MHF Program Provides Global Community-Based Mental Health Awareness and Stigma Reduction Education

The World Health Organization’s estimate that more than 450 million people worldwide have unmet mental health care needs should serve as a crucial motivator in our ongoing efforts to improve mental health equity. In some communities, services are inadequate and overwhelmed, and in others, there are no resources at all. To help bridge this gap and increase access to care, in 2003, NBCC’s Global Capacity Building Department began collaborating with the World Health Organization to develop the Mental Health Facilitator (MHF) program.

The MHF is not a particular mental health certification, nor does it indicate that an individual who has received the training is qualified to provide professional mental health services. Instead, the program provides professionals from outside the mental health field, including teachers, volunteers, college and university students and staff, and other community members, with the foundational skills to introduce conversations regarding mental health, identify potential mental health needs, inform peers and others about mental health resources available in their community, and normalize attending to one’s mental health. Normalizing conversations regarding mental health and increasing public awareness of mental health needs are critical components of reducing stigma and increasing the utilization of available services. Training and services are provided in a culturally appropriate manner by matching each community’s needs with its available resources and providing the locally contextualized MHF training to increase those resources. Currently, there are four MHF program curriculum options and three training levels for those interested in helping others in their communities.

Research has shown that many individuals in need of mental health care are living at the margins of society and that better care management is achieved when people receive education, training, and support to carry out their roles as caregivers. The MHF program combats stigma related to mental health by including community leaders in this training that openly discusses and normalizes the realities of mental health needs and care.

Since the onset of the pandemic, NBCC and its program partners have delivered over 45 online, hybrid, or in-person MHF trainings in more than 10 countries. Today, there are more than 4,500 registered MHFs, trainers, and master trainers making a difference in communities around the world.

MHF program master trainer Carolyn C. Quiba, a Registered Guidance Counselor in the Philippines, is the director of the Guidance and Testing Center of the Lyceum of the Philippines University. She is also involved in her community as a career counselor and mental health advocate. Quiba says that the MHF program has helped meet an urgent need in her country due to its state of mental health combined with a vast lack of resources.

“I truly believe in the MHF program,” she says. “Even before the pandemic, the two most common mental health conditions, anxiety and depression, accounted for over 800,000 years of life lived with disability in the country. Currently, The Department of Health estimates that at least 3.6 million Filipinos are facing mental health issues during the pandemic, including depression, substance use disorders, and mood disorders.

“The ratio of mental health workers per capita in the Philippines is low, at 2 to 3 per 100,000 people,” Quiba continues. “Resources are scarce—only 3 to 5% of the total health budget is allocated to mental health. And with 20 million public school students, it is next to impossible to meet the recommended ratio of one guidance counselor for every 500 students.”

In the Philippines, much like the rest of the world, COVID-19 has made a challenging situation even more difficult.

“The Filipino people have experienced natural calamities, loss of jobs, domestic violence, and other crises brought by the pandemic,” she says. “The stigma is still felt, and the feeling of shame in asking for help or even in discussing mental health issues may have lessened due to the pandemic, but it is still apparent.”

MHF trainees gain a valuable new perspective, Quiba says.

"The program allows participants to look at themselves and see how they are affected by the situations in their lives. At first, they would like to undergo training to be of help to others; however, the MHF program helps them realize they also need assistance and self-care. The challenge is how to strike balance in both taking care of oneself and helping others, which is essential.”

Dr. Manal Salih, the coordinator of NBCC’s MHF partnership in the United Arab Emirates, is also an MHF master trainer. She shares Quiba’s sentiments regarding the urgent need for mental health care in her region and how the program has been beneficial.

“Unfortunately, in the time we live in, there is a huge imbalance between the number of people that could benefit from mental health support and the number of people that are able to provide it,” she says. “The MHF program bridges that gap by training members of the community to have more compassion and to be gentler with the people around them, as well as to guide them in the direction of additional resources.”

Dr. Salih says the MHF program has been eye-opening for many people she has worked with for the past 6 years.

“The program has given trainees an understanding of psychological disorders, many of which they had never heard of or did not have an accurate understanding of,” she says. “It has also provided them with healthy ways to help people dealing with the struggles of daily life. The program has done a great job of empowering trainees to advocate for mental health and reduce some of the associated stigma, and trainees have all left feeling better equipped to help those around them, as well as themselves.”

She views the MHF program not only as a means of mental health education for providers, but also as a channel for fostering hope in underserved and never-served communities.

“Becoming an MHF opens up your heart to people and allows you to show them kindness and empathy in a way you may not have been able to before, and that the person in front of you may never have experienced,” she says. “You could make a huge difference to someone else’s life and also to your own.”