“The world has changed. I must do something.”

This was the thought that pushed psychologist Manuel “Pocholo” Delos Santos to act on what he observed as the increasing need for mental healthcare services in Cebu City. 

Delos Santos said that based on his experience with his clients, he has seen how the need for instant gratification has resulted in a negative impact on young people’s resilience. 

“They have less tolerance, less patience, and they are demanding, they want it right here and right now,” Delos Santos said. 

He said the children’s constant exposure to technology has also affected their mental health. One example of this is the prevailing TV habits of young people. 

“Kay kaniadto motindog mi, among ilison ang channel mobalik mi og lingkod. Karon mag-remote nalang. (Back then, we had to stand up and go to the TV to switch channels. Nowadays, you only use the remote to do it),” said Delos Santos. 

This prompted the Cebuano psychologist to ask himself: “How can I help Cebu or the Philippines in terms of mental health?”

1st barangay mental health clinic 

It was in 2019 that the answer to Delos Santos’ question finally took shape in brick and mortar. 

Together with his late brother who was a psychiatrist, he founded the Barangay Behavioral Health Unit (BBHU) in Barangay Lahug, Cebu City. This is the first community-based facility in the country that offers mental health services at the barangay level. 

The unit was born out of Delos Santos’ belief that the people who need their services the most are in the grassroots level. 

The BBHU opened at Barangay Lahug when his sister, Councilor Mary Ann de los Santos, who is also a mental health advocate, was the barangay captain. The latter is the co-author of City Ordinance 2479 entitled “An Ordinance Creating the BBHU within the Barangay Health Center.” 

All services offered at the BBHU are free for indigents. 

The BBHU is integrated in the services offered by the Barangay Health Center, also known as Lahug Wellness Center, along with consultation, TB Directly Observed Therapy (TB-DOTS), birthing services, among others.

When BBHU first opened its doors, it was exclusively for Barangay Lahug residents. 

However, the Cebu City Health Office and the Department of Social Welfare and Development approached delos Santos’ team if they can refer clients to them amid the increasing number of people needing mental healthcare services. 

It was then that the BBHU became a facility for all. 

Since it opened in 2019, the BBHU has seen an uptick in the number of clients seeking their services.

Delos Santos said they have seen a growing number of clients going to the clinic due to paranoia, anxiety, depression, and suicide ideations. 

According to Renzi-Lee Casas, a psychometrician at BBHU, the common concerns from their clients involve anxiety, depression, and bipolar cases, which he said are on the rise. 

Increasing cases 

The same observation on the increasing mental health cases is also shared by the Vicente Sotto Memorial Medical Center (VSMMC) Center for Behavorial Sciences. 

Their records show a 29 percent increase in the number of cases from 2021 to 2022. 

By the fourth quarter of 2023, the center logged a 31 percent increase in the number of calls their received in their hotline. 

According to Christian Abarca, a psychometrician at VSMMC, psychotic disorders are the leading cases in their center at 60 percent, followed by mood disorders at 30 percent. 

Stress, anxiety, suicidal behaviors, and somatic disorders are next, which collectively account for 10 percent of the cases.

In VSMMC, 30 percent of their cases involve clients aged 20 years old and below, 25 percent are within the 21 to 30-year-old age group, and 23 percent are 31 to 40 years old. 

Most of the cases at BBHU fall within the 20 to 30 age group. 

He attributes the rising number of mental health cases to the following factors: increased awareness of mental health issues, increased incidence of stress and anxiety, and improved access to mental health care.

Abarca said the Lahug BBHU has been a big help in decongesting their facility after the latter opened their facility for all people even outside of the barangay. 

VSMMC was once the sole facility known to the public when it comes to mental healthcare. 

Currently, the BBHU’s technical working group is composed of a psychiatrist, psychologists, and a social worker. This limits the facility’s services to cater to outpatient cases only. 

To help augment the unit’s services especially during emergencies, the barangay workers in Lahug have been trained on Psychological First Aid and Crisis Management. 

Holistic approach 

Delos Santos shared they are taking a holistic approach in their mental health services. 

“You have to look at the person holistically. Motan-aw gyud in all angles before anything else kay in mental health dili man ta ka maka-conclude dayon. (We have to consider all angles because in mental health, you don’t make quick conclusions). You cannot tell what’s wrong in just one sitting,” he said. 

He said the environment, family background, the community surrounding the person are all considered in addressing mental health issues. 

The BBHU director stressed that most mental disorders are due to chemical imbalance of the neurotransmitters, which is why the facility uses the two-pronged approach: medication management and self-management.

Through this approach, he said clients will learn life skills in order to cope with their condition so they will not be fully dependent on medication. 

“We teach them, we educate them, we give them the skills to manage their illness,” Delos Santos said.

The BBHU covers psychiatric diagnosis and medication, psychological assessment, psychological evaluation, and education and training for self-management. 

The BBHU technical working group also delivers trainings and seminars to interested groups or organizations. 

They also produced a booklet “Understanding Mental Health - Basic Information About Mental Health”  for the public to better understand mental health. 

Moving forward

The BBHU aims to inspire other barangays to establish their own facility.

Apart from a Behavioral Health Unit, Delos Santos said they also aim to establish a Student Behavioral Assistance Program in the academe and the Employee Behavioral Assistance Program for organizations and workplaces.

On this, they hope to forge a partnership with the Department of Interior and Local Government, Department of Education, and other government organizations. 

Seek help 

Delos Santos is encouraging those with mental health concerns to seek treatment either at the BBHU or other mental health services unit.

“They can still live a normal life,” he said, provided that they will undergo a holistic treatment, both medication (if needed) and self-management. 

“Mental health is about life and it is not about being crazy. Mental health is there from womb to tomb,” he added. 

The Lahug BBHU can be reached through the following hotline numbers: (032) 233 9159; (032) 2315262 ; Globe - 09063239329 and 09954533250; and Smart - 09199224938. (JAT/PIA7)