One-third of gov’t employees have mental problems

By Dona Pazzibugan
Philippine Daily Inquirer

MANILA, Philippines—As many as three out of 10 government employees have mental health problems, a recent survey has found out.

The most common mental disorders found among state workers were depression and anxiety disorder, which require professional intervention, said Dr. Edgardo Tolentino Jr. of the Philippine Psychiatric Association.

He said the 2007 survey, an initiative of the Department of Health, used the diagnostic tool Composite International Diagnostic Interview (CIDI) recommended by the World Health Organization and the American Psychiatric Association to get a picture of the mental health of Filipino government workers.

Employees of major government departments based in the National Capital Region were covered by the survey.

“Surprisingly as much as 30 per cent of the respondents were found to have mental health problems. There was one or two who were even possibly suicidal,” Tolentino said at a forum organized by the Philippine College of Physicians on Tuesday.

“We think that people are just normal, but they are actually harboring mental health problems which could be picked up by a diagnostic tool,” continued Tolentino, who practices at the Makati Medical Center.

He explained that depression is not to be confused with the sadness caused by the loss of or separation from a loved one.

“Depression is an illness triggered, even without any loss or separation... (by) brain chemical imbalance. It has to be treated because of the danger of suicide. So we help non-psychiatrists detect this,” Tolentino said.

Dr. Tante Delia of the PPA who practices at the Philippine General Hospital, said the recent findings jibe with the findings made more than a decade ago by the late Dr. Antonio Perlas, then one of the country's leading practitioners of mental health care.

Perlas' 1994 survey conducted in communities in Region VI with 3,000 respondents showed that 14.3 per cent or nearly two out of 10 persons suffered from a range of anxiety disorders, such as panic disorder, phobia and general depression.

“They needed professional help, medication or psycho-therapy,” Delia explained.

Tolentino said a nationwide survey is being planned to get a bigger picture of the mental health among Filipinos.

He said the findings of the 2007 survey indicated that those who showed mental problems were those with less formal education and those in difficult family situations.

“The more stressors you have and if you don't have enough resources to deal with the problem, it may turn to be a mental health problem,” Tolentino said.

He stressed the “life-saving” importance of diagnosing mental disorder.

In some celebrated cases of suicide, the “psychological autopsy” revealed that the suicidal person had given out several warning signs which were unfortunately undetected.

Tolentino cited one case where the suicide left not only a note but gave his bank automated teller machine PIN number to his staff to give to his family after his death.

“There were a lot of signs but the people around them didn't detect that there was already depression. It's life-saving to detect depression. It's preventable, there's something we can do to prevent it,” he stressed as he noted the high number of patients suffering from anxiety attacks.

“Over the past 10 years, there's a high incidence of anxiety among Filipinos. We are an anxious people,” Tolentino said.

But he also noted how Filipinos use humor as a coping mechanism during times of disaster and national upheavals.

“Is it good or bad? It could be good. But the mature way of coping is if we can use it to find a solution,” he said.

The Philippine Psychiatric Association is lobbying Congress to pass a mental health bill to strengthen and institutionalize services for mental health care.

‘Train village health workers to nurses’

June 26, 2009 10:01:00
INQUIRER.net

MANILA, Philippines—The country’s 1.3 million village health workers should be given the chance to train as midwives, nurses, doctors, and other health professionals, said Akbayan Representatives Risa Hontiveros and Walden Bello.

The two congressmen filed a bill establishing such a program to fill the gap created by migration of health professionals. Called “Bibong BHW Education and Training Program,” the program seeks to institutionalize a training and education program initiated by the University of the Philippines.

The program offers a ladderized training and education scheme for barangay (village) health workers. The first step is a basic training on community healthcare delivery, which shall be mandatory to all BHWs. The second step is a more comprehensive training on community health work where they could specialize in midwifery, pharmacology, occupation therapy, dentistry, or physical therapy.

The next two steps would be more rigorous and specialized. Step three is a course for those who wish to become nurses. It’s a 15-month program that shall include all the necessary courses on nursing. Graduates of this course shall be eligible to take the Nursing Licensure Board Examination.

To be eligible to take the licensure examination for doctors, they have to take a five-year program that shall include all courses on Medicine.

The bill also grants additional benefits for BHWs, among them full scholarships, socialized subsidies, or study now pay later schemes for those who wish to proceed to advanced courses; an increase in their allowance to P4,500, exclusive of other allowances; mandatory PhilHealth membership for all accredited BHWs; and free medical services for veteran BHWs.

“Global outbreaks like the swine flu are exacerbated by our lack of nurses and doctors. With better training, our BHWs (barangay health workers) could become an effective and efficient first line of defense against the swine flu and other diseases,” said Hontiveros, the principal author of the measure.

“The migration of our health professionals has seriously impaired the provision of health services, especially at the community level. Hospitals have actually closed down in the past three years because of the lack of nurses and doctors,” she said.

Hontiveros said this training program for BHWs could help reverse the brain drain.

“Our pool of potential health professionals could be expanded if the government could tap and capacitate our BHWs, which today number around 1.3 million,” she pointed out.

“We can train our BHWs to become midwives, pharmacists, occupation therapists, dentists, physical therapists, nurses, and doctors,” she said.