Mental health and substance use services in schools and workplaces

Background@#In 2021, the World Health Organization (WHO) reported that about 3.6 million Filipinos suffer from mental health (MH) or substance use (SU) conditions [1]. However, there is a dearth of literature on the delivery of MH and SU services in Philippine schools and workplaces.@*Objectives@#This study aimed to describe the prevalence of MH and SU services in Philippine schools and workplaces. It also examined the level of institutional support, barriers, and stigma and discrimination for MH and SU.@*Methodology@#Data was gathered in October 2022 using an online survey. The survey generated 262 respondents from all regions of the country. Schools represented 55% of respondents whereas 45% were from government and private workplaces. @*Results@#Schools and workplaces report providing more services for MH compared to SU. They also have more budget for mental health compared to substance use. The most commonly provided services are prevention programs on stress with a greater percentage of schools providing this compared to workplaces. Majority of schools and workplaces do not have any screening or treatment programs for MH and SU. Barriers to service delivery include the lack of budget, personnel, and knowledge of what services to provide. Results showed moderate levels of stigma and discrimination, with attitudes towards substance users being more negative compared to those with MH issues.@*Conclusion@#Despite national policies requiring MH and SU services in schools and workplaces, gaps in service delivery and institutional support hinder implementation. To improve service delivery, there is a need to strengthen resources, policy, leadership support and address stigma and discrimination.

Evaluating community mental health and substance use treatment integration in the Philippines: Policy and practice implications

Background@#In recent years, both mental health (MH) and substance use (SU) have emerged as important issues among Filipinos. Not all clients need specialized services and can be treated in non-specialized settings. However, no previous study has examined integration of MH and SU in the Philippines.@*Objectives@#This qualitative study explored the current practices, gaps, and potential for integration of MH and SU treatment in communities.@*Methodology@#In-depth interviews were conducted among eight subject matter experts from five Department of Health (DOH) Centers for Health Development and three local government units. Data was analyzed using Framework analysis and the SAMHSA-HRSA Framework.@*Results@#Findings suggest very low levels of integration of mental health and substance use services given inadequate resources and divergent policies and governance structures. However, findings show the potential for integration of community-based drug rehabilitation (CBDR) and community-based mental health (CBMH) especially for low and moderate risk clients.@*@#Conclusion: CBDR programs appear to be a promising model for care and lay the groundwork for implementation of CBMH. However, policy changes are needed to decriminalize drug use and implement an integrated flow for MH and SU. In addition, incorporating screening and early interventions in primary care are key to decreasing mental health inequity in the Philippines.