The aim of this presentation is to share with the thoughts and insights learned as the program responds to the needs of the community as well as to gather reactions, comments, suggestions, and recommendations for a more effective, and efficient approach in the development of community based psychiatric programs as wells as to identify points of entry for PPA and its members.
COMMUNITY MENTAL HEALTH SERVICES

In accordance with the Republic Act (RA) 11036, also known as the Mental Health Act of 2017, the Department of Health (DOH) was tasked to "establish a balanced system of community-based and hospital-based mental health services at all levels of the public health care system from the barangay, municipal, city, provincial, regional to the national level." It is also expected that the Local Government Units (LGUs) "promote deinstitutionalization and other recovery-based approaches to the delivery of mental health care services."1 Even before RA 11036 was enacted, the Davao Center for Health Development (DCHD) had already facilitated the establishment of several Community-Based Mental Health Programs (CBMHPs) in rural health units (RHUs) within the region since 2015. These programs are guided by six principles–coordinated level of referral system for better patient care, optimizing the expertise of the regional mental hub to guarantee rational use of drugs, community-based patient care for a more cost-effective treatment, capitalizing family and patient's support groups for better patient outcomes, optimizing innovative long-acting injections for better compliance and decreased relapse, and neutralizing the stigma against schizophrenia to improve mental health.2 The aim of this article is to recommend health care policies based on the report on observations and lessons learned from the implementation of the CBMHPs by the DCHD in four municipalities in Davao Region.
Community Health Services ; Mental Health Services

In Japan, the number of people with mental illness, especially depression and dementia, is growing. Although mental health care in Japan is in its transition phase from traditional hospital-based care to community-based in the recent decades, it has been characterized by orientation to large psychiatric institutions. This paper aims to provide recommendations for achieving well-balanced mental health care both in hospital and the community in Japan by reviewing facilitators and barriers of current mental health care system. A narrative literature review was conducted to identify facilitators and barriers to implementing community-based mental health care in Japan. The databases PsycInfo, Medline, Pubmed, CiNii and Google Scholar were searched in English and Japanese. 46 studies published from 1980 to 2016 were included in the review. The review identified six categories of mental health care services provided in the Japanese community: Outpatient clinics, Outreach services, Rehabilitation and Living support, Case management and public health centers, Community-based residential care, and Work and Occupation. The crosscutting themes of facilitators and barriers to implement these services in the community were funding, staff management, and collaboration among community resources. To further promote the transition to community mental health care in Japan, this paper recommends the following actions: to shift funding and human resources from inpatient to community care services, to strengthen a capacity building system and supportive environment for service providers in the community, and to set a clear policy and strategic framework integrating medical and social welfare services in the community.
Mental health services ; mental health care system ; community mental health care ; Mental disorders ; Japan

OBJECTIVE: This study was performed to support and enhance the community mental health for the urban poor. The purposes of the study were as follows: 1) to investigate the mental health states of the urban poor, who are the first target population, 2) to identify the factors influencing their mental health states. METHODS: The subjects were community residents in low socioeconomic level, who are 20-59 years old. And the scale used was GHQ (General Health Questionnaire) which is used for screening the mental health states of groups and self-esteem. The survey subjects were directly interviewed by staffs in Public Mental Health Center. SPSS PC 6.0 was used for the statistical analysis. It investigated the mental health states, according to social and demographic attributes, and self-esteem of target population. And the mental health states were analyzed to three subdomains: overall mental health states, social dysfunction, and anxiety-depression domains. RESULTS: First, in demographic attributes, the old men, who are of low socioeconomic level, single, bad physical health, low community life satisfaction, low educational background, and having no religons, were low in overall mental health states, social function, and high in anxiety-depression domain. Second, the residents, who had high self-esteem, were high in overall mental health states, social funtion, and low in anxiety-depression domain. Third, the residents, who had high self-esteem scores, were significantly high in overall mental health states, social function, and low in anxiety-depression domain. Fourth, Among the various factors influencing the mental health states, the self-esteem was the most important factor, and the physical health was the next important factor. And the higher self-esteem they had, the better physical health states, the older they were, the higher the mental health states became. Fifth, comparing the high risk group with non-risk group, those who were in their 20's and 40's, had no wives or husbands, low educational background, physical workers, and were not well healthy, were apt to have mental diseases. CONCLUSION: In the future, the first target population in the community mental health services will be the urban poor in low mental health states. For those who are apt to have mental diseases, the first step of community mental health works is to find, select and give basic mental health services. The staffs in community mental health center have to develop various mental health programs and inform the public of them.
Community Mental Health Services ; Health Services Needs and Demand ; Humans ; Male ; Mass Screening ; Mental Health Services ; Mental Health* ; Spouses

OBJECTIVES: The objective of this study was to analyze the relationships of psychological distress, social support, mental fitness and suicidal idea among patients of chronic schizophrenia using community mental health services. METHODS: This study was conducted in patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 chronic schizophrenic patients were evaluated using Mental Fitness Scale (MFS), Kessler Psychological Distress Scale (K10), and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS: Results showed that 37% (n=146) of patients had suicidal ideas and 63% (n=249) of patients did not have suicidal ideas. The group that had suicidal ideas showed significantly lower scores on MFS, K10, and MSPSS than the group with no suicidal ideas (p=0.000). Logistic regression analysis showed a significantly lower score on MFS, K10 for the suicidal ideation group than the group with no suicidal ideas. CONCLUSION: These results suggest that health care providers should consider mental fitness and psychological distress, in order to prevent suicidal idea of schizophrenic patients.
Community Mental Health Services* ; Health Personnel ; Humans ; Logistic Models ; Mental Health Services ; Schizophrenia* ; Suicidal Ideation

INTRODUCTION: According to WHO about 80% of people living with a severe mental disorder in Low-and-Middle-income countries (LAMICs) do not have access to appropriate healthcare. Low literacy regarding mental disorders is one of the main barriers that prevent access to mental healthcare, which leads to stigma, socio economic exclusion, suffering of people with mental disorders and forces families to hide their relatives rather than to direct them to the community healthcare centre. To address this issue mental health, stakeholders from more than 20 countries joined forces with the World Association of Social Psychiatry and Sanofi in the FAST program, based on 3 pillars: (1) Mental health literacy, (2) health care professionals training and (3) affordable quality medicines.
OBJECTIVE: This research aimed or develop Information-Education-Communication materials to improve mental health literacy in LAMICs.
METHODOLOGY: Workshops with participants from different sectors (public, academic, associative, private) were set up to develop generic documentsbased on the experienced derived from malaria awareness programs. Then, for each country, documents were revised and adapted by a local working group.
RESULTS: A flip chart, an educational comic book, a leaflet, a poster and a brochure on schizophrenia were made available with versions adapted to the local specificities of (a) Sub - Saharan Africa (b) North Africa (c) Eastern Europe and (d) Latin America. The main message of the educational materials was that: mental disorders are like any other disease i.e. they can be treated and people with mental disorders are like any other person. The following specific topics where covered: frequency of mental disorders, symptoms recognition, cause of disease, where to seek help, stigma. Recommendations on how to use these materials were also available.
CONCLUSION: Improving mental health literacy in developing countries calls for relevant materials. A rigorous evaluation of the impact of the FAST documents is now required.

INTRODUCTION: According to WHO about 80% of people living with a severe mental disorder in Low-and-Middle-income countries (LAMICs) do not have access to appropriate healthcare. Low literacy regarding mental disorders is one of the main barriers that prevent access to mental healthcare, which leads to stigma, socio economic exclusion, suffering of people with mental disorders and forces families to hide their relatives rather than to direct them to the community healthcare centre. To address this issue mental health, stakeholders from more than 20 countries joined forces with the World Association of Social Psychiatry and Sanofi in the FAST program, based on 3 pillars: (1) Mental health literacy, (2) health care professionals training and (3) affordable quality medicines.
OBJECTIVE: This research aimed or develop Information-Education-Communication materials to improve mental health literacy in LAMICs.
METHODOLOGY: Workshops with participants from different sectors (public, academic, associative, private) were set up to develop generic documentsbased on the experienced derived from malaria awareness programs. Then, for each country, documents were revised and adapted by a local working group.
RESULTS: A flip chart, an educational comic book, a leaflet, a poster and a brochure on schizophrenia were made available with versions adapted to the local specificities of (a) Sub - Saharan Africa (b) North Africa (c) Eastern Europe and (d) Latin America. The main message of the educational materials was that: mental disorders are like any other disease i.e. they can be treated and people with mental disorders are like any other person. The following specific topics where covered: frequency of mental disorders, symptoms recognition, cause of disease, where to seek help, stigma. Recommendations on how to use these materials were also available.
CONCLUSION: Improving mental health literacy in developing countries calls for relevant materials. A rigorous evaluation of the impact of the FAST documents is now required.

OBJECTIVES: To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.
Community Mental Health Centers ; Community Mental Health Services ; Humans ; Mental Health Services* ; Mental Health* ; Personal Satisfaction ; Psychotic Disorders ; Questionnaires ; Reproducibility of Results*

PURPOSE: This study was done to assess effects of Assertive Community Treatment (ACT) in a community mental health center. METHODS: This study was a non-equivalent control group design with two groups, each of 20 clients. The instruments were the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF), Satisfaction of Life, and the number and duration of admissions. Data collection was done in March, 2010 for the pre-test, and in March, 2011 for the post-test in the S community mental health center in Gyung-gi province. The collected data were analyzed using descriptive statistics, Fisher's exact test, and Mann-Whitney U test with the SPSS/WIN program. RESULTS: The experimental group showed significant differences in the duration of admission, GAF, and Satisfaction of Life, but not on number of admissions and BPRS. CONCLUSION: The results of this study indicate that ACT can be applied as an effective case management model in Korea.
Brief Psychiatric Rating Scale ; Case Management ; Community Mental Health Services ; Data Collection ; Korea ; Mental Health

OBJECTIVES: The purpose of this study was to examine the current situation and the limitations of the Mental Health Review Board and to identify the effectiveness of the community linkage for discharged patients. METHODS: The data was collected from the 116 patients who were discharged from August 2005 to July 2007 by the order of the Mental Health Review Board. The survey was conducted by telephone with using a structured questionnaire. RESULTS: 51 patients (44.0%) were able to be referred to community mental health services when they discharged. The readmission rate was 50.9% and the mean duration to the first readmission was 51.73 days (S.D.=103.5). The mean duration to the first readmission was significantly longer for the group that was referred to community services and that had a negative correlation with the stability of health security. The outpatient maintenance rate and the current admission status were also significantly different between the group that was referred to community services and the group that was not referred. CONCLUSION: The activities of the mental health review board have definite limitations in Korea such as the high rate of immediate readmissions after the discharge orders. A hospital-community integrated service system could be one possible solution to improve the maintenance of mental health patients in the community and to prevent their readmission.
Community Mental Health Services ; Follow-Up Studies ; Humans ; Korea ; Mental Health ; Outpatients ; Social Welfare ; Telephone