精神醫學與心理衛生在菲律賓的發展

The Evolution of Psychiatry and Mental Health in the Philippines

菲律賓是一個集合歐亞與美國影響，擁有豐富歷史的東南亞自治國家。本篇綜說將會考究這個國家在精神醫學與心理衛生領域上的獨特歷史敘事，描述菲律賓精神醫學在西班牙殖民前及殖民、美國統治、日本佔領與美國解放等四個時期的發展，尤其是那些對菲律賓精神醫學發展有貢獻的重要人物與機構。本文也將提及為了解決國家心理衛生需求及早前地區心理衛生機構過度負擔間日漸加大的缺口，而發展的國家心理衛生制度及專科學會，藉由提供臨床業務及大眾教育以促進心理衛生活動。本文也介紹了菲律賓精神醫學訓練的現況，包括大學階段醫學院教育的時程與教學模式，及能提供畢業學生專科訓練的機構、住院醫師訓練的時間、教學與評估模式，與如何在訓練完成後取得認證而成為專科醫師的過程。本文的最後提到了菲律賓精神衛生法之所以需要立法的四個主要理由、該法的重點及目標、與目前其在參眾議院審議的進程。菲律賓身為目前少數尚未有精神衛生專法的國家，相關的心理衛生從業人員正在積極奔走，以求能早日通過這個對國家心理衛生至關重要的法案。

The Philippines is an autonomous Southeast Asian country which portrays a rich history combining Asian, European, and American infl uences. This overview is examining the country’s distinctive historical narratives in the domain of psychiatry and mental health, chronicling the evolution of Philippine psychiatry in four periods namely, the pre-Spanish and Spanish era, the American regime, the Japanese occupation, as well as American liberation. Concurrently, it highlights the key fi gures and institutions that contributed to the progress of psychiatry in the Philippines. It also touches on the existing national mental health systems and specialty societies which were developed to address the expanding gap between the country’s mental health needs and the excessive burden of our earlier local mental institutions, thereby promoting the mental health activities in the country through the provision of clinical services and public education. A review of the current status of the psychiatric training in the Philippines is also provided. On the undergraduate level, it expounds on the country’s medical schools and its milieu in terms of duration of education as well as modes of instruction by the training faculty. Furthermore, it discusses the current post-graduate training institutions, the duration of the residency programs, modes of instruction and assessments, as well as the process of qualifying for certifi cation in addition to becoming a diplomate and fellow of the national specialty society after the completion of training. Finally, it highlights and expounds on the Philippine Mental Health Act, a currently important and critical mental health advocacy of the country. Being one of the remaining minority countries without a national mental health law, the Philippines’ stakeholders in mental health are advocating and working towards the passage of the fi rst ever mental health law which is in keeping with the existing administration’s aim of having mental health in the forefront of its health agenda. At the end of the overview, the author elaborates on the four important grounds of the bill, its highlights and objectives, as well as its most recent status in the Philippine senate and congress.