PhilHealth to cover out-patient mental health consultation fees

Sherrie Ann Torres, ABS-CBN News

Posted at May 09 2023 09:06 PM

MANILA — Health experts see the varying degrees of stress and crisis as the main culprit why many individuals today confront mental health issues.

Their basis: the number of calls that the National Center for Mental Health (NCMH) received from 2019 to 2021.

In 2019, calls received by the NCMH totaled 3,125, with 712 related to suicide.

In 2020, the number of calls went up to 11,017, with 2,841 classified as suicide-related calls.

And in 2020, calls recorded were placed at 14,897, with 5,167 suicide-related concerns.

NCMH’s “Crisis Hotline” last year recorded 1,895 with 794 coming from 17-year-old callers.

The first three months of this year meanwhile recorded 4,327 NCMH callers, with problems relating to family, relationships, school, work, anxiety, depression, and absence of someone to talk to as their main concern.

For Senator Sherwin Gatchalian, it is a must for health experts to zero in on the mental health concerns of the youth, given the fact that from school year 2021 to 2022 alone, a total of 2,147 suicide attempts were recorded.

Of that number, 404 students died of suicide.

“What I’m driving at is, are we reachable, are we analyzing the data... are we successful in thwarting calls, suicide-related cases? What are we doing? The pandemic of mental health is already here,” Gatchalian said during a Senate hearing on Tuesday.

"Majority of them have been managed by specific treatments like anti-depressants or undergoing counseling," NCMH Medical Chief Dr. Noel Reyes said. "Of course meron ding porsyento na lost to follow-up, hindi na tumatawag."

The DOH on the other hand, is also designing various programs to help those suffering from mental health issues. 

“We are developing other platforms. First of which is the self-based mechanism, the Lusog-Isip app which we developed, this has been more piloted to more users. There are around 13,000 users, but definitely, there’s a lot to reach.

"At the local government ang isang important program din is peer support... It’s currently being piloted in several LGUs and we’re planning to expand that,” Dr. Razel Nikka Hao, Director IV of DOH said.

Still, health officials admitted they cannot really reach everyone in the country who are suffering from mental health.

They assured committee members that they are doing everything to address such health issue.

Gatchalian for his part stressed, the DOH should not stop from expanding their helpline’s coverage.

“That’s scary because people are becoming hopeless, don’t see the need to call the hotline. Maganda presentation ninyo but we’re doing it wholesale. You are not analyzing the data. You have to do something,” Gatchalian said.

The Philippine Health Insurance Corporation (Philhealth) only covers in-patient mental health expense at a maximum of P7,800.

Medicines are cheaper if a patient will buy his or medicines at the NCMH or other government hospitals.

Still, those who are able to recover still have a big challenge, according to panel chairman, Senator Christopher Go.

“Yun yung sinasabi kong napakaraming pasyente na 30 years, 50 years, yung iba taga-Mindanao, ayaw na pong umuwi sa Mindanao dahil wala na silang mauwian, wala na yung pamilya nila o maaaring di na sila welcome sa pamilya nila. Iyon po ang dapat nating i-address kasi sa tingin ko ganoon din po ang problema sa ating mental hospital sa Mandaluyong,” Go said. 

“We have the centers," Assistant Secretary Janet Armas of the Department of Social Welfare and Development said. "Residential facilities that can cater to them. We can also coordinate with LGUs to locate families para kung may relatives o wiling mag-accomoodate sa kanila, we can coordinate with them. If nobody wants to take them back, they can be catered to our centers."

PhilHealth said it is now finalizing a program that would cover the consultation fees of out-patients too, for services of psychologists, psychiatrists, neurologists, and other doctors.

“Iyon pong mga programa ng PhilHealth ngayon para sa mental health, karamihan, actually lahat po ay pang in-patient. In our opinion that may already be too late. Suicide can be prevented but we can save lives even outside, even before the hospital,” PhilHealth Director Albert Edralin Domingo said.

Domingo, who is with the agency’s Health Finance Police Sector, added: “Lahat po ng Pilipino may HMO, ang tawag po doon ay PhilHealth. PhilHealth has been developing a mental health package expanding it, na hindi lang tayo sa kulay gray which is P7,800 para sa case rate in-patient condition. Pero magkaroon na rin ng out-patient."

The PhilHealth Board is now only discussing how many sessions it would cover for out-patient consultation for mental health issues.

Their target of implementation is either in June or July.

“We’re hoping to begin by July but again in specific centers muna then we will gradually broaden it as we see operations happen... 'Yung goal nationwide siya pero para hindi biglaan na masa-shock ng sistema natin, kailangan sisimulan natin siya sa selected sites. Pero definitely in the site selection hindi naman puro Metro Manila lang, puro malalaking urban centers,” Domingo said.

“Under the actions of Philhealth for this year, there will be this package which is also out-patient... The target facilities that will be contracted include level three hospitals,” he added.

The board will discuss if medicines for mental health including online or teleconsultation will also be covered by PhilHealth, Domingo said.

Meanwhile, Senator Raffy Tulfo’s grilled NCMH Director, Dr. Noel Reyes regarding the alleged irregularities inside the hospital facility which include the opening up of pay parking, and the administration’s decision to contract a third-party food supplier.

Reyes vowed to look into the issue and make appropriate actions.