Tag Archives: depression

Mental health in the Philippines

After more or less 28 years, the law that could provide affordable mental health services for Filipinos has been signed.

Referred to as the Mental Health Law, the Republic Act 11036 would secure the rights and welfare of persons with mental health needs, provide services for them even in barangays, improve mental healthcare facilities, and promote mental health education in schools and workplaces.

It also aims to (1) provide psychiatric, neurologic and psychosocial services to the regional and other tertiary level hospitals, (2) add mental health service providers, and (3) introduce anti-stigma or anti-discrimination programs in schools and workplaces. Mental healthcare would not just be concentrated in urban areas anymore and would highlight the importance of research required to formulate and develop culturally-relevant national mental health programs.

The Mental Health Law has been signed by Senate President Vicente Sotto III and Senators Loren Legarda, Antonio Trillanes IV, Paolo Bengino Aquino IV, Juan Edgardo Angara, and Joel Villanueva.

A Human Right

Before the Mental Health Law was legislated, there have been at least 16 other bills focusing on mental health.

Former senator Orlando Mercado was the first one to file an act about it in 1989. The next year, another version was filed by Senator Jose Lina. Then in 2000, Executive Order 470 was issued, creating a council for mental health attached to the Department of Health (DOH).

The Philippine Mental Health Policy came into being in 2001, signed by former health secretary Manuel M. Dayrit. But it was revised four years after over 4.5 million cases of depression had been reported.

The figures went down as a result but the cases of anxiety and alcoholism have gone up in the succeeding years. Suicide, too, which was “seriously contemplated” by Filipino students as young as 13 years old. By 2012, 2,558 Filipinos died by suicide (World Health Organization) and 1 in 5 Filipino adults has some form of mental illness (Department of Health).

The destruction wrought by Typhoon Yolanda (Haiyan) across the central Philippines—particularly in Marabut, Samar, Carles, and Estancia—led the government to scale up its community mental health programs and train city and municipal health officers in identifying mental health problems. It spearheaded the first public health convention on PWDs in order to improve their access to health and wellness services.

Then it signed an administrative order in 2016 for the nationwide implementation of its mental health program. It also created a national hotline for mental health assistance in 2017. That same year, the Senate passed the Senate Bill 1354 or the Mental Health Act of 2017 that enable affordable and accessible mental health services to Filipinos.

Globally, more than 300 million people are living with depression so, in the Philippines,  the DOH together with the WHO and the Natasha Goulbourn Foundation launched Hopeline, a 24-hour phone-based counseling service for individuals who suffer from that. Other organizations that are helping are the Youth for Mental Health Coalition, Incorporated, Silakbo PH, Isanliyab Servant Leaders’ Union, and Where There Is Hope (WTIH).

Mental health is important because all aspects of people’s lives is affected by it. Depression, suicidal ideation, and bipolar disorder are currently the most common mental health problems in the country, and one in every three Filipinos has a mental health problem1. There is only one psychiatrist for every 250,000 mentally ill patients, though, and the fund set aside for mental health is just five percent of the health department’s total annual budget2.

Furthermore, most of the mental health facilities and institutions are within the National Capital Region3. Most of the victims are overseas Filipino workers, residents of typhoon-prone areas, families that have abusive parents, and those that lived through disasters and violence.

With these in mind, The PWD Forum cannot but echo a Philippine senator’s hope for mental health in the country: that it will be eventually accepted as a genuine public concern that requires accessible medical care, consistent government support, and compassionate social understanding.

“Help is finally here. The Mental Health Law cements the government’s commitment to a more holistic approach to healthcare: without sound mental health there can be no genuine physical health.” ~ Sen. Risa Hontiveros

Video taken from the YouTube Channel of the GMA News

1This estimate was from a population survey conducted by the UP-Philippine General Hospital in Western Visayas more than 20 years ago. It was shared by Dr. Lourdes Ignacio, professor emeritus at the University of the Philippines College of Medicine, during her lecture on “Reaching the unreached: Integrating mental health care in general health care” before national academicians and national scientists of the National Academy of Science and Technology.

2From the allotment, 95% goes to the maintenance of mental health institutions and personnel’s salary.

3They are the National Center for Mental Health in Mandaluyong, Cavite Center for Mental Health in Trece Martires, Mariveles Mental Ward in Bataan, and psychiatric wards in the Philippine General Hospital, Makati Medical Center, University of Santo Tomas Hospital, University of the East Ramon Magsaysay Memorial Medical Center, and Metro Psychotherapy Facility.

Notes:

  1. Depression is a common and serious medical illness that can cause feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to suicidal ideation, which means thinking about or planning suicide.

Bipolar disorder, on the other hand, is an illness that causes unusual shifts in mood. Schizophrenia is a mental disorder characterized by failure to understand reality. Anxiety causes nervousness, fear, apprehension, and worrying. All of them—depression, suicidal ideation, bipolar disorder, schizophrenia, and anxiety—can be treated through medication, counselling, and social rehabilitation.

  1. In rural areas: mental disorders are a result of other-worldly spirits or witchcraft.
  2. The state-run insurance firm, Philippine Health Insurance Corporation (Philhealth) recently added mental illness under its coverage but for severe disorders and short- duration of confinement only.
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On the bouts of depression

At certain points in his life, Miggy Bautista has battled with depression. He has envied his classmates “who enjoy certain activities such as tambay in organizations, bondings, competitions, as well as facilities for value adding talks and seminars.” He would eventually find himself “alone” most of the time, “wishing I can do what they do.”

“Amidst the positive achievements and personal experiences, I still feel unhappy from time to time. I know that we can all feel this but recognizing its life-threatening implications for prolonged period of times is something we should all be aware significant,” he has written in his own blog.

He has then thought “to examine ourselves today and recognize how dangerous we can become.” He has also called for civil and advocacy groups “to strengthen calls for proper implementation of laws as well as its compliance,” believing that each and every one must “uphold the rule of law.”

“Since we cannot do anything about the genetic makeup composing our body, we can only do something in controlling stress and associated factors leading it. It may be cliché to say but since ‘no man is an island’, being alone is, I believe, one of the major contributors of [depression] bringing loneliness or unhappiness. Being different or unique can be a source of aloneness or maybe isolation.”

Miggy has also proposed to “remember the people who are always there for us.” “Personally, my parents and siblings are my primary source of strength. I would be honest that I previously take for granted their efforts to help me pursue my goals because I am definitely a responsibility.”

“However, I was able to recognize moving forward that life is more than just a responsibility. It is sacrifice and love amidst all the trials, misunderstandings and challenges. Moreover, we can extend this perspective to the people who continuously come to assist us in this world. For my case, I like to include in it professors, security guards, utilities, fellow students and others who continue to become part of my journey and share in my aspirations.”

To date, the cum laude graduate of business administration from the University of the Philippines (UP) Diliman has conceptualized a ride sharing app that could cater to PWDs and non-PWDs alike with Ady Castueras, also a PWD who graduated from the University of the Philippines-Los Banos.

“Yung life natin ay hindi lang simpleng pananagutan sa kapwa. Ang pananagutang ito ay pagmamahal at sakripisyo sa kabila ng di pagkakaintindihan, pagsubok at hirap.” ~ Alexander Nicolabo Bautista

Video taken from the YouTube Channel of TED-Ed

HIV, CF, CMT, and HD in CR

The presence of organizations in the Czech Republic that cares for its citizens with human immunodeficiency virus (HIV), cystic fibrosis (CF), Charcot-Marie-Tooth (CMT), and Huntington’s Disease (HD) could only mean that the mentioned diseases are prevalent there and, therefore, should be controlled.

The human immunodeficiency virus (HIV) is a virus that attacks the immune system. Without it, our bodies would have trouble fighting off diseases. It could lead to dementia, anxiety and depression, and seizure, among others.

As such, the Bill and Melinda Gates foundation donated $140 million dollars to search for its cure. It would be similar to a pump in the form of an implant.

Cystic fibrosis (CF) is an inherited disorder that can damage the cells in the body that produce mucus, sweat and digestive juices. It can affect the respiratory system, gastrointestinal system, musculoskeletal system, genitourinary system, and the reproductive system. The disease is caused by a defect in a single gene, which scientists refer to as CFTR.

Recently, though, researchers at the Case Western Reserve University have found a way to replace the gene that causes CF with a new imaging technique.

It is called the tri-modal imaging device that consists of an x-ray, the first modality that can tell about the structure; and the gamma emission and the optical, the other two modalities that can both give information function.

Charcot-Marie-Tooth (CMT) is caused by mutations in genes that produce proteins involved in the structure and function of either the peripheral nerve axon or the myelin sheath. Once it degenerates, the motor nerves could result in muscle weakness and atrophy in the extremities (arms, legs, hands, or feet) while the sensory nerves could bring about a reduced ability to feel heat, cold, and pain.

Last October 24, 2016, though, scientists at the Washington University School of Medicine in St. Louis and Stanford University reported that they have designed small compounds with a potential to correct the mitochondrial dysfunction in CMT. “This mitochondrial protein has never been targeted before,” the senior author Gerald W. Dorn II, MD, the Philip and Sima K. Needleman Professor of Medicine was quoted saying in a report.

A progressive brain disorder, Huntington’s Disease causes uncontrolled movements, emotional problems, and loss of thinking ability (cognition). It usually happens in a person’s thirties or forties (adult-onset Huntington disease) or during childhood or adolescence (juvenile Huntington’s disease) and affects an individual’s walking, speaking, and swallowing.

Fortunately, an electric wheelchair was invented by Dr. Yodchanan Wongsawat from the Center for Biomedical and Robotics Technology Faculty of Engineering at Mahidol University in Thailand. It has an automated navigation system that can adapt on whether the hands of the user are still functional. If it is, a patient could use their hands. If it is not, the modes can be operated by one’s chin or eye.

The wheelchair can also detect obstacles on the floor with its Rotating Laser Scanner, map location with its Laser Scanner, describe commands with its 7’’ LCD screen, and acquire data with its Mini-PC.

Another device, the Eye Gaze System, can generate speech by simply looking at control keys or cells displayed on a screen. It could empower people with Huntington’s disease—particularly those in later stage—since they usually have poor muscle coordination, mental decline, and behavioral symptoms.

“Congress acknowledged that society’s accumulated myths and fears about disability and disease are as handicapping as the physical limitations that flow from actual impairment.” ~William J. Brennan, Jr.

Video taken from the YouTube Channel of the AP Archive

Chronic Illnesses in Netherlands

In 2002, chronic diseases accounted for 88% of all deaths in the Netherlands.

Back then, overweight and obesity has been the culprit. It was even projected that the prevalence of these health conditions would increase in both men and women over the next 10 years.

But overweight and obesity continued to “soar” in the Netherlands; one in 10 people in the country suffered from the aforementioned diseases in 2012. Type 2 Diabetes1, high blood pressure2, degenerative joint disease, and cardiovascular disease3 were still developed; and anxiety, depression and poor mental health grew more common.

Through advances in technology, however, chronic diseases in the Netherlands could now be controlled. Diabetes could be kept in check through various smartphone applications such as the BG Monitor Diabetes, which can keep a photo log of meals; Diabetes in Check, which can scan barcodes on packaged foods to immediately get their nutrition information; and Diabetic Connect, which make connectivity to the larger diabetes community possible.

Speaking of connectivity, mySugr Diabetes Logbook can track meals necessary for HbA1c reading. Insulin dosages and blood sugar measurements could also be logged in Glucose Buddy and OnTrack Diabetes. Children with this chronic illness could benefit, too, from the “simple and intuitive” interface of the BlueLoop as well as with the games and fun illustrations of Carb Counting with Lenny.

High blood pressure, on the other hand, could be regulated by the sound therapy HIRREMTM (high resolution, relational, resonance-based electroencephalic mirroring) using audible tones to reflect the brain’s pattern of electrical frequencies. Also labeled Brainwave OptimizationTM, the non-invasive neurotechnology can correct neural imbalances of the hemispheres in the brain.

Degenerative joint disease cannot be cured; the pain can only be eased and the swelling reduced. Joints with end-stage disease, however, can be remedied with either arthrodesis (fusion of the joint) or prosthetic joint replacement. UW-Madison researchers have also though of inhibiting the activity of cathepsin K and cathepsin S (TRAP) to nurse the disease somehow.

Incidences of cardiovascular disease can also be lessened with CADence™. It is quick, noninvasive, no-needle, and a zero-radiation test to “look” for Coronary Artery Disease (CAD) risk factors in patients by the sound of blood flow in the coronary arteries.

Anxiety could already be confronted with virtual reality nowadays, too. Depression could be treated with Deep TMS [Deep Transcranial Magnetic Stimulation]4 and poor mental health could be improved with telemental health services.

“It’s the repetition of affirmations that leads to belief. And once that belief becomes a deep conviction, things begin to happen.” -Muhammad Ali

 

Video taken from the YouTube Channel of EU CHRODIS

1Type 2 diabetes causes cells to change, making them resistant to the hormone insulin. Blood sugar cannot be taken up by the cells then, resulting in high blood sugar and for the cells to gradually fail.

2Having a large body size increases blood pressure. Excess fat may also damage the body’s kidneys.

3Excess weight may cause the heart to “work harder” to be able to send blood to all the cells in the body.

4Not unlike the technology in a magnetic resonance imaging, TMS works through a mounted helmet that generates an electrical pulse, too. But the patients cycle through two-second pulses followed by 20 seconds of rest for each sequence—called a “Train”—in this method, and is repeated for about 20 minutes. It should be done daily for about six weeks, followed by a three week tapering off period.

Disability in order

Countries with institutions on social security are one and the same in considering the following disabilities to be given benefits (in alphabetical order) –

ADHD – Attention Deficit Hyperactivity Disorder

Alcohol or Drug Addiction

Allergies

Alopecia areata

Amputation

Anxiety Disorder

Arthritis

Asthma

Autism and Asperger’s

Bipolar Disorder

Burn Injury

Carpal Tunnel Syndrome

Celiac disease

Charcot-Marie-Tooth disease

Chronic Migraines

Chronic Pain

Cleft lip and palate

COPD and Emphysema

Coronary Artery Disease

Crohn’s Disease

Crohn’s disease

Cystic fibrosis

Degenerative Disc Disease

Depression

Diabetes

Disorders of the Spine

Dwarfism

Dyscalculia

Eating disorders

Eczema

Endometriosis

Epilepsy

Fetal alcohol syndrome

Fibromyalgia

GERD (Gastroesophageal Reflux Disease)

Gout

Growth hormone deficiency

Hearing Loss

Heart Failure

Hepatitis

High Blood Pressure

HIV/AIDS

Huntington’s disease

Inflammatory bowel disease

Interstitial Cystitis

Irritable Bowel Syndrome

Kidney Failure

Lactose intolerance

Liver Disease

Lupus, or systemic lupus erythmaosus

Lyme Disease

Mono(nucleosis)

Multiple sclerosis (MS)

Muscular dystrophy

Narcolepsy

Neuropathy, Peripheral Neuropathy

Obesity

Obsessive compulsive disorder (OCD)

Organic Mental Disorders (incuding Organic Brain Syndrome)

Panic Attacks

Polycystic ovary syndrome (PCOS)

Psorias

PTSD, Post Traumatic Stress Disorder

Rheumatoid Arthritis

RSD, or Reflex Sympathetic Dystrophy

Ruptured Disc

Schizophrenia

Scleroderma

Scoliosis

Seizure Disorder

Sickle cell anemia

Sleep Apnea

Spina bifida

Spinal cord injury

Stroke (CVA, Cerebrovascular Accident)

Thyroid disease

Tourette syndrome

Traumatic Brain Injury, or TBI

Turner syndrome

Ulcerative Colitis

Ulcerative colitis

Ulcers

Vision Loss

Williams syndrome

There are disabilities, though, that are “invisible.” Examples of these are renal failure, agoraphobia, arachnoiditis, Coeliac Disease, Ehlers Danlos Syndrome, Fructose Malabsorption, Hyperhidrosis, Hypoglycemia, Interstitial Cystitis, Myasthenia Gravis, Reflex Sympathetic Dystrophy, Schnitzler’s Syndrome, Scleroderma, Sjagren’s syndrome, Temporomandibular Joint Disorder, and Transverse Myelitis.

It is, thus, necessary, beneficial, and practicable to integrate special education (SPED) in the basic and secondary curriculum of every country.

One doesn’t have to finish grade school and high school first before being given the option to study SPED.

A certain illness could be discovered and considered a disability at any given moment, too.

SPED would be the saying “prevention is better than cure” practiced.

Currently, 19% of the less educated people have disabilities1. Eighty percent of the PWDs, too, live in developing countries2.

Disability rates are significantly higher, too, among the member countries of the Organization for Economic Cooperation and Development (OECD) with lower educational attainment.

“We have a responsibility to ensure that every individual has the opportunity to receive a high-quality education, from prekindergarten to elementary and secondary, to special education, to technical and higher education and beyond.” ~ Jim Jeffords

1 Based on the information collated by the United Nations

2 Based on the information collated by the UN Development Programme

 

Video from the YouTube Cannel of Julia Davila

Autism

The most severe form of autism spectrum disorder (ASD), autism is a pervasive developmental disorder characterized by severe deficits in social interaction and communication, by an extremely limited range of activities and interests, and often by the presence of repetitive, stereotyped behaviors. The role of genetics and environmental factors in its cause is still being studied while theory factoring on parental practices has long been disproved.

Symptoms of autism improve with treatment and with age. Children whose language skills regress before the age of 3 may develop a higher risk of developing epilepsy. Adolescents may become depressed. Services and support are then vital for them to be able to work successfully and live independently. Autismspeaks.org has listed the various sites  linking to how technology can assist PWDs with autism.

Portable computers—iPad or tablet—can encourage communication; the screen just have to be touch to be activated. There are apps that come with plenty of pictures, too, for beginning language learners or scheduling apps with visual support. Recently, Drs. Connie Kasari and Ann Kaiser along with team members, Drs. Charlotte Mucchetti, Stephanie Shire from UCLA and Dr. Courtney Wright from Vanderbilt University have found out that speech generating devices (SGD) aid social communication.

These application programs are listed in this site while the suggestions on how to set up a portable computer are discussed in another.

Meanwhile, Rosalind Picard, founder of the Affective Computing Research Group at Massachusetts Institute of Technology’s Media Lab, is finding out how a facial recognition software with Google Glass can be used to identify emotions. Other devices can also teach simple tasks, social skills, interaction with a computer-simulated environment, or steps in a specific activity such as robots, social stories, video modelling, and virtual reality.

“Autism is like a rainbow. It has a bright side and a dark side. Even though it can mean rough weather, it can be beautiful.” ~Lacy Bella Designs

Video taken from the YouTube Channel of the behaviorfrontiers

On Technology

Last year’s International Day of Persons with Disabilities focused on the role of technology in (1) disaster risk reduction and emergency responses, (2) creating enabling working environments, and (3) disability-inclusive sustainable development goals. Persons with disabilities (PWDs) can benefit from it, the secretary general of the United Nations believed, only that ‘too many lack access to these essential tools.’

The special rapporteur on the rights of PWDs and the special envoy of the secretary-general on Disability and Accessibility even congratulated the organization’s member states ‘for promising advances in a post-2015 development agenda which is sustainable, inclusive and accessible.’ The 151 member states have been ensuring the realization of Article 11 of the Convention on the Rights of Persons with Disabilities (CRPD) as well as the commitment of the special representative of the secretary-general on Disaster Risk Reduction; Japan; and the Nippon Foundation.

There really is no doubt that adaptive, assistive and inclusive technology can let PWDs ‘make the most of their potential in their communities and in the workplace.’ All of them can increase, maintain, and improve the functional capabilities of PWDs.

But 80% of the PWDs are in third-world countries. They have not much money to spend for food, more so for an electronic device that could help them do the most basic of things. Nothing else could alleviate this fact except for more understanding on climate change and special education for all.

PWDs have a higher prevalence of mortality during disaster situations—up to 2 to 4 times—compared to non-PWDs ‘due to inaccessible evacuation, response (including shelters, camps, and food distribution), and recovery efforts.’ Simply using mass transit, reusing a grocery sack, eating nutritiously, and unplugging electronic devices that are not in use can assuage the impacts of climate change.

Prevention is better than cure, too. And there’s no other way through it but an increased awareness only special education to everybody could bring. Each of the illness leading to disability has been caused by a factor or two. It would be wise to understand why it has been so. Moreover, all of us either are or will become disabled during the course of our lives. How technology can be accessed affordably should be thought of as well as how to solve climate change and how to provide special education to all.

“On this day in which we remind ourselves of the situation of persons with disabilities around the globe, it is important, first of all, to resist the temptation to think in terms of ‘us’ and ‘them’. Instead we must remind ourselves that disability is part of the human condition: all of us either are or will become disabled to one degree or another during the course of our lives.” ~WHO Director-General Dr Margaret Chan’s message on the International Day of Persons with Disabilities 2014 (IDPD, 2014)