Honor and Excellence from Within: Enhancing University Mental Health Systems in Developing Resilient Medical Professionals

Abstract

Providing individuals with an environment that enables them to achieve both organizational and personal goals is essential to creating a healthy setting. As aptly expressed in the Ottawa Charter, “health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love.” Health promotion within learning institutions must therefore focus on providing population-based interventions, age-appropriate health education, and policies that foster well-being. This is particularly important in universities that train future physicians.

The study by Chiong III et al. underscores the importance of health promotion in supporting the well-being and development of medical students who are expected to become compassionate doctors in the future. It is therefore a moral imperative for stakeholders to ensure a healthy learning environment, one that does not only foster academic growth but also nurtures well-adapted and resilient healthcare professionals.

Three key policies are relevant: the Philippine Universal Health Care (UHC) Law (Republic Act No. 11223), the Philippine Mental Health Law (Republic Act No. 11036), and the Philippine Guidelines on Healthy Settings Framework in Learning Institutions. The first two emphasize the importance of access to quality and affordable healthcare services with the latter being specifically concerned with ensuring that mental health is valued, promoted, and protected. The third policy underscores the positive impact of health promotion on learner development.

In principle, these policies mandate the development and implementation of programs that promote the mental well-being of both students and personnel. Such programs must raise awareness on mental health issues, identify and support individuals at risk, and provide access to mental health services and referrals. Higher Education Institutions are also required to have a complement of mental health professionals.

In achieving the goals of these three policies, the UP College of Medicine must ensure that health systems within its halls are in place and work for both its employees and students. After all, Chiong et al. demonstrated that medical students have unique mental health needs and are generally exposed to a broad range of mental health problems such as depression, anxiety, and burnout. This necessitates a closer examination of the current system’s components to identify strategic interventions to address service delivery gaps.

At large, government leadership and policymaking set targets, guide action, allocate resources, and improve service accessibility and quality. In UP Manila, the health and safety of constituents are supported by the Healthy University Office (HUO), Office of Student Affairs (OSA), and UP Health Service (UPHS). HUO spearheads initiatives and programs for the health and wellness of UP Manila students, faculty, and staff; OSA provides student support, including guidance and counseling services; UPHS provides an array of medical services that assure them of a clean bill of health. The University also launched its revised health and safety policy in 2023. However, UP Manila has yet to formulate a mental health policy that institutionalizes clear guidelines, delineates responsibilities, and mandates prioritizing the mental well-being of its constituents. Such a policy will require active collaboration among the three offices, the college deans, and other relevant university offices to improve the conditions of the environment to foster students’ well-being.

In terms of funding for mental health, the Philippines has made promising progress over time. There was an increase in the government mental health financing between 2022 and 2023, jumping from 57 million to 1 billion. Unfortunately, the UP System, which includes the UP-Philippine General Hospital (PGH), continues to suffer from budget cuts with the most recent one amounting to PhP 2.08 billion, its largest since 2016. The reduction mainly affected capital outlays, which cover maintenance, improvement, and acquisition of resources like buildings, facilities, and research equipment. While there is no further breakdown on how the constituent universities were affected by the cut, system-wide budget cuts likely delay improvements in infrastructure and resources for colleges like the UP College of Medicine, a concern expressed by the study participants in Chiong III et al.

Further, quality service delivery is crucial in the efforts to improve the mental well-being of medical students. Within the campus, OSA offers individual and peer counseling services. The UP Health Service, the main entry point of care for UP Manila students, faculty, and staff, offers mental health screening services and referrals to PGH’s specialty departments, including those that provide mental health support. It also conducts annual physical examinations to students before classes start. HUO also conducts mental health promotion activities primarily through the Wellness Wednesdays Project. However, the impact and effectiveness of such services on the well-being of students remains undocumented. This highlights the need to expand the scope of the survey in Chiong III et al.’s study to produce comprehensive evidence to inform program adjustments to improve such services.

Lastly, there is a need to maintain opportunities for effective mentorship as these provide guidance and support for students to achieve their professional goals. Sessions involve mentors who are already experts in the medical field; hence, capable of efficiently and effectively supporting their mentees’ well-being. This also reiterates the recommendation of Chiong III et al. to ensure incorporation of mentorship sessions across year levels. After all, mentoring programs benefit resilience and contribute to mental health.

Establishing the UP College of Medicine as a healthy learning institution requires ensuring that both its system and environment support student well-being. This involves fostering active collaboration among university and college offices, formulating mental health policies, securing program funding, assessing the impact of current services on the students, and maintaining effective mentorship opportunities. It is essential to recognize that honor and excellence must start from within, and that outcomes related to student well-being are also crucial results of UP’s medical education program, which prides itself on producing top-notch health service providers.