Investing in Mental Health Towards

Healthy Workplaces
EBENEZER RAMOS BONBON
Specialty Care Division | Mental Health
DOH- Disease Prevention and Control Bureau

Department of Health, Philippines

WHAT IS MENTAL HEALTH?
Mental Health is critically important for everyone, everywhere
● It is integral to our general well-being.
● Everyone has the right to mental health.
● Its is relevant to many sectors and stakeholders.

Mental Health is important to:

World Mental Health Report slides

Republic of the Philippines

Department of Health
/doh.gov.ph
MENTAL HEALTH IS NOT A BINARY STATE

World Mental Health Report slides

Republic of the Philippines

Department of Health
/doh.gov.ph
MHA Objectives
4. Strengthen information systems,
1. Strengthen effective leadership and
evidence and research for mental
governance for health
health

2. Develop and establish a comprehensive,

5. Integrate mental health care in the
integrated, effective, and efficient national
basic health services
mental health care system

6. Integrate strategies promoting

3. Protect the rights and freedoms of
mental health in educational
persons with psychiatric, neurologic,
institutions, the workplace, and in
and psychosocial health needs
communities.

Republic of the Philippines

Department of Health
/doh.gov.ph
Mental Health and Well-being
Improved practices on
Prevention & mental health and Mental Health and
wellbeing in schools,
Promotion workplaces, and
Wellbeing is
communities valued, promoted,
and protected
Strengthened effective
Governance &
Leadership
leadership and Mental health
governance for MH
conditions are
Pillars

identified, treated and

Improved access to prevented
Services mental health services
in all levels of care
Persons affected by
mental health
Increased availability, conditions are able to
Information & accessibility and
exercise the full range
Research utilization of evidences
for Mental Health of human rights

Republic of the Philippines

Department of Health
/doh.gov.ph
Top Causes of DALYs* in the Philippines, 2019
Rate per Percentage Mental disorders of all
Cause 100,000 of Total
population DALYs types ranked 8th among
1. Cardiovascular diseases 4,886.20 16.76% 22 DALY aggregate
2. Respiratory infections and tuberculosis 2,887.77 9.91%
3. Neoplasms 2,284.23 7.84% cause groupings#.
4. Maternal and neonatal disorders 2,252.40 7.74%
5. Diabetes and kidney diseases 1,977.70 6.78%
6. Other non-communicable diseases 1,827.55 6.27%
Self-harm and
7. Musculoskeletal disorders 1,807.98 6.19% interpersonal violence of
8. Mental disorders 1,365.84 4.68% all types ranked 10th
9. Chronic respiratory diseases 1,163.56 3.99%
10. Self-harm and interpersonal violence 1,114.01 3.82% among 22 DALY
aggregate cause
groupings#.
#Using the Level 2 and by rate hierarchical classification of the
GBD Study 2019; with 22 disease and injury aggregate
groupings.
*Measured in Disability Adjusted Life Years (DALYs). DALYs for a disease or health condition
are the sum of the years of life lost due to premature mortality and the years lived with a
Source: Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019
disability due to prevalent cases of the disease or health condition in a population.
Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020
Types of Mental Disorders, Philippines, 2019

DALY* rate per

Rank Type of Mental Disorder Prevalence
100,000 population
1 Anxiety disorders 422.53 4,398.16
2 Depressive disorders 398.78 2,571.93
3 Schizophrenia 180.85 279.82
4 Other mental disorders 90.90 1,222.09
5 Conduct disorder 80.56 660.81
6 Bipolar disorder 69.95 322.83
7 Autism spectrum disorder 49.75 323.96
8 Idiopathic developmental intellectual disability 35.67 952.77
9 Eating disorders 24.19 112.06
10 Attention-deficit / hyperactivity disorder 12.66 1,037.64

*Measured in Disability Adjusted Life Years (DALYs). DALYs for a disease or health condition
are the sum of the years of life lost due to premature mortality and the years lived with a
Source: Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019
disability due to prevalent cases of the disease or health condition in a population.
Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020
RELATED POLICIES AND
GUIDELINES
A. LAWS AND POLICIES
● Legal Basis
○ Republic Act 11036 | Mental Health Act of 2018
■ Enhances the delivery of integrated mental health services, promotion and protection of
the rights of persons utilizing psychosocial health services
● Policies and Standards Developed
○ The Mental Health Strategic Plan 2019-2023
■ Details outputs, key activities, and targets for the first five years of the implementation
of the Mental Health Act (2019-2023) and the agencies or sectors responsible for these
outputs and key activities at the national, regional, and local levels.
○ Administrative Order (AO) No. 2022-0004 | Guidelines for Ethical and Responsible
Reporting and Portrayal of Suicide in the Media, Audiovisual, and Films
■ Aims to reduce the incidence of suicidal thoughts, suicide attempts, and deaths by
suicide in the country through responsible and ethical reporting and portrayal of suicide
and proper handling of suicide events.
A. LAWS AND POLICIES
● Policies and Standards Developed
○ Administrative Order (AO) No. 2022-0017 | Guidelines for Informed Consent, Supported Decision Making,
Advance Directives, and Legal Representation, in relation to Republic Act 11036, otherwise known as the
Mental Health Act
■ Provide implementing guidelines, systems and procedures for the operationalization of obtaining and
documenting informed consent, exceptions to informed consent, advance directive, legal representative, and
supported decision making of service users, excluding minors and special populations.
○ Administrative Order (AO) No. 2021-0012 | Implementing Guidelines on the Medicines Access Program for
Mental Health (MAP-MH)
■ Set overall guidelines on the implementation of MAP-MH in access sites such as DOH hospitals, Centers for
Health Development (CHDs), Ministry of Health - Bangsamoro Autonomous Region in Muslim Mindanao
(MOH-BARMM), Treatment and Rehabilitation Centers (TRCs), and other health facilities.
○ Department Order (DO) No. 2021-0001 | Designation of specialty centers for Mental Health under the Resource
Stratified Framework
■ Provide policy direction for DOH offices and hospitals for the establishment of Specialty Centers and define
the role of Specialty Centers in the provision of specialty care services across HCPNs in the country.
○ Administrative Order (AO) No. 2022-0018 | Development and Utilization of the Omnibus Health Guidelines
per Lifestage
■ Provide guidance on an integrated and consolidated approach to health service delivery across various life
stage
A. LAWS AND POLICIES

● Policies and Standards Developed

○ Memorandum Circular No. 04 s. 2020 | Mental Health Program in the Public Sector
■ Promote overall mental wellness and provide an inclusive, conducive and supportive
work environment for all public servants to ensure healthy and productive workforce.
○ Department Order No. 208 s. 2020 | Guidelines for the Implementation of Mental Health
Workplace Policies and Programs for the Private Sector
■ Aims to guide employers and workers in the private sector for effective implementation
of Mental Health Workplace Policies and Programs.
○ Joint Administrative Order (JAO) 2023-0001 | Guidelines on the Creation of the
Mental Health Internal Review Board and Providing its Rules of Practice
■ Provide the implementing guidelines on the creation of IRB for public and private
mental health facilities, define the functions of the IRB, and provide the rules for the
efficient disposition of matters and cases falling within its scope of authority.
A. LAWS AND POLICIES

● Policies and Standards Developed

○ Joint Administrative Order (JAO) 2022-0001 | Guidelines on Healthy Settings
Framework in Learning Institutions
■ Provide framework, through coordination of DOh, DSWD, DepEd, CHED, LEB, TESDA,
DILG, and LGUs, for the establishment and/or strengthening of healthy learning
institutions across life stages in the Philippines in support of the UHC Law.
○ Joint Administrative Order (JAO) No. 2021-0002 | National Policy Framework on the
Promotion and Recognition of Healthy Communities
■ Aims to provide a policy framework on the promotion and recognition of healthy
communities
○ Joint Administrative Order (JAO) No. 2023-0001 | National Policy Framework on the
Promotion of Healthy Workplace
■ Promotion, establishment, and strengthening of Healthy Workplaces in support of the
implementation of the Universal Health Care Law
Access to basic mental health services

Nationwide and regional hotlines available 362 sites nationwide; 27 medicines provided
Republic of the Philippines
Department of Health
/doh.gov.ph
SERVICE DELIVERY
LIST OF TRAININGS FOR HEALTH AND NON-HEALTH PERSONNEL
Objective Target Audience Mode of Learning Remarks

Basic training available at

provides basic understanding on MHPSS and build
MHPSS Service Providers both from DOH academy; conducts
the core competencies of service providers based
MHPSS the government and non-government face-to-face training to HEMB led
on the Inter-Agency Standing Committee Pyramid of
agencies select LGUs with WHO
Intervention
assistance

Face to face training for the

scaling up care for MNS disorders; expand mental primary care facilities personnel like identified SIMH focus sites
conducts face-to-face and
health services that can be provided in non- doctors, nurses, and other health (Ilocos, Cordillera, Western
mhGAP virtual training to select
specialized health settings particularly on primary workers as well as health planners and Visayas, Eastern Visayas and
LGUs with WHO assistance
care by providing massive capacity building managers Caraga) thru Technical
Assistance from WHO

For review and evaluation

Tulong, community based mental health education approach General public, advocates, supporters,
Basic training available at following the competency
Alalay, as prevention, early intervention, and crisis mental health service providers within
DOH academy and capacity development
Gabay intermediation tool in the Philippines. and outside health sector
framework to be developed.

improve the quality of care provided by mental

WHO health services and promote the human rights of General public, advocates, supporters,
Online training at WHO
Quality people with psychosocial, intellectual and cognitive mental health service providers within WHO-Led
website
Rights disabilities; offers a new approach to mental health and outside health sector
care which is rights-based and recovery- oriented
SERVICE DELIVERY
LIST OF TRAININGS FOR HEALTH AND NON-HEALTH PERSONNEL

Objective Target Audience Mode of Learning Remarks

Developed the Modules but

was not pilot tested because
To strengthen the capacity of the LCEs of unavailability of the target
Leadership
towards improving the local health system in LCE participants; For review
training for Selected Local Chief Executives Online
the context of Universal Health Care and and evaluation following the
LGUs
Mental Health Act competency and capacity
development framework to be
developed.

Pilot tested the elearning

To capacitate Persons with Lived course; For review and
evaluation following the
PWLEs Experience Persons with Lived Experience Online
competency and capacity
on mental health advocacy and leadership
development framework to be
developed.

Pilot testing conducted for

Mental Health Facilities, the Basic IRB training; Pilot
To capacitate selected Facilities with Online
Commission of Human Rights, testing conducted for the
IRB Mental Health Services in establishing their
Centers for Health Development, TOT
Internal Review Board Face to face
Service User Organization
2023 roll-out
SERVICE DELIVERY
LIST OF TRAININGS FOR HEALTH AND NON-HEALTH PERSONNEL

Objective Target Audience Mode of Learning Remarks

Conducted i batch of Pilot trainings for

Local Health Official in the LGU, LGU’s:
To capacitate non-mental health
municipal health workers, 1. Tolosa Leyte
specialists to deliver basic
community nurses/midwives, 2. Sta. Barbara ,Iloilo
CBMH mental health services at the Face to face
barangay health workers,social 3. New Washington ,Aklan
community level.
workers and other relevant 4. Muntinlupa City, NCR
community stakeholders
BARMM roll out in 2023

Conducted pilot sessions for module

Media organizations, national
Ethical To capacitate media providers to development:
government agencies, and support
reporting responsibly portray and report Face to face 1. National government agencies
organizations with media monitoring
of Sucide on suicide 2. Media organizations
and review functions
3. Media support organizations

To develop and conduct a pre Pre-tested the modules on 52

Teaching and non-teaching staff (
testing of basic training modules participants, from teaching and non-
teachers, guidance designates,
Suicide on Suicide Prevention in teaching staff from DepEd CAR (including
principals, guidance counselors,
Prevention Schools, focused on early DOH, Deped, WHO tech staff)
administrative assistant, child Face to Face
Training in identification, assessment,
protection committee member,
Schools management and follow-up for For review and evaluation following the
nurse, doctors etc,)
those affected competency and capacity development
framework to be developed.
PHILHEALTH PACKAGES
● Outpatient Benefits Package for Mental Health (PhilHealth Circular No. 2023-0018: Outpatient Benefits Package for
Mental Health)

○ General Mental Health Service Package (PhP 9,000)

■ Inclusion: Screening, assessment based on mhGAP, diagnostics, 12 follow-up visits (at most),
psychoeducation, psychosocial support, medicines currently provided under the MAP-MH
■ Prospective providers: Primary Care facilities

○ Specialty Mental Health Service Package (PhP 16,000)

■ Inclusion: Assessment, specialist diagnostics, 12 follow-up visits (at most), psychotherapy, medicines
currently provided under the MAP-MH
■ Prospective providers: Level 2 and 3 facilities with the required specialist (psychiatrist, neurologist and
psychologist)
Healthy Communities
Health promotion playbook
for mental health to assist LGUs in setting up
Lusog-Isip Application
10, 341 users as of Dec 31, 2022
community level social support structures

Republic of the Philippines

Department of Health
/doh.gov.ph
Integrating Mental Health
into Community and
Workplace Settings

Opportunities and Ways Forward

Republic of the Philippines

Department of Health
/doh.gov.ph
Mental health risks and protective factors
Individual Family and Community Structural

Sexual abuse and violence,

poor quality infrastructure ,
emotional and physical
poor access to services ,
abuse and neglect, poor
RISKS genetic factors, unhealthy
living conditions, dangerous
injustice, discrimination and,
undermine and risky behaviors, body social exclusion, social,
neighborhood, difficult
mental health dissatisfaction economic, and gender
family relationships, job
inequalities, conflict and
strain, job loss and
forced displacement
unemployment

positive family relationships ,

Genetic factors, good quality infrastructure,
physical security and safety,
interpersonal, social and equal access to services,
PROTECTIVE emotional skills, sense of
positive social networks,
quality natural environment,
quality education, school
FACTORS self-worth and mastery,
level policies for well-being,
social justice and integration,
enhance mental health good physical health, income and social protection,
social capital and social
physical activity social and gender equality
supports, green spaces

World Mental Health Report, WHO, 2022 Republic of the Philippines

Department of Health
/doh.gov.ph
Opportunities to Address Long Standing Gaps and
Build Preparedness

Address longstanding, Build preparedness and

existing gaps in service strengthen system
mix, coverage and capacity in context of
quality ‘new normal’
Shift in focus from specialized
services to integration into
general health and
community settings.
Stronger mental health system
for the future
MH promotion/prevention activities in community
settings, utilising community resources available

Republic of the Philippines

Department of Health
/doh.gov.ph
Opportunity to Shift Mix
CURRENT REALITY DESIRED REALITY

Services
Services concentrated in specialist psychiatric concentrated
hospitals in specialist
psychiatric
hospitals
Mental health services in general
hospitals, including outpatient care Licensing general hospitals to
include MH services
Integrate MH services into
primary care, with particular
Limited primary health care focus on common mental
integration disorders

Step-up, low intensity including self-

Limited
help support for early/mild
community-based
services difficulties in community settings

Self Care
MH promotion/prevention activities in community
settings, utilising community resources available

Republic of the Philippines

Department of Health
/doh.gov.ph
Opportunity to Shift Mix

Creation of IRBs, Mental Health Information System

mhGAP training, leadership and advocacy for PWLEs; adoption
of Live Life Strategy, Innovative Cap build for LCEs, and training
package for community based mental health in select pilot sites

Republic of the Philippines

Department of Health
/doh.gov.ph
LGUs as champions of community based mental
health | CBMH Framework
Shift in focus from
specialized services to
integration into general
health and community
settings.

Pilot sites for CBMH

Muntinlupa
New Washington, Aklan
Tolosa, Leyte
Santa Barbara, Iloilo

Republic of the Philippines

Department of Health
/doh.gov.ph
What makes Filipinos healthy?

Republic of the Philippines

Department of Health
/doh.gov.ph
Health Promotion Framework Strategy 2030
Multi-
Sectoral

Protecting and enabling

Filipinos to care for self &
community

Taking care of Filipinos Health

when needed Sector

Republic of the Philippines

Department of Health
/doh.gov.ph
Mental-Neurologic-Substance Use Disorders

Mental health &

substance use
are inextricably VICIOUS
linked. CYCLE

Both share underlying

causes - brain composition,
genetic vulnerabilities, and
early exposure to stress or
trauma

Republic of the Philippines

Department of Health
/doh.gov.ph
Mental Health is Beyond the Health Sector: What Can We Do?
● Push for local ordinances supporting our service users (mental health clients) and the general
population
● Advocacy for upholding human rights
● Support to non-health settings
○ early detection and intervention in schools and workplaces
○ mental health care in justice systems (SC CARES Program)

● Support to key social services

○ Child protection
○ Education and training
○ Supported housing
○ Access to employment
○ Social benefits (maternity, disabilities, unemployment, pensions)

● Intensify awareness and education programs

○ Continue conversations on mental health e.g. local health boards, local health councils
○ Advocate for healthy behaviors and addressing the social determinants of health
○ Orienting barangay officials and other members of the community and key decision makers

Republic of the Philippines

Department of Health
/doh.gov.ph
How do we get there, faster?
Build capacities across all settings

Objective Bring services closer to people

Statement
Increase available financing
Enhance Filipinos’ well-being
and ensure quality mental
health services Meaningfully engage service users

Address policy barriers & apply EBM

Republic of the Philippines

Department of Health
/doh.gov.ph
1a Building capacity for health service delivery

Improved access to
mental health services in
all levels of care 362 access sites nationwide 75 mental health facilities
with 27 mental health (23 specialty care centers; 52
medicines; 161,570 service acute and custodial care
users served in 2022 facilities) nationwide

Republic of the Philippines

Department of Health
/doh.gov.ph
 Build capacities in workplaces, schools, communities and
1b primary care providers, emphasizing LGU leadership

COMMUNITY-
BASED MNS
PREVENTION
TREATMENT
REHABILITATION
PLAYBOOK

Republic of the Philippines

Department of Health
/doh.gov.ph
Build capacities in workplaces, schools, communities and primary
care providers, emphasizing LGU leadership

Schools Primary Care

Workplaces Teachers, School personnel,
HCW and Administrators learners’ capacity to engage in Providers
MH activities mHGAP, Quality Rights

Republic of the Philippines

Department of Health
/doh.gov.ph
 Bring information and services to people using
2a
1. innovative delivery models

Lusog-Isip Application Lusog-Isip Web

for Adults for Students

Republic of the Philippines

Department of Health
/doh.gov.ph
 Bring information and services to people using
2b
1. innovative delivery models

Mental Health Specialty

Centers Growth Plan

2023 14

2024 20

2025 23

Republic of the Philippines

Department of Health
/doh.gov.ph
 Increase financing for population-based and
3a individual-based health services

2021 & 2022 2023

Healthy Setting Funds Healthy Settings Funds
DOH -
Central Healthy Settings Funds

DOH - Healthy Settings Funds Healthy Settings Funds

Healthy Settings Funds
Region

Healthy Settings Budget Healthy Settings Budget

LGU

Republic of the Philippines

Department of Health
/doh.gov.ph
 Current PhilHealth benefit packages
Increase financing for population-based and
3b
for mental health covers mental health
conditions such as dementia, bipolar
individual-based health services disorders, schizophrenia and anxiety
disorder under Mental and Behavioral
Disorders by in-patient admission
under all case rate (ACR) amounting
General Mental Health Specialty Mental Health to Php 7,800.00.
Service Package Service Package

Php 9,000 Php 16,000

Screening, assessment Assessment, specialist

(mhGAP) diagnostics, 12 diagnostics, 12 follow-up
follow-up visits, visits, psychotherapy
psychoeducation,
psychosocial support

Primary Care facilities Level 2 and 3 facilities with

the required specialist
(psychiatrist, neurologist
and psychologist)

Republic of the Philippines

Department of Health
/doh.gov.ph
 1.4 Meaningfully engage service users

Protect the rights and freedoms of

persons with psychiatric, neurologic,
and psychosocial health needs Guidelines on Ethical and Guidelines for Informed Consent, Guidelines on the Creation of
Responsible Reporting and Supported Decision-Making, the Mental Health Internal
Portrayal of Suicide in Media Advance Directives, and Legal Review Board and Providing
Representation for its Rules of Practice

Republic of the Philippines

Department of Health
/doh.gov.ph
The Philippine Council for Mental Health
Strategic Framework
2024-2028

Republic of the Philippines

Department of Health
/doh.gov.ph