The unexpected suicide of famous designer Kate Spade and food icon Anthony Bourdain in early-June and the highly publicized suicide of well-loved actor Robin Williams shocked and saddened fans around the globe. These events underscored the tragic reality that mental-health problems, in particular suicide, do not discriminate on the basis of demographics. Men and women, young and old, the wealthy and poor, the successful and failures, professionals and students are vulnerable to mental-health problems.
In the United States, federal data show that suicide rates have increased across nearly every demographic over the past two decades, rising by 28 percent, from 1999 to 2016. Almost 45,000 Americans committed suicide in 2016, making it the 10th-most common cause of death. From 2010 to 2016 a 70-percent increase in suicide rate was noted among girls, narrowing the gender gap between the number of boys and girls who commit suicide (“A Disturbing Trend on the Rise” by Jaime Ducharme, TIME Magazine, June 18, 2018).
In the Philippines, “every day, seven Filipinos turn to suicide. One in 5 Filipino adults also suffers from a form of mental disorder,” and the Philippines “has the highest number of depressed people in Southeast Asia,” said Sen. Riza Hontiveros, a mental-health advocate.
President Rodrigo Duterte signed into law on June 20, 2018, Republic Act (RA) 11036, otherwise known as the Mental Health Act, barely two weeks after the Spade and Bourdain incidents, making good his promise of integrating mental health in the country’s public health-care system.
RA 11036 defines “Mental Health” as a state of well-being in which the individual realizes one’s 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 (Section 4 (j)). “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 behavior that reflects a genetic or acquired dysfunction in the neurobiological, psychosocial or developmental processes 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 (Section 4(k). “Mental Health Services” refer to psychological, psychiatric or neurologic activities and programs along the whole range of the mental-health support services, including promotion, prevention, treatment and aftercare, which are provided by mental-health facilities and mental-health professionals
“Service User” is defined as a person who experienced a mental-health condition, including persons who require or are undergoing psychiatric, neurologic or psychosocial care. Section 5 enumerates the rights of “Service Users” as follows:
(a) Freedom from social, economic, and political discrimination and stigmatization, whether committed by public or private actors;
(b) Exercise all their inherent civil, political, economic, social, religious, educational and cultural rights respecting individual qualities, abilities and diversity of background, without discrimination on the basis of physical disability, age, gender, sexual orientation, race, color, language, religion or nationality, ethnic, or social origin;
(c) Access to evidence-based treatment of the same standard and quality, regardless of age, sex, socioeconomic status, race, ethnicity or sexual orientation;
(d) Access to affordable essential health and social services for the purpose of achieving the highest attainable standard of mental health;
(e) Access to mental-health services at all levels of the national health-care system;
(f) Access to comprehensive and coordinated treatment integrating holistic prevention, promotion, rehabilitation, care and support, aimed at addressing mental health- care needs through a multidisciplinary, user-driven treatment and recovery plan;
(g) Access to psychosocial care and clinical treatment in the least restrictive environment and manner;
(h) 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;
(i) Access to aftercare and rehabilitation when possible in the community for the purpose of social reintegration and inclusion;
(j). Access to adequate information regarding available multidisciplinary mental-health services;
(k) Participate in mental-health advocacy, policy planning, legislation service provision, monitoring, research and evaluation;
(l) Confidentiality of all information, communications and records, in whatever form or medium stored, regarding the service user, any aspect of the service user’s mental health, or any treatment or care received by the service user, which information, communications, and records shall not be disclosed to third parties without the written consent of the service user concerned or the service user’s legal representative, except under certain circumstances.
Under the Act, “the State commits itself to promoting the well-being of people by ensuring that mental health is valued, promoted and protected; mental-health conditions are treated and prevented; timely, affordable, high-quality and culturally appropriate mental-health care is made available to the public” (Section 2). People suffering from additional and other substance-induced mental- health condition will be provided care and treatment and hospitals are required to coordinate with drug-rehabilitation centers (Section 18). Also, 24/7 hot lines to give assistance to individuals with mental-health conditions, especially individuals at risk of committing suicide, shall be set up, and existing hot lines shall be strengthened (Section 21). The Philippine Council for Mental Health (“Council”) is established under Section 45 as a policy-making, planning, coordinating body attached to the Department of Health to oversee the implementation of the law. The amount needed for the initial implementation of this Act shall be charged against the 2018 appropriations of the DOH. For succeeding years, the amount shall be based on the strategic plan formulated by the Council (Section 45).
The DOH is required to coordinate with the Philippine Health Insurance Corp. to ensure that insurance packages are available to patients affected by mental-health conditions (Section 30(f)) PhilHealth currently covers hospitalization due to acute attacks of mental-health and behavioral disorder with a P7,800 package only.
It is hoped that the Mental Health Act will not be among the good laws that will suffer from lack of government funding. The way our legislators and government leaders are behaving, it would seem that they could be the primary beneficiaries of the Mental Health Act.
Need I say more?