Sustainable mental health care

Dr. Anna Cristina Tuazon’s proposal (PDI, 10/24/2024) to create government positions for dedicated mental health (MH) providers within public health units, while well-intentioned, is impractical. It also overlooks a more cost-effective and efficient solution already present in the Philippines. The government should instead leverage the existing workforce of registered nurses, specifically school and occupational nurses, who are well-positioned to address mental health needs in schools and workplaces.

Thousands of school and company nurses across the Philippines are in a prime position to contribute to comprehensive mental health services. By providing capacity-building programs to enhance their knowledge and skills in mental health, these nurses could effectively serve as frontline mental health professionals without the need to create new positions. This approach is not only financially prudent, but also utilizes an existing workforce that already has a deep understanding of their environments.

School nurses have direct and consistent access to students, enabling them to observe behaviors and identify early signs of mental health issues. Their presence in schools allows them to build relationships of trust with students, creating a safe and approachable environment for children to express their concerns. With proper training, school nurses can assess, intervene early, and coordinate with other mental health professionals, educators, and parents to ensure that students receive the necessary support.

This ability to provide immediate, on-the-ground care makes school nurses an invaluable asset in addressing mental health concerns among children and adolescents. Similarly, occupational nurses in companies can play a crucial role in promoting mental health in the workplace. They understand the physical and psychosocial aspects of the working environment and are well-positioned to identify stressors that could impact employee well-being. Occupational nurses can assess and address mental health issues, provide referrals, and coordinate care. Their regular presence in the workplace enables them to offer continuous support, fostering a healthier work environment and reducing absenteeism and productivity losses.

Dr. Tuazon argues that creating dedicated MH positions would provide predictable personnel costs and long-term program sustainability. However, this overlooks the significant financial investment required to train, hire, and maintain a separate cadre of MH professionals. Utilizing existing nurses and enhancing their capabilities is a far more cost-effective strategy. By investing in targeted capacity-building programs, the government can equip school and occupational nurses with the skills necessary to manage mental health issues, thus bypassing the need for extensive new hiring.

Moreover, nurses already embedded within schools and companies, have unique insights into the specific stressors and challenges faced by students and employees. Their experience in care coordination also ensures a holistic approach to health, integrating physical and mental well-being. Rather than establishing new government positions, the Philippines should focus on maximizing the potential of its current nursing workforce. This approach not only saves costs but also ensures that mental health services are delivered efficiently and sustainably, utilizing the strength of an existing network of healthcare professionals.

Jerome Babate