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.