Lahug Wellness Center will be a ‘one-stop shop’, multi-service facility housing the country’s first ever established BBHU pursuant to the ordinance sponsored by Deputy Mayor for Health Mary Ann De Los Santos. She said it is a dream come true for their team to finally have a BBHU, as they have been advocating for comprehensive health services that includes mental health for years. With a BBHU, they would be able to address the very roots of problems in society like drugs, depression, domestic violence, juvenile delinquency, family and relational conflicts and the like.
Barangay Behavioral Health Unit
Rationale
The first thing that comes to mind about mental health is the “taong grasa” wandering in our streets. Unfortunately, this has become the basis of our understanding of mental health – “buang”. In the countryside, what comes to mind is possession by evil spirit – a myth that explains why a mentally disturbed person is tied to a “doldol” tree. These distortions do not come close to what mental health is. We miss the mark when we view mental health through its illness.
Mental health in the Philippines is defined as “crazy”. Pathetic, but how can health be defined by its illness? This misnomer reflects the condition of “health” in our country, a lopsided view of health that focuses only on the medical side, neglecting the mental side. A better view of health should be an integrated concept, that considers a healthy body and a sound mind. Mental health therefore refers to a sound mind which means a mind that is free of injury or disease and is capable of showing good judgment or sense. It also brings us to the fact that mental health is equally important as medical health and must be given our full attention.
The rising number of murders, rape, rage, addiction, incest, suicides, child pornography, domestic violence, and many more plague us with desperation and makes us wonder what in the world is happening today. Never did it occur to us that these are all mental health concerns and issues. We do not know that our behavior is a result of what is in our minds (thinking) and how we feel (emotions), our everyday life. This is mental health – living life. But where are we in all this? How many people are aware? How can we help ourselves achieve a state of well-being when we don’t know what we are up against?
It is evident that we need to educate the people so that they can be empowered to help themselves. It is evident that we need to support them so that they can be guided in the process of facing their problems. It is also evident that we need to provide treatment services so that they can be confident in their recovery. With only one hospital and a handful of psychiatrists in cebu city, it is herculean to accept the challenge of redefining mental health. For this reason, the barangay behavioral health unit (bbhu) can help bring mental health into the picture for people to grasp the meaning of mental health and lessen their stigma. With the barangay behavioral health unit, mental health is brought down to the barangay level, a better way of reaching out and delivering the basic primary care of mental health.
Barangay Behavioral Health Unit (BBHU)
BBHU is designed to reach out to the people in the barangay level. With the stigma, where people are reluctant to address mental problems, the BBHU will be a good way to make them feel safe and confident since their problems are common knowledge in their barangay or Sitio. It is also in the barangay level that the psychosocial background is more visible and accessible.
Further, it is also intended to redefine mental health and to provide the necessary primary mental health treatment limited to diagnosis, crisis intervention and referral.
BBHU, however, is not a hospital or clinic and does not treat severe cases. However, its thrust is in education, support, and primary care treatment. Please note that primary care treatment means diagnosis (the first step in treatment), crisis intervention (psychiatric emergencies), and referral (referral of severe cases to the right professionals and hospital).
BBHU is a unit directly under the barangay captain and is backed up by ordinance no. 2479 and has its own budget. It is located in the barangay health center of barangay lahug. It has two rooms, one for consult and the other for examination. It is run and managed by a technical working group (twg) headed by a program director with one psychiatrist (on call), one psychologist, and one social worker as members. It is also assisted by the barangay health workers assigned to the unit and the gender and development group who acts as community organizers.
Bbhu works closely with vicente sotto memorial medical center, mental health facilities and rehabilitation centers for its referrals. It also operates in collaboration with other government agencies; DSWD, DEPED, TESDA, DOH, PNP, DILG, PDEA, and DDB.
BBHU PROGRAM
BBHU program is an outpatient program with three main objectives: (1) educate, (2) support, and (3) treat (primary treatment limited to diagnosis, crisis intervention, and referral).
Educate
Ignorance about mental health is evident. Information about mental health concerns and issues need to be discussed. This is covered by the program through a regular (weekly) educational forum which can be conducted in the barangay hall or in the sitio. Information is comprehensive and specific and simplified for easier understanding. Topics have a wide range but are arranged to make it digestible for the audience.
Support
A person in a crisis needs assistance. With mental problems, a lot of moral support is needed through group sessions or individual sessions. The support group also serves as an aftercare service which provides a shoulder that an afflicted person can lean on and acts as a monitoring arm to see how they are progressing.
Treatment
Treatment is limited to primary mental health care as follows:
Diagnosis – is conducted by a doh accredited psychiatrist (member of the technical working group). The venue for treatment is in the bbhu clinic in the barangay on a regular weekly schedule. Cases are assessed and appropriately referred.
Crisis intervention –is performed for psychiatric emergencies. The barangay health workers (including some tanods) are properly trained to handle these situations.
Referral – a system established for cases that need intensive or more serious treatment. A memorandum of agreement is created between bbhu and the appropriate hospital, facility, center or professional to expedite the treatment.
Collaboration
A collaborative relationship is established with DSWD, DEPED, TESDA, DOH, DILG, PNP, PDEA, and DDB for the reason that these agencies can lend a hand in education, support, and treatment. A corresponding letter of undertaking is drawn in order to facilitate the relationship.
Operations manual
Legal basis
1) Ordinance no. 2479 creating the barangay behavioral health Unit within the barangay health center, and providing funds. Thereof (resolution no, 14-1829-2017 of the Sangguniang Panglungsod of the City of Cebu)
2) Objective
A. General
To introduce the integrated concept of health which includes the mental component.
B. Specific
To redefine mental health; changing the people’s notion of Mental health from “crazy” to “living life” thereby reducing the stigma through education
To provide the primary mental health care; diagnosis and assessment, crisis intervention, and referral through support and treatment
3) Application
This manual shall serve as the template and shall be used by all Barangay Behavioral Health Units of any barangay that wishes to establish a BBHU in the city of Cebu or the province.
Matter. The technical working group refered herein shall also serve as the technical working group for the other barangay Behavioral health units that will be established in the future.
Organization and personnel Organization