Mental health is a level of psychological well-being or an absence of mental illness.

It
is the "psychological state of someone who is functioning at a satisfactory level of emotional
and behavioral adjustment".] From the perspective of positive psychology or holism, mental
health may include an individual's ability to enjoy life, and create a balance between life
activities and efforts to achieve psychological resilience. According to the World Health
Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy,
autonomy, competence, inter-generational dependence, and self-actualization of one's
intellectual and emotional potential, among others." The WHO further states that the well-
being of an individual is encompassed in the realization of their abilities, coping with normal
stresses of life, productive work and contribution to their community Cultural differences,
subjective assessments, and competing professional theories all affect how "mental health"
is defined.

Mental illnesses are more common than cancer, diabetes, or heart disease. Over 26
percent of all Filipinos over the age of 18 meet the criteria for having a mental illness. In
2012 alone, the World Health Organization (WHO) reported that there were 2,558 cases of
Filipinos who died by suicide, or an average of 7 cases per day. The Department of Health,
for its part, reported that one in 5 Filipino adults has some form of mental illness, topped by
schizophrenia, depression, and anxiety. A WHO report estimates the global cost of mental
illness at nearly $2.5 trillion (two-thirds in indirect costs) in 2010, with a projected increase
to over $6 trillion by 2030.

Evidence from the World Health Organization suggests that nearly half of the world's
population is affected by mental illness with an impact on their self-esteem, relationships
and ability to function in everyday life. An individual's emotional health can also impact
physical health and poor mental health can lead to problems such as substance abuse.

Maintaining good mental health is crucial to living a long and healthy life. Good mental
health can enhance one's life, while poor mental health can prevent someone from living an
enriching life. According to Richards, Campania, & Muse-Burke, "There is growing evidence
that is showing emotional abilities are associated with prosocial behaviors such as stress
management and physical health." Their research also concluded that people who lack
emotional expression are inclined to anti-social behaviors (e.g., drug and alcohol abuse,
physical fights, vandalism), which are a direct reflection of their mental health and suppress
emotions. Adults and children with mental illness may experience social stigma, which can
exacerbate the issues.

Mental health is one of the most common health problems that Philippines are facing today.
Mental health facilities aren’t accessible and poverty is a hindrance. That’s why President
Rodrigo Duterte has signed the landmark Mental Health Law, which would provide
affordable and accessible mental health services for Filipinos. Senator Risa Hontiveros on
Thursday, June 21, lauded Duterte, saying the signing of Republic Act 11036 would “set the
path for the government’s policy in integrating mental healthcare in the country's public
healthcare system.”

"Help is finally here. The Mental Health Law cements the government’s commitment to a
more holistic approach to healthcare: without sound mental health there can be no genuine
physical health," said Hontiveros, author and principal sponsor of the bill.

The law would secure the rights and welfare of persons with mental health needs and
mental health professionals; provide mental health services down to the barangays;
integrate psychiatric, psychosocial, and neurologic services in regional, provincial, and
tertiary hospitals; improve mental healthcare facilities; and promote mental health education
in schools and workplaces.

"No longer shall Filipinos suffer silently in the dark. The people's mental health issues will
now cease to be seen as an invisible sickness spoken only in whispers,” Hontiveros said.

Gatchalian, for his part, said: "I am hopeful that this law will cause to fade away the
unfortunate social stigma surrounding depression, anxiety, and other mental health
conditions, so that eventually our society as a whole will come to accept mental illness for
what it really is – a genuine public health issue that requires accessible medical care,
consistent government support, and compassionate social understanding."

Villanueva said that "by making mental health care accessible down to the barangays and
promoting mental health education in schools and workplaces, this important piece of
legislation would give awareness regarding mental health and remove social stigma against
people with suicidal tendencies.”
 Mental Disorders do exist with scientific basis. According to studies, scientists have
largely attributed it to the brain’s functioning. Most scientists believe that mental illnesses
result from problems with the communication between neurons in the brain called
neurotransmission and chemical compounds called neurotransmitters. For instance the
neurotransmitter serotonin levels of those with depression are lower than normal
individuals. Apart from serotonin there could also be other changes in other
neurotransmitters in the brain. In schizophrenia, studies show that there are disruptions in
neurotransmitters dopamine, glutamate and norepinephrine.

Mental Disorders can also be psychosomatic. Psychosomatic pertains to physical ailments

that are caused by or notably influenced by emotional factors, such factors that can be
attributed to mental disorders. Dr. Jercyl Leilani Demeterio says that mental disorders are
as debilitating as any form of illness affecting the person’s ordinary daily activities, even
relationships and even results to, if not correlated with, physical illnesses such as heart
diseases, thyroidism, stroke, cancer and many others.

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.
Close to 800,000 people die due to suicide every year. For every suicide, there are many
more people who attempt suicide every year. A prior suicide attempt is the most important
risk factor for suicide in the general population, according to a World Health Organization
(WHO) fact sheet, updated August 2017.

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. 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.
There are discriminations against mentally ill patients particulary in employment and
education. Overseas contract workers for instance, prior to departure, must undergo
neuropsychiatric screening and those found with symptoms of mental distress and
symptoms are not certified to leave for overseas employment. Any reapplication must be
accompanied by psychiatric clearance, according to a noted psychiatrist Dr. Bernardo
Conde of University of Santo Tomas. This regulation of the Department of Labor and
Employment (DOLE) is unfair and a total violation of social justice. With this regulation
those who are afflicted with mental disorders have no opportunity of having greener
pastures abroad to help their families but those with physical disabilities do since the latter
do not have the same kind of regulation. Yet, according to Dr. Jercyl Leilani Demeterio, with
proper treatment or psycho-therapy and medication, workers with mental illnesses can
function as normal individuals. If this is the case why does the DOLE not accept them with
the same regulation as normal individuals? One reason for this is poverty.

Not all Filipinos afflicted with mental illnesses can afford to have the maintenance treatment
and medication. In the Philippines alone, a disability survey done in 2000 by the National
Statistics Office (NSO) found out that mental illness was the third most common form of
disability. Prevalence rate of mental disorders were 88 per 100,000 populations and was
highest among the elderly group. This finding was supported by a more recent data from
the social weather survey commissioned by the Department of Health(DOH) in 2004. It
revealed that 0.7% of the total household have a family member afflicted with mental
disability.

Out of 412 Psychiatrists in the Philippines, a majority of 237 of them are based in the
National Capital Region, making medical treatment from health therapists out of reach to
patients from provinces and far-flung barrios. Apart from this, The majority of mental health
facilities are still located in the National Capital Region. Hence, access to mental
healthfacilities is uneven across the country, favoring those living near the main cities.

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 professional.

[Section 4(O)]

“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.

But how exactly will we be able to gauge the law's success once it is fully implemented?
Ideally, the offshoot would be the presence of mental health services at the primary health
care setting such as in barangays health stations and not just hospitals, Chua said.

Adequate training of teachers and officials in mental health knowledge as well as mental
health programs should also be required in schools and the workplace.

"Our general practitioners, doctors, nurses, teachers being taught the mental health
dimensions of their work adequately...those are measures or goals of the mental health law
and when we achieve those things, the mental health law is doing its purpose," Chua said.

Mental health advocates also hope that with the implementation of the mental health law,
more people would be enticed to become practicing psychiatrists. Currently there are
roughly only 600 in the whole country for a population of nearly 100 million.

According to Nadera, success would also mean fewer reports of violence or human rights
violations against persons with mental health problems. Mental health policies and services
should also be made available to vulnerable sectors.
 SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH NURSING
CATBALOGAN CITY

CASE STUDY
Mental Health Law and its
relevance

SUBMITTED TO:
MA’AM YBOA

SUBMITTED BY:
MA. CHERRY MHAY MARTINEZ