Mental Health Act

The Mental Health Act:
Minding Your Mental Health during the Pandemic
(Image from: https://carersmatternorfolk.org.uk/world-mental-health-day/)
How long will the enhanced community quarantine last? When will the country
be able to surpass this crisis? How can I keep my family safe? How can I survive during
the lockdown without any current income? Will I be able to work from home? How can I
pass my subjects now when I am having a hard time concentrating on studying?
These are only a few of the recurring concerns during these trying times for one
cannot help but to be worried of their safety and welfare. So not only our physical health
will suffer in the long run, these uncertainties are also at the expense of our mental
health. In fact in the United States, ‘The Disaster Distress Helpline, a federal crisis
hotline, has seen a huge spike in calls of people seeking help recently. In March, the
helpline saw a 338% increase in call volume compared with February, according to
spokesperson with the agency. And compared to last year for the month of March, they
had an 891% increase of calls.’ (CNN, 2020)
The fundamental law of the land, the 1987 Constitution, under Section 14 Article
II provides that the State shall protect and promote the right to health of the people and
instill health consciousness among them. This verily includes the mental health of the
people.
Brief History of the Philippine Mental Health System

During the Spanish era, mental health conditions manifesting abnormal way of
thinking and behavior were attributed to religious and supernatural forces. Some
instances are: individuals who were referred as having a mental illness were believed to
have offended or displeased the gods; having infuriated the mangkukulam who would
get back at them by casting wicked chants and incantations or pricking mystic dolls with
a needle; and manggagaway who would make them mentally ill by praying to the dark
forces. It was only during the American regime when mental health problems were
finally recognized just as a medical illness. Thus, an advocacy towards a more humane
approach towards the mentally ill was adopted. As a result, a good number of hospitals
were established.1
1
Samaniego, R. M. (2017). The Evolution of Psychiatry and Mental Health in the Philippines. Taiwanese Journal of
Psychiatry, 101-114.
(Image from: https://pia.gov.ph/news/articles/1009563)
What is the Mental Health Act?

The Mental Health Act or Republic Act no. 11036 is a major milestone not only
for mental health considerations, but Philippine law itself. The law promotes and
protects the rights of those with mental health conditions in order for them to get the
help that they need. The law also aims for the continued development of the mental
health system.
Mental health is ‘a state of well-being in which the individual realizes one's own
abilities and potentials, scopes adequately with the normal stresses of life, displays
resilience in the face of extreme life events, works productively and fruitfully, and is able
to make a positive contribution to the community’. Moreover, mental health condition
refers to ‘a neurologic or psychiatric condition characterized by the existence of a
recognizable, clinically-significant disturbance in an individual's cognition, emotional
regulation, or behavioral that reflects a genetic or acquired dysfunction in the
neurological, psychosocial, or developmental process underlying mental functioning.
The determination of neurologic and psychiatric conditions shall be based on
scientifically-accepted medical nomenclature and best available scientific and medical
evidence’. (Republic Act No. 11036, 2018)
What are the rights of those who have a mental health condition?
The law outlines that a patient or service user is ‘a person with lived experience
of any mental health condition including persons who require or are undergoing
psychiatric, neurologic or psychosocial care.’ (Republic Act No. 11036, 2018) The law
protects the rights of the patient, namely: a right to freedom from discrimination, right to
a humane treatment free from solitary confinement, torture, and other forms of cruel
inhumane, harmful or degrading treatment and invasive procedures not backed by
scientific evidence; right to aftercare and rehabilitation; right to be adequately informed
about psychosocial and clinical assessments; right to participate in the treatment plan to
be implemented; right to give informed consent; right to confidentiality; right to appoint a
person of legal age to act as his or her legal representative; and right to counsel. 2
Informed consent means ‘consent voluntarily given by a service user to a plan
for treatment, after a full disclosure communicated in plain language by the attending
mental health service provider, of the nature, consequences, benefits, and risks of the
proposed treatment, as well as available alternatives’. The patient ‘must provide
informed consent in writing prior to the implementation by mental health professionals,
workers, and other service providers of any plan or program of therapy or treatment,
including physical or chemical restraint’. The only exception is for cases when there are
psychiatric or neurologic emergencies or when the service user has impairment or
temporary loss of decision-making capacity. Strict safeguards and conditions are still
imposed during these cases in order to protect the rights of the patient. Thus the
treatment must still be:
(a) In compliance with the service user's advance directives, if available, unless
doing so would pose an immediate risk of serious harm to the patient or another person;
(b) Only to the extent that such treatment or restraint is necessary, and only
while a psychiatric or neurologic emergency, or impairment or temporary loss of
capacity, exists or persists;
(c) Upon the order of the service user's attending mental health professional,
which order must be reviewed by the internal review board of the mental health facility
where the patient is being treated within fifteen (15) days from the date such order was
2
Tully, J. (2019). Mental Health Legislation in the Philippines: Philippine Mental Health Act. BJPSYCH
INTERNATIONAL, 1-3.
issued, and every fifteen (15) days thereafter while the treatment or restraint continues;
and,
(d) That such involuntary treatment or restraint shall be in strict accordance with
guidelines approved by the appropriate authorities.
Moreover, the patient ‘may designate up to three persons or supporters,
including the service user's legal representative, for the purposes of supported decision
making. These supporters shall have the authority to: access the service user's medical
information; consult with the service user vis-a-vis any proposed treatment or therapy;
and be present during service user's appointments and consultations with mental health
professionals, workers and other service providers during the course of treatment or
therapy.’
The Mental Health Law also incorporates rights of the patient’s family members.
They have the right to:
(a) Receive appropriate psychosocial support from the government agencies;
(b) With the consent of the service user, participate in the formulation,
development and implementation of the treatment plan;
(c) Apply for release and transfer of the service user; and
(d) Participate in mental health advocacy, policy planning, legislation, service
provision, monitoring, research and evaluation.
There is no specific method or treatment provided under the Mental Health Act
however, the said law introduces the concept quality of mental health services in order
to ensure that the treatment given to the patients are humane. Section 14 provides that
mental health services should be:
(a) Based on medical and scientific research findings;
(b) Responsive to the clinical, gender, cultural and ethnic and other special
needs of the individuals being served;
(c) Most appropriate and least restrictive setting;
(d) Age appropriate; and
(e) Provided by mental health professionals and workers in a manner that
ensures accountability.
Implementation
All the above provisions of the Mental Health Act are definitely significant in
safeguarding the rights of the persons suffering from mental health conditions.
However, the problem lies with the implementation.
In 2010, the Philippine Statistics Office found that 200,000 people were
identified to have a disability due to mental disorder, which amounted to 14% of a total
of 1.4 million Filipinos. Moreover, the incidence of suicide has increased, escalating
from 0.23 to 3.59 per 100,000 in males and from 0.12 to 1.09 per 100,000 in females
between 1984 and 2005. The most recent data from 2016 identified an overall suicide
rate of 3.2 per 100 000, with a higher rate in males, which is 4.3 per 100000 persons,
than females or 2.0 per 100 000.3
Further, the 2014 data shows that there are only 0.52 psychiatrists and 0.07
psychologists per 100,000 of the population and 0.49 mental health nurses per 100,000.
These are very dire numbers compared to the World Health Organization recommended
10 psychiatrists per 100,000 persons. In addition, people suffering from mental health
conditions are hesitant to seek professional help due to inaccessibility, economic
reasons and fear of the stigma attached to mental illnesses. 4
All the foregoing show that there is a significant lack of resources and
underdeveloped mental health services which hamper the effective implementation of
the Mental Health Act. However, not all hope is gone.
Under the Mental Health Act, ‘persons who avail of the voluntary submission
provision and persons charged pursuant to Republic Act No. 9165, otherwise known as
the Comprehensive Dangerous Drugs Act of 2002, shall undergo an examination for
mental health conditions and. if found to have mental health conditions, shall be
covered by the Mental Health Act.’
The law also penalizes those who: (a) fail to secure informed consent of the
service user, unless it falls under the exceptions; (b) violates of confidentiality of
information; (c) discriminate against a person with mental-health condition; and (d)
3
Tully, J. (2019). Mental Health Legislation in the Philippines: Philippine Mental Health Act. BJPSYCH
INTERNATIONAL, 1-3.
4
Lally, J. (2019). Mental health services in the Philippines. BJPSYCH INTERNATIONAL, 1-3.
administer inhumane, cruel, degrading or harmful treatment not based on medical or
scientific evidence. Those who are in violation shall be ‘punished by imprisonment of not
less than six (6) months, but not more than two (2) years, or a fine of not less than Ten
thousand pesos (P10,000.00), but not more than Two hundred thousand pesos
(P200,000.00), or both.’
The most noteworthy in the law is the ‘mechanism for suicide intervention,
prevention, and response strategies, with particular attention to the concerns of the
youth. Twenty-four seven (24/7) hotlines, to provide assistance to individuals with
mental health conditions, especially individuals at risk of committing suicide, shall be set
up, and existing hotlines shall be strengthened.’ (Republic Act No. 11036, 2018) On
May 2, 2019, the Department of Health launched the National Center for Mental Health
(NCMH) crisis hotline. The hotline can be reached at 0917-899 8727 or 989-8727. 5
Thus despite the present pandemic and all the current uncertainties, we must
remember that help is there whenever we need it.
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About the Author
5
The Philippine Star. (2019, May 3). Mental health crisis hotline launched. Retrieved from The Philippine Star:
https://www.philstar.com/headlines/2019/05/03/1914618/mental-health-crisis-hotline-launched.
Raven Claire A. Malaca is earned her degree in Bachelor of Arts in Political Science
from the University of Santo Tomas. She is currently a fourth year student in the Faculty
of Civil Law of the University of Santo Tomas.
References
Carers Matter Norfolk. (2018, October 10). World Mental Health Day. Retrieved from
Carers Matter Norfolk: https://carersmatternorfolk.org.uk/world-mental-health-
day/
CNN. (2020, April 10). A crisis mental-health hotline has seen an 891% spike in calls.
Retrieved from CNN: https://edition.cnn.com/2020/04/10/us/disaster-hotline-call-
increase-wellness-trnd/index.html
Lally, J. (2019). Mental health services in the Philippines. BJPSYCH INTERNATIONAL,
1-3.
Republic Act No. 11036. (2018, June 21). Retrieved from LawPhil:
https://lawphil.net/statutes/repacts/ra2018/ra_11036_2018.html
Samaniego, R. M. (2017). The Evolution of Psychiatry and Mental Health in the
Philippines. Taiwanese Journal of Psychiatry, 101-114.
The Philippine Star. (2019, May 3). Mental health crisis hotline launched. Retrieved from
The Philippine Star:
https://www.philstar.com/headlines/2019/05/03/1914618/mental-health-crisis-
hotline-launched
Tully, J. (2019). Mental Health Legislation in the Philippines: Philippine Mental Health
Act. BJPSYCH INTERNATIONAL, 1-3.

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The Mental Health Act:

Minding Your Mental Health during the Pandemic

(Image from: https://carersmatternorfolk.org.uk/world-mental-health-day/)

Brief History of the Philippine Mental Health System

What is the Mental Health Act?

(Image from: https://www.etsy.com/listing/253711032/)

About the Author

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