The Community Mental Health Program in Calabarzon: Preliminary report from an internal review of an innovative service integration initiative for Schizophrenia

@#The Community Mental Health Program (CMHP) of the Center for Health Development Calabarzon is an initiative that aims to integrate mental health into primary care to facilitate person-centered and holistic services. At the core of CMHP is a referral pathway between health centers and tertiary-level mental health services for the diagnosis and continuing management of persons with mental health conditions, as well as the use of an innovative medication (specifically for schizophrenia). This commentary presents lessons learned from a one-year implementation of CMHP in four pilot sites in the provinces of Rizal and Laguna, which stakeholders in mental health may consider in the design of community-based mental health programs to further the mandate of the Mental Health Act.

Estimated range of cost of treatment of adult Schizophrenia patients at a tertiary government hospital as of October 2015

OBJECTIVES@#Using the patient’s perspective, the study’s objective was to estimate the economic cost of treatment for adult schizophrenia patients in a tertiary hospital using key informant interviews.@*METHODS@#A guided structured key informant interview was done to determine key practices in the treatment of adult schizophrenic patients in the charity and pay in-patient and out-patient settings of the tertiary hospital. Cost of treatment included direct (medication, room and board, professional fees, ancillaries) and indirect costs (productivity losses of both patient and caregiver) and was computed based on 1 to 4 week length of stay for inpatients and varying intervals of follow-up for outpatients. Total costs were computed depending on the treatment setting.@*RESULTS@#Twenty nine members of the Department of Psychiatry, involving 5 psychiatric nursing staff, 13 residents-in-training, 4 fellows-in-training and 7 consultants were interviewed. The cost, for charity inpatient care, may range from PhP 2332.00 to PhP 44,861.00 (USD 50.88 to 978.86). For charity outpatient care, this may range from PhP 2892.00 to PhP 21,3612.00 (USD 63.10 to 4660.96) annually. For pay patients, costs were estimated to range from PhP15347.00 to PhP 24,6831.00 (USD 334.87 to 5385.80) for inpatient care and PhP 17,292.00 to PhP 1,125,600.00 (USD 377.31 to 25681.04) for outpatient care. The factor that influenced costs the most was the choice of medication. As of October 15, 2015, 1 USD = 45.83 PhP.@*CONCLUSION@#Schizophrenia is a chronic psychiatric illness that places a significant financial burden on patients and their caregivers. Based on the data gathered, patients’ and their families could spend from as low as 2332 to as high as 1,125,600 pesos depending on the treatment setting.