Re: Philippine Mental Health (MH) Law of 2018 (RA 11036) Summary
(Signed into law by President Rodrigo Roa Duterte on June 21, 2018)
>Goal (Sec 2. Declaration of Policy): to “affirm(s) the
basic RIGHT of all Filipinos to MH as well as the fundamental rights of people
who require MH service”
>Objectives (Sec 3):
1. “Strengthen effective leadership and governance for MH by,
among others, formulating, developing, and implementing NATIONAL POLICIES,
strategies, programs, and regulations relating to MH;
2. Develop and establish a comprehensive, integrated,
effective, and efficient national mental HEALTH CARE system responsive to the
psychiatric, neurologic, and psychosocial needs of the Filipino people;
3. Protect the RIGHTS and freedoms of persons with PNP health
needs;
4. Strengthen INFORMATION systems, evidence and research for
MH;
5. INTEGRATE MH care in the basic health services; and
6. Integrate strategies promoting MH in EDUCATIONAL
institutions, the WORKPLACE, and in COMMUNITITES.”
>Definition of Terms (Sec 4) [Selected]
1. Deinstitutionalization = “the process of transitioning
service users (SUs), including persons with MH conditions and psychosocial
disabilities, from institutional and other segregated settings to
COMMUNITY-BASED settings that enable social participation, RECOVERY-BASED
approaches to MH, and INDIVIDUALIZED care in accordance with the SU’s will and
preference.
2. MH = “a state of WELL-BEING in which the individual
realizes on’es own ABILITIES and potentials, COPES 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.”
3. MH Professional = “a medical doctor, PSYCHOLOGIST, nurse,
social worker, or any other appropriately-trained and qualified person with
specific skills relevant to the provision of MH services.”
4. MH Service Provider = “an entity or individual providing
MH service as defined in this Act, whether public or private, including, but
not limited to MH professionals and workers, social workers and COUNSELORS,
informal community caregivers, MH advocates and their organizations, personal
ombudsmen, and persons or entities offering NONMEDICAL alternative therapies.”
5. Psychosocial Problem = “a condition that indicates the
existence of DYSFUNCTIONS in a person’s behavior, thoughts and feelings brought
about by sudden, extreme, prolonged or cumulative stressors in the physical or
social environment.”
6. Recover-Based Approach = “an approach to intervention and
treatment centered on the STRENGTHS of a SU and involving the active
participation, as EQUAL partners in care, of persons with lived experiences in
MH. This requires integrating a SU’s UNDERSTANDING of his or her condition into
any plan for treatment and recovery.”
7. Service User (SU) = “a person with lived experience of any
MH condition including persons who require or are undergoing psychiatric,
neurologic or psychosocial care.”
>Rights of SUs and other Stakeholders (Sec 5)
1. ALL RIGHTS guaranteed by the Constitution, and those
recognized under the UN Universal Declaration of Human Rights and the Convention
of the Rights of Persons with Disabilities
2. Freedom from DISCRIMINATION and STIGMATIZATION – social,
economic, and political
3. ACCESS to:
a. EVIDENCE-BASED
treatment of the same standard and quality
b. MH services at
ALL LEVELS of the national health care system
c. COMPREHENSIVE and
COORDINATED treatment integrating HOLISTIC prevention, promotion,
rehabilitation, care and support, through MULTIDISCIPLINARY, USER-DRIVEN
treatment and recovery plan
d. PSYCHOSOCIAL care
and CLINICAL treatment in the LEAST RESTRICTIVE environment and manner
e. AFTERCARE and
REHABILITATION when possible in the community for the purpose of social
reintegration and inclusion
f. adequate
INFORMATION re: available multidisciplinary MH services
4. RIGHT to:
a. HUMANE treatment
free from solitary confinement, torture, and other forms of cruel, inhumane,
harmful or degrading treatment and invasive procedrues not backed by scientific
evidence
b. PARTICIPATE in MH
advocacy, policy planning, legislation, service provision, monitoring, research
and evaluation
c. CONFIDENTIALITY –
information, communications, and records shall not be disclosed to third
parties without the WRITTEN CONSENT of the SU concerned or his/her legal
representative, except when required by law, in case of a life-threatening
emergency, a minor, in an administrative, civil, or criminal case (negligence
or breach of professional ethics)
d. Give and withdraw
INFORMED CONSENT
e. PARTICIPATE in
developing and formulating the psychosocial care or clinical treatment plan
f. Designate a LEGAL
REPRESENTATIVE
g. Send or receive
uncesored private COMMUNICATION and VISITORS at reasonable times
h. LEGAL SERVICES
i. Access to their CLINICAL
RECORDS unless, in the opinion of the attending MH professional, revealing such
information would cause harm to SU’s health or other’s safety
j. INFORMATION,
within 24-HRs of admission to a MH facility of one’s rights
k. File COMPLAINTS
of inproprieties, abuses, violations of rights, including illegal or unlawful
INVOLUNTARY TREATMENT or CONFINEMENT
>Rights of Family Members, Carers and Legal
Representatives (Sec 6)
1. receive appropriate PSYCHOSOCIAL SUPPORT
2. PARTICIPATE in formulation, development, and
implementation of treatment plan (with SU’s consent)
3. apply for RELEASE and TRANSFER to an appropriate MH
facility
4. PARTICIPATE in MH advocay, policy planning, legislation,
service provision, monitoring, research and evaluation
>Rights of MH Professionals (Sec 7)
1. a SAFE and SUPPORTIVE work environment
2. participate in a continuous PROFESSIONAL DEVELOPMENT
program
3. participate in the planning, development, and management
of MH SERVICES
4. contribute to the development and regular review of
STANDARDS for evaluating MH services
5. participate in the development of MH POLICY and service
delivery GUIDELINES
6. MANAGE and control all aspects of his/her practice
(including whether or not to accept or decline a SU for treatment), except in
emergency situations
7. ADVOCATE for the rights of a SU, in cases wher ethe SU’s
wishes are at odds with those of his/her famioly or legal representative
>Treatment and Consent (Ch III) [Selected]
1. Public and private health facilites are mandated to create
their respective INTERNAL REVIEW BOARDS to expeditiously review all cases,
disputes, and controversies involving the treatment, restraint or confinement
of SUs within their facilities
>MH Services (CH IV)
1. QUALITY (Sec 14): based on medical and SCIENTIFIC research
findings; RESPONSIVE to the clinical, gender, cultural and ethnic and other
special needs of the individual; most APPROPRIATE and least RESTRICTIVE
setting; age appropriate, & provided by MH professionals & workers in a
manner that ensures ACCOUNTABILITY
2. COMMUNITY (Sec 15): Responsive PRIMARY MH services shall
be developed and INTEGRATED as part of the basic health services at the
appropriate level of care, particularly at the CITY, MUNICIPALITY, and BARANGAY
level
3. COMMUNITY-BASED MH Care Facilities (Sec 16): “The national
government through the DOH shall FUND the establishment and ASSIST in the
operation of community-based MH care facilities in the PROVINCES, CITIES and
cluster of MUNICIPALITIES in the entire country based on the needs of the
population, to provide ADEQUATE MH servcies, and enhance the rights-based
approach to MH care.
“Each
community-based MH care facility shall, in addition to ADEQUATE ROOM, office or
clinic, have a complement of MH PROFESSIONALS, allied professionals, support
STAFF, trained BARANGAY HEALTH WORKERS (BHW), volunteer family members of
patients or SUs, basic EQUIPMENT and SUPPLIES, and adequate stock of MEDICINES
appropriate at that level.”
4. CLINCAL SERVICES (Sec 18: Psychiatric, Psychosocial, and
Neurologic (PPN) Services in Regional, Provincial, and Tertiary Hospitals) –
“ALL regional, provincial, and tertiary hosptials, including private hospitals
rendering service to paying patients, shall provide the following PPN services:
(a) “SHORT-TERM
in-patient hospital care in a small
psychiatric or neurologica ward for SUs exhibiting acute psychiatric or
neurologic symptoms;
(b) PARTIAL hospital
care for those exhibiting psychiatric symptoms or experiencing difficulties vis-avis
their personal and family circumstances;
(c) HOME CARE
service for SUs with special needs as a result of, among others, long-term
hospitalization, noncompliance with or inadequacy of treatmen, and absence of
immediate family;
(e) Coordination
with DRUG REHABILITAION centers vis-avis the care, treatment, and
rehabilitation of persons suffering from addiction and other substance-induced
MH conditions; &
(f) A REFERRAL
system involving other public and private health and social welfare service
providers, for the purpose of expanding ACCESS to programs aimed at preventing
mental illness and managing the condition of persons at risk of developing
mental, neurologic, and psychosocial problems.”
5. DRUG SCREENING Service (Sec 20) – “Pursuant to its duty to
provide MH services and consistent with the policy of treating drug dependency
as a MH issue, each local health care facility must be capable of conducting
drug screening.”
6. SUICIDE HOTLINE (Sec 21) – “MH servcies shall also include
mechanisms for suicide intervention, prevention, and response strategies, with
particular attention to the concerns of the youth. Twenty-four sever (24/7)
hotlines to provide assistance to individuals with MH conditions, especially
individuals at risk of committing suicide shall be set up, and existing
hotlines shall be strengthened.”
7. PUBLIC AWARENSS (Sec 22) – “The DOH and the LGUs shall
initiate and sustain a heightened NATIONWIDE MULTIMEDIA CAMPAIGN to raise the
level of public awareness on the protection and promotion of MH and rights
including, but not limited to, MH and nutrition, stress handling, GUIDANCE AND
COUNSELING, and other elements of MH.”
>SCHOOLS (CH V, Sec 23): “The State shall ensure the
INTEGRATION of MH into the educational system….”
>CAPACITY BUILDING (CH VI, Sec 26) – “In close
coordination with MH facilities, academic institutions, and other stakeholders,
MH professionals, workers, and other service providers shall undergo capacity
building, reorientation, and training to develop their ability to deliver
EVIDENCE-BASED, gender-sensitive, culturally-appropriate and huamn
rights-oriented MH services, with emphasis on the community and public health
aspects of MH.”
>ROLE OF DOH (Ch VII, Sec 30) [Selected]
1. “Formulate, develop, and implement a NATIONAL MH
PROGRAM….” (a)
2. “Integrate MH into the routine health INFORMATION system
and identify, COLLATE, routine report and use core MH datea isaggreaged by sex
and age, and health outcomes, including data on completed and attempted
suicides, in order to improve MH service delivery, promotion and prevention
strategies;” (c)
3. “Improve research capacity and academic collaboration on
national priorities for research in MH, particularly OPERATIONAL RESEARCH with
direct relevance to service development, implemenation….” (d)
4. “Coordinate with the PHILIPPINE HEALTH INSURANCE
CORPORATION to ensure that insurance packages equivalent to those covering
physical disorders of comparable impact to the patient, as measured by
Disability-Adjusted Life Year or other methodologies, are available to patients
affecgted by MH conditions;” (f)
5. “Prohibit forced on inadequately REMUNERATED LABOR within
MH facilities, unless such labor is justified as part of an accepted
therapeutic treatment program;” (g)
6. “Develop alternatives to institutionalization,
particularly COMMUNITY RECOVERY-BASED approaches to treatment aimed at
receiving patients discharged from hospitals, meeting the needs expressed by
perons with MH conditions, and respecting their autonomy, decisions, dignity,
and privacy;” (i)
7. “Establish a balanced system of community-based and
HOSPITAL-BASED MH services at all levesl of the public health care system from
the barangay, municipal, city, provincial, regional to the national level;” (k)
>ROLE OF DSWD (Sec 36) – “Provide or facilitate access to
public or group HOUSING facilities, COUNSELING, THERAPY, and LIVELIHOOD TRAINING
and other availabel skills development programs;” (b)
>ROLE OF LGU (Sec 37) – “Review, formulate, and develop
the regulations and guidelines necessary to implement an effective MH care and
wellness policy within the territorial juristiction of each LGU, including the
passage of a LOCAL ORDINANCE on the subject of MH, consistent with existing
relevant national policies and guidelines;” (a)
>PHILIPPINE COUNCIL FOR MENTAL HEALTH (PCMH) (Ch VII)
1. Mandate: the
“policy-making, planniong, coordinating and advisory body, attached to the DOH
to oversee the implementation of this Act… and the delivery of a NATIONAL,
unified and integrated MH services responsive to the needs of the Filipino
people” (Sec 39);
2. Composition: (Sec 41) DOH Secretary (Chair), Secretaries
of DepEd, DOLE, DILG; Chairs of CHR & CHED; Representatives of
academe/research, medical or health professional organization, and an NGO
involved in MH;
3. Duties & Functions: a “national multi-sectoral
strategic plan” (Sec 40, a), “targets and strategies” (a1), “service delivery
network” (a2), “budgetary requirements” (3), “monitor” (3b), “ensure
implementation of policies” (3c), “coordinate” (3d, 3e, f, g)
NB: Creation of the DOH MH Division (Sec 42) – “There shall
be created in the DOH, a MH Division, under the Disease Prevention and Control
Bureau, staffed by qualified MH specialists and support staff with permanent
appointments and supported with an adequate yearly BUDGET. It shall implement
the Nationa MH Program and, in additon, shall also serve as the secretariat of
the Council.”
>DRUG DEPENDENTS (CH IX, Sec 43. Voluntary Submission) –
“Persons who avail of the voluntary submission provision and persons charged
pursuant to RA 9165, otherwise known as the ‘Comprehensive Dangerous Drugs Act
of 2002,’ shallundergo an exzamination for MH conditions and, if found to have
MH conditions, shall be covered by the provisions of this Act.”
