WHO Multimedia Library

Reference ID U271HL2

Description A smiling doctor came to Manila. This photo story made by Eric Schwab in the capital of the Philippines shows what a dynamic, optimistic psychiatrist can do to help the mentally ill. Dr Manuel Escudero arrived in Manila one day in 1957 to help the Government reorganize its mental health services, he found that the country's one hospital for the mentally ill, the National Mental Hospital, Mandaluyong, had 4300 patients instead of the 1000 for which it had been built. Dr Escudero realized that basic changes were needed in the attitude of the public before necessary improvements could be made in the mental health services. Mobilizing the best talent available, he produces a play with a simple, yet unexpected message: "Mental illness is no different from any other illness and can be cured - once it is cured, the patient is ready to be accepted by the community". The play was given many times throughout the country and made a deep impression, helping to prepare people for the drastic changes that soon took place in the National Mental Hospital. First, the iron bars and grills within the patio compound were removed to give way to individual open-air system; games and athletics contests were organized; music was heard for the first time in the hospital at daily concerts given by a band of talented patients; classes in painting, ceramics, handicrafts were started. Patients and the public reacted angrily at first. Many of the mentally ill felt that they were about to be abandoned because the bars had become a symbol of protection against a world that had treated them badly. Some of the staff were anxious and apprehensive: like the public, they thought the community might be endangered. It was the rule for families of patients to insist on confinement. The thought of treating the mentally ill at home, or partly at home, had never occurred to most people. A strict screening of admissions was instituted with similarly increased emphasis on outpatient services and domiciliary treatment. This also helped to relieve some of the severe overcrowding in the hospital. Because of the nature of its activities, the outpatient department is in constant touch with immediate members of the family of the mental patients. Group discussions on their problems and ways in which the family could help on the road to recovery were organized to bridge the gap between the institutional and the outside world. Changes did not take place immediately; the mentally ill, especially in the rural areas, had too long been considered to be possessed of witches; fairies were also held responsible, or the food the man had eaten. Another problem of outlying districts was that patients who came from provinces far from Manila often were forgotten by their families, and, as a general rule, the greater the distance, the more difficult it was for the patient to return home and be accepted. Dr Escudero is planned to divide the National Hospital: three or four small hospitals are being started so that patients can be nearer their families. His time and attention are not devoted to patients only but also on the training of hospital staff. Short-term fellowships for physicians, psychiatric aides a

Home visit : Talking to one of the eight Jimenez children at school, the teacher thought the mother might be ill and asked that someone from the mental hospital visit the home. The mother proved to be a schizophrenic and was treated is an outpatient and the doctor and the psychiatric nurse explained to the children that their mother was ill but probably soon would be well again.

Asset date 01/01/1960

Country, area, WHO office Philippines

WHO Region WPRO

Consent No

File size 1.66 MB

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