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

Abstract

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.