Up Scaling Mental Health and Psychosocial Services in a Disaster Context: Lessons Learnt from the Philippine Region Hardest Hit by Typhoon Haiyan

In the aftermath of typhoon Haiyan which struck Philippines in 2013, the World Health Organization
Philippines in collaboration with the Philippine government acted to improve access to mental
healthcare in affected regions. Eastern Visayas with population 4, 3 million had merely four
psychiatrists and seven generalists providing mental health care. It was selected as a model region
for integration of mental health care into primary and secondary care. This study was carried out to
evaluate the intervention’s success in strengthening mental health services in Eastern Visayas with
particular regard to availability, accessibility and affordability of these services. Between June 2014
and March 2015, 1038 community workers were trained in psychosocial care and support and 290
non-specialized healthcare providers received training on assessment and management of mental
health conditions including on-the-job supervision. By the end of the March 2015, 155 of 159 or 97.5%
of primary healthcare units, 21 of 24 District Hospitals (87, 5%) and all eight provincial hospitals had a
doctor and a nurse trained in assessment and management of mental health conditions. The
supervised sessions in each locale benefited 50 to 200 patients per location. Regional Medical Centre
added a 10 bed inpatient unit for the mentally ill. All provincial hospitals developed the capacity to
admit 2 to 4 patients for acute psychiatric care and additional capacity was established in at least 6
district hospitals. In addition, services were enhanced to include access to and use of psychotropic
medicines, cross-sectoral collaboration and a clinical referral pathway from the community to the
tertiary level. This study demonstrates the feasibility of an intervention in a resource poor context,
post-disaster, to improve access to mental healthcare care services over a relatively short period of
time. The remote follow-up of this intervention three years later showed that the intervention was also
to a great extent sustainable.