Abstract
BackgroundFor more than forty years, episodes of violence in the Mindanao conflict have recurrently led to civilian displacement. In 2008, Medecins Sans Frontieres set up a mental health program integrated into primary health care in Mindanao Region. In this article, we describe a model of mental health care and the characteristics and outcomes of patients attending mental health services.MethodsPsychologists working in mobile clinics assessed patients referred by trained clinicians located at primary level. They provided psychological first aid, brief psychotherapy and referral for severe patients. Patient characteristics and outcomes in terms of Self-Reporting Questionnaire (SRQ20) and Global Assessment of Functioning score (GAF) are described.ResultsAmong the 463 adult patients diagnosed with a common mental disorder with at least two visits, median SRQ20 score diminished from 7 to 3 (p < 0.001) and median GAF score increased from 60 to 70 (p < 0.001). Baseline score and score at last assessment were different for both discharged patients and defaulters (p < 0.001).ConclusionsBrief psychotherapy sessions provided at primary level during emergencies can potentially improve patients' symptoms of distress.
Highlights
For more than forty years, episodes of violence in the Mindanao conflict have recurrently led to civilian displacement
Setting The Mindanao conflict in the Philippines first flared in the 1960s when the Moros, the Muslim minority, began an armed struggle to regain their ancestral homeland in the southern island [8]
Out of the 962 patients referred to the team, 771 (80.1%) were considered to suffer from a mental health disorder after evaluation by the primary health care psychologist (Table 1)
Summary
For more than forty years, episodes of violence in the Mindanao conflict have recurrently led to civilian displacement. We describe a model of mental health care and the characteristics and outcomes of patients attending mental health services. During the acute phase of an emergency, mental health interventions to reduce traumatic stress are often put in place. In addition to syndromes often associated with conflict such as post-traumatic stress disorders [1], other disorders occur, such as depressive or anxiety disorders [2]. In a context of limited access to health care, patients with mental health or neurological disorders not directly linked to the conflict, such as psychosis or epilepsy, may be neglected by vertical interventions related to the conflict or natural disaster [3]. Descriptions of treatment models and research about the outcome of interventions in emergencies are rare [4]. Less attention may be given to the needs of those
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