a significantly increased risk for substance use, suicidality, and health complications. Effective treatment options exist, including family-based treatment and cognitive- based therapy. Disruptive Behaviour and Dissocial Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders 40 million people, including children and adolescents, were living with conduct-dissocial disorder in 2019 (1). This disorder, also known as conduct disorder, is one of two disruptive behaviour and dissocial disorders, the other is oppositional defiant disorder. Disruptive Behaviour and Dissocial Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Disruptive behaviour and dissocial disorders are characterized by persistent behaviour problems such as persistently defiant or disobedient to behaviours that persistently violate the basic rights of others or major age- appropriate societal norms, rules, or laws. Disruptive Behaviour and Dissocial Disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Onset of disruptive and dissocial disorders, is commonly, though not always, during childhood. Effective psychological treatments exist, often involving parents, caregivers, and teachers, cognitive problem-solving or social skills training.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Neurodevelopmental disorders are behavioural and cognitive disorders, that arise during the developmental period, and involve significant difficulties in the acquisition and execution of specific intellectual, motor, language, or social functions.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Neurodevelopmental disorders include disorders of intellectual development, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD) amongst others.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders ADHD is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Disorders of intellectual development are characterized by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficulties with everyday conceptual, social, and practical skills that are performed in daily life.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Autism spectrum disorder (ASD) constitutes a diverse group of conditions characterized by some degree of difficulty with social communication and reciprocal social interaction, as well as persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities.  Neurodevelopmental disorders https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Effective treatment options exist including psychosocial interventions, behavioural interventions, occupational and speech therapy. For certain diagnoses and age groups, medication may also be considered.  Who is at risk from developing a mental https://www.who.int/ news-room/fact- disorder? sheets/detail/mental- disorders At any one time, a diverse set of individual, family, community, and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability, and inequality – are at higher risk. Protective and risk factors include individual psychological and biological factors, such as emotional skills as well as genetics. Many of the risk and protective factors are influenced through changes in brain structure and/or function.  Health Systems and Social Support https://www.who.int/ news-room/fact- sheets/detail/mental- disorders Health systems have not yet adequately responded to the needs of people with mental disorders and are significantly under resourced. The gap between the need for treatment and its provision is wide all over the world; and is often poor in quality when delivered. For example, only 29% of people with psychosis and only one third of people with depression receive formal mental health care.  Health Systems and Social Support https://www.who.int/ news-room/fact- sheets/detail/mental- disorders People with mental disorders also require social support, including support in developing and maintaining personal, family, and social relationships. People with mental disorders may also need support for educational programs, employment, housing, and participation in other meaningful activities.