Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

17% CONGRESS
First Regular Session

HOUSE BILL No. 8796

Introduced by REP. TEDDY BRAWNER BAGUILAT

AN ACT PROMOTING MENTAL HEALTH, PROMULGATING A POLICY TOWARDS THE
NATIONAL MENTAL HEALTH ENHANCEMENT OF INTEGRATED MENTAL HEALTH
SERVICES AND ESTABLISHMENT OF A PHILIPPINE MENTAL HEALTH COUNCIL

EXPLANATORY NOTE

In a survey conducted by the Department of Health among 327 government employees
in Metro Manila, 32% were found to have experienced mental health problems. Almost
one per 100 households (0.7%) has a member with mental disability (DOH-SWS,
2004). As early as 2003, intentional self-inflicted cases were already found to be the
Om leading cause of death among 20-24 years old Filipino adults (DOH 2003). The
incidence of suicide in males increased from 0.23 to 3.59 per 100,000 between 1984
and 2005 while rates rose from 0.12 to 1.09 per 100,000 in females (Redaniel and
Gunnell, 2011). Individuals with chronic mental illness, children, overseas Filipino
workers and those in areas of armed conflict have higher risk of getting mental health
problems

Further adding to the woes of those afllicted with mental health illnesses is the
shortage in qualified mental health professionals. At present, there are only an
estimated 490 psychiatrist and 1000 nurses working in psychiatric care, and even less
general practitioners trained in early assessment and management of common mental
health problem in the community. The number of addiction specialist, psychologists,
occupational therapists, guidance counselors and social workers are extremely
inadequate to meet the mental health needs of the 100 million Filipinos.

‘There are two mental hospitals, 46 outpatient facilities, four day treatment facilities,
19 community-based psychiatric inpatient facilities and 15 community residential
(custodial home-care) facilities for the whole country. Almost all mental health
facilities are in the major cities, while the only mental hospital in the National Capital
Region houses only 4,200 beds.

‘This bill secks to integrate mental health services into the national health system in
order to meet the needs of those who lack access to readily-available, affordable and
equitable mental health care, especially the poor. It proposes to create the Philippine
Council for Mental Health as an attached agency of the Department of Health, to
provide a rational and unified response to mental health problems, concerns and
efforts through the formulation and implementation of the National Mental Health
Care Delivery System

For the reason cited, the passage of this bill is earnestly requested.

TEDDY BRAWNER BAGUILAT
Afugaé Lone District


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

17% CONGRESS
First Regular Session

3796

HOUSE BILL NO.

Introduced by REP, TEDDY BRAWNER BAGUILAT

AN ACT PROMOTING MENTAL HEALTH, PROMULGATING A POLICYTOWARDS
‘THE NATIONAL MENTAL HEALTH ENHANCEMENTOF INTEGRATED MENTAL
HEALTH SERVICES AND ESTABLISHMENT OF APHILIPPINE
MENTAL HEALTH COUNCIL

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Short Title. This Act shall be known as the “Philippine Mental
Health Act of 201”

SECTION 2. Declaration of Policy. It is hereby declared the policy of the State
to uphold the basic right of all Filipinos to mental health and to respect the
fundamental rights of people who require mental health services. As enshrined
in the Universal Declaration of Human Rights, and the International Covenant
on Economic, Social and Cultural Rights, and the International Covenant on
Civil and Political Rights, the State acknowledges that persons with mental
disabilities have the right to equality and non-discrimination, dignity and
respect, privacy and individual autonomy, information and participation. The
State further recognizes that people with mental disabilities by virtue of the
nature and or severity of their illness, have specific vulnerabilities and
therefore need special care appropriate to their needs and based on nationally
and internationally-accepted standards.

‘The State recognizes its obligations as a State-Party to the UN
Convention on the Rights of Persons with Disabilities under Article 4 of the
present Convention “to ensure and promote the full realization of all human
rights and fundamental freedoms for all persons with disabilities without
discrimination of any kind on the basis of disability”. Likewise, the State aligns
itself with the UN General Assembly resolution 46/119 of December 17, 1991,
on the Principles for the Protection of Persons with Mental Illness and the
Improvement of Mental Health Care which lays down the policies and
guidelines for the protection from harm of persons with mental disabilities and
the improvement of mental health care.

Through the passage of this Mental Health Act, the State commits to the
promotion and protection of the rights of the person with mental needs and the
belief that addressing their profound social disadvantage enhances their
significant contribution in the civil, political, economic, social and cultural
spheres.

SECTION 3. Objectives. This Act seeks to:
a. Ensure a community of Filipinos who are mentally healthy, able to

contribute to the development of the country and attain a better
auality of life through access to an integrated mental health care


system that responds to mental health needs of Filipinos in equity
with their physical health needs.

. Protect the rights and freedom of persons with mental health needs

and the reduction of the burden and consequences of mental ill-
health, mental and brain disorders and disabilities.

. Provide the direction for a coherent, rational and unified response to

the national mental health issues.

SECTION 4. Definition of Terms. The following terms, as used in this Act,
shall mean the following:

a)

b)

°)

q)

e)

f)

“Mental health” refers to a state of well-being in which every
individual realizes his or her own potential can cope with the normal
stresses of life, can work productively and fruitfully, and is able to
make contribution to her or his community.

“Mental illness” refers to mental or psychiatric disorder characterized
by the existence of recognizable changes in the thoughts, feelings and
general behavior of an individual brought about by neurobiological
and or psychological causes manifested by behavioral symptoms with
associated mental and or emotional conditions.

“Psychosocial problem” refers to a condition that indicates the
existence of recognizable disturbances in an individual’s behavior,
thoughts and feelings brought about and closely related to sudden,
extreme or prolonged stressors in the physical or social environment.

“Patient” refers to a person receiving/utilizing mental health care and
treatment or psychosocial intervention from mental health care facility
or clinic.

“Legal representative” refers to a substitute decision-maker charged
by law with the duty of representing a patient in any specified
undertaking or of exercising specified rights on the patient’s behalf.
‘The legal representative may also be a person appointed in writing by
the patient to act on his behalf unless the patient lacks mental
capacity, or otherwise fails to appoint a legal representative in writing,
in which case the legal representative shall be taken to be in the
following order:

i. the spouse, if any, unless permanently separated from the
patient and rendered by a Court of competent jurisdiction or
has deserted or has been deserted by the patient for any period
which has not come to an end; or

ii, sons and daughters over the age of eighteen (18) years old; or

iii, either parent by mutual consent; or

iv. a person appointed by a decree of a court to represent the
patient.

“Mental health professional” refers to a person with formal education
and training in mental health and behavioral sciences such as but
not limited to, a psychiatrist, psychologist, psychiatric nurse or
psychiatric social worker.


g) “Mental health worker” refers to a trained volunteer or advocate
engaged in mental health promotion and services under the
supervision of a mental health professional.

h.) “Allied professional” refers to any trained or certified non-psychiatric
physician, social worker, nurse, occupational therapist, counselor,
priest, minister, pastor, nun, trained or certified non-psychiatric
individual or non-physician.

i.) “Mental disability” refers to impairments, activity limitations, and
individual and participatory restrictions denoting dysfunctional
aspects of interaction between an individual and his environment.

j.) “Mental or psychological incapacity” is the inability to:

i. understand the information given concerning the nature of the
disorder;

i, understand the consequences that his/her decisions and
actions have for their own life or health

ii, understand that treatment might mitigate or remedy the
condition and that lack of treatment might aggravate it;

iv. understand information about the nature of treatment
proposed, including the means of treatment, its direct effects
and its possible side effects

v. effectively communicate with others regarding their condition
and their consent to treatment or hospitalization.

‘The caregiver shall be a person who may or may not be the
person's next of kin or relative who maintains a close personal
relationship with the patient and manifest concern for his
welfare.

k. “Psychiatric Emergencies” are conditions which may present a serious
threat to a person's well-being or that of others, and require
immediate psychiatric interventions, such as attempted suicide, acute
intoxication, severe depression, acute psychosis, or violent behavior.

1) "Discrimination on the basis of disability’ means any distinction,
exclusion or restriction on the basis of disability which has the
purpose or effect of impairing or nullifying the recognition, enjoyment
or exercise, on an equal basis with others, of all human rights and
fundamental freedoms in the political, economic, social, cultural, civil
or any other field. It includes all forms of discrimination, including
denial of reasonable accommodation.

SECTION 5. Rights of Persons with Mental Health Needs. Without prejudice
to anything provided in this Act and unless prevented by law, persons with
mental health needs shall have the right to:

a.) Exercise all their inherent civil, political, economic, social, religious,
educational and cultural rights individual qualities, abilities and
diverse backgrounds, and without any discrimination on grounds of
physical disability, age, gender, sexual orientation, race, color,
language, religion or national or ethnic or social origin of the patient
concerned;


b.) Receive treatment of the same quality and standard as other
individuals;

c.) Receive treatment which addresses holistically their needs through a
multidisciplinary care plan approach;

d.) Receive treatment in the least restrictive environment and in the least
restrictive manner;

e.) Receive care primarily in the community;

f.) After-care and rehabilitation when possible in the community so as to
facilitate their social inclusion

g.) Be adequately informed about the disorder and the multidisciplinary
services available to cater for their needs and the treatment options
available;

h,) Actively participate in the formulation of the multidisciplinary
treatment plan.

SECTION 6. Right to Therapeutic Environment. The State through its
authorized agencies shall ensure conditions for a safe, therapeutic and
hygienic environment with sufficient privacy in mental health facilities.

SECTION 7. Prohibition on Torture and Cruel Treatment. The State through
its authorized agencies shall ensure that all public and private mental health
institutions are protecting the rights of patients against cruel, inhuman and
degrading and/ or torture. It shall prohibit forced or inadequately remunerated
labor by patients within mental health institutions. This does not include
activities justified as part of an accepted therapeutic treatment.

SECTION 8. Prohibition on Solitary Confinement. The use of solitary
confinement shall be prohibited.

SECTION 9. Respect for Human Rights. The Commission on Human Rights
is authorized to conduct inspection of all places where psychiatric patients are
held for involuntary treatment or otherwise, to ensure full compliance with
domestic and international standards governing the legal basis for treatment
and detention, quality of medical care, and living standards, and to ensure that
no patients therein are treated in a manner less than humane or are victims or
torture and other cruel, inhuman and degrading treatment.

SECTION 10. Alternatives to Health. As the primary duty-bearer shall
develop alternatives to institutionalization, especially community-based
treatment, in particular with a view to receiving persons discharged from
hospitals. Such alternatives should meet the needs expressed by persons with
mental disorders and respect the autonomy, choices, dignity and privacy of the
person concerned.

SECTION 11. Complaints and Investigation. The Department of Health,
Commission on Human Rights or Department of Justice shall receive all
complaints of improprieties and abuses in mental health care and shall initiate
appropriate investigation and action. The patient / legal representative shall be
entitled to a competent counsel of his own choice. In case he cannot afford one,
he/she will be assisted by the Public Attorney's Office or any legal aid
institution of choice.

SECTION 12. Oversight and Quasi-Judicial Procedures. The State shall
mandate the appointment of a Focal Commissioner on Mental Health under the


Philippine Council for Mental Health with the following functions and duties:

a)

b)

Co)

a)

e)

f)

8)

h)

Promote and safeguard the rights of persons utilizing mental health
services and their caregivers;

Review any policies and make such recommendations to any
competent authority to safeguard or to enhance the rights of such
persons and to facilitate their social inclusion and wellbeing;

Investigate any complaint alleging breach of patient's rights and take
any subsequent action which may be required to protect the welfare of
that person;

Investigate complaints about any aspect of care and treatment
provided by a licensed facility or a healthcare professional and take
any decisions or make any recommendations that are required;

Conduct regular inspections, at least annually, of all licensed facilities
to ascertain that the rights of patients and all the provisions of this
Act are being upheld. During such visit he shall have unrestricted
access to all parts of the licensed facility and the right to interview in
private any consenting patient in such facility;

Report any case amounting to a breach of human rights within a
licensed facility to the appropriate competent authority recommending
the rectification of such a breach and take any other proportional
action he deems appropriate

Report to the appropriate competent authority any health care
professional for breach of human rights or for contravening any
provision of this Act and this without prejudice to any other
proportional action that he may deem necessary to take;

Prepare an annual report of activities to be submitted to the
Department of Health. In the performance of his functions, the Focal
Point Commissioner on Mental Health shall consult with Healthcare
professionals, service users and caregivers, and other relevant
stakeholders

SECTION 13. Duties of Health Authorities. Health authorities shall have the

following dutie:

a)

b)

Ensure that guidelines and protocols for minimizing restrictive care are
established.

Inform patients of their rights. Every patient, whether in voluntary or
involuntary treatment, should be fully informed about the treatment to be
prescribed and the reason for recommending it and given the opportunity to
refuse treatment or any other medical intervention. Informed consent must
be sought from all psychiatric patients at all times except in instances of
mental or psychological incapacity as defined in Section 3 of this Act.

Ensure that any involuntary medical treatment and restraint, physical or
chemical, for those with mental disorder can only be used to the extent
strictly necessary under the following conditions:

i. Psychiatric emergencies;
ii, That the treatment without consent and restraint is at the order

of an attending physician whose orders must be reviewed as soon as possible
and not to exceed one month by a qualified psychiatrist;


d)

e)

f)

8.)

h)

iii, That the decision subject to involuntary treatment is resorted to
only when all other means of control have been attempted and
failed.

iv. That such a decision is overseen by the head of the
institution/medical or mental health facility strictly following
approved guidelines which include clear criteria for regulating
the application and termination of such interventions;

v. Only for the shortest possible period of time as assessed by a
psychiatrist or attending physician on supervision by a
psychiatrist.

vi. Recorded and subjected to regular external independent
monitoring

Must certify that the patient who has been subjected to any
intervention without consent has been debriefed as soon as the
mental condition meaningfully permits it and he / she and legal
guardian/substitute decision-maker must have access to the medical
record.

Must keep a register on involuntary treatment and procedures.

Must ensure that the rights, will and preferences of the patient are
respected as far as possible, A legal representative/substitute
decision-maker shall:

i. Be allowed only for reasons of mental incapacity following
established judicial procedures;

ii, Apply for the shortest time possible;

Be free of conflicts of interest and undue influence from family
members or the institution where the person is treated or
others;

iv, Be subject to regular review by a competent, independent and
impartial authority or judicial body;

y. Be overseen by an independent monitoring body;
vi Be subjected to appeal by the person or a trusted next of kin.

Must ensure that families or other primary caregivers are entitled to
information about the person with a mental disorder unless the
patient refuses the divulging of such information.

Must involve family members or other primary caregivers in the
formulation and implementation of the patient's individualized the
treatment plan.

Must make transparent and accessible to the person affected, its
family and to the public in general the decision to apply involuntary
treatment must be as this is an essential factor for building and
maintaining mutual confidence.

Must mandate the creation of an appropriate body which will ensure
compliance with the requirements and procedures provided by this
act.


k) Must provide the patient under treatment and hospitalization without
consent access to an independent mechanism of complaint and
compensation for any inappropriate treatment provided. Complaint
mechanisms must:

i. Be designed in a manner that is sensitive to the particular
needs of the patient;

ii, Provide the individual with the necessary assistance to lodge a
complaint and the complaint mechanism must be empowered
to inquire effectively and independently into the circumstances
leading to the complaint;

iii, Be mandated to initiate disciplinary sanctions or pass the case
to the prosecuting authorities with a view to initiating a
criminal investigation against a person or persons found guilty
of misconduct;

iv. Ensure that complaints are dealt with in a speedy manner.

SECTION 14. Philippine Council for Mental Health. The Philippine Council
for Mental Health, herein after referred to as the Council, is hereby established
as an attached agency under the Department of Health (DOH), to provide for a
coherent, rational and unified response to mental health problems, concerns
and efforts through the formulation and implementation of the National Mental
Health Care Delivery System.

SECTION 15. National Mental Health Care Delivery System. The National
Mental Health Care Delivery System shall constitute a quality mental health
care program, through the development of efficient and effective structures,
systems and mechanisms that will ensure equitable, accessible, affordable,
appropriate, efficient and effective delivery of mental health care to all its
stakeholders by qualified, competent, compassionate and ethical mental health
professionals and mental health workers.

SECTION 16. Duties and Functions. The Council shall exercise the following
duties with regard to Mental Health Education and Information as a health
service:

a. Review and formulate policies and guidelines on mental health issues
and concerns;

b. Develop a comprehensive and integrated national plan and program
on mental health;

c. Conduct regular monitoring and evaluation in support of policy
formulation and planning on mental health;

d. Promote and facilitate collaboration among sectors and disciplines for
the development and implementation of mental health related
programs within these sectors;

e. Provide over-all technical supervision and ensure compliance with
policies, programs, and projects within the comprehensive framework
of the National Mental Health Care Delivery System and other such
activities related to the implementation of this Act, through the review
of mental health services and the adoption of legal and other remedies
provided by law;

f. Plan and implement the necessary and urgent capacity building,
reorientation, and training programs for all mental health
professionals, mental health workers and allied professionals as


articulated in this Act;

. Review all existing laws related to mental health and recommend

legislation which will sustain and strengthen programs, services and
other mental health initiatives;

. Conduct or cause to be conducted studies and researches on mental

health, with special emphasis on studies that would serve as basis for
developing appropriate and culturally relevant mental health services
in the community;

Create such inter-agency committees, project task forces, and other
groups necessary to implement the policy and program framework of
this Act; and

Perform such other duties and functions necessary to carry out the
purposes of this Act.

SECTION 17. Inter-agency Mechanisms. The Council shall collaborate with
the following agencies:

a.

. PHILHEALTH to make sure that availabili

DOST and attached agencies like PITAHC and PCHRD to advance
research on basic and clinical studies into mental illness and
complementary and alternative treatment;

. DepEd and CHED to develop school based mental health promotion,

screening and referral systems;

of insurance packages is
in place with substantial equity to physical disorders with similar
impact to the patient’ as measured by Disability Adjusted Life Years or
similar instrumentation;

|. TESDA, DSWD, DA, DTr, SENR and DILG and other agencies to

develop vocational opportunities via innovative systems like Care,
Farms, Psychosocial Rehabilitation and similar modalities with
program design and planning in conjunction with psychiatrists and
other mental health specialists;

. DOLE to promote diversity and equal protection in the workplace

mandating companies to develop programs to enhance mental
wellness and work accommodations for the mentally ill employees;

NEDA to envision programs to promote the mental wealth of our
nation, including inclusive growth among the mentally ill;

. The National Center for Health promotion shall lead the formulation of

the standard and the development of mental health information
education and communication and advocacy strategies to ensure the
promotion of a totally healthy and less stressful lifestyle for the
Filipinos:

. National Epidemiological Center to develop and update the

epidemiology of mental diseases and services available in the country
in the form of a census or a similar instrument. Research into
epidemiology, risk factors, treatment and management of mental
disorders should be given a priority. It shall ensure the development
or enhancement of national reporting and surveillance systems and
methodologies and the generation, availability accessibility baring
exchange and distribution of information and knowledge on mental



neurological cases;

i. Philippine Statistical Authority to formulate and integrate mental
health protective risk factors and other such data that may help in
the formulation of policies towards mental wellness and prevention of
mental illness;

j. Commission on Human Rights on matters pertaining to human rights
issues, particularly, the protection of persons utilizing mental health
services and the prevention of cruel, inhuman and degrading
treatment in mental health care facilities.

SECTION 18. Composition. The Council shall be composed of the following:

‘The Secretary of Health, as ex-officio chairman;

The Executive Director, as vice chair;

Two (2) representatives from the government sector;

One (1) representative from the private health sector or consumer
groups;

One (1) representative from the academe/research;

f. Two (2) representatives from the professional organization; and

g. Two (2) representatives from the allied nongovernment organizations
involved in mental health issues,

eege

The members of the Council shall be appointed by the President from
among the nominees of their respective organizations within 30 days from the
date of effectivity of this Act.

SECTION 19. Term of Office. The members of the Council shall serve for a
term of three (3) years. In case a vacancy occurs in the Council, any person
chosen to fill the vacancy shall serve only for the unexpired term of the member
whom he succeeds.

SECTION 20. Meetings. The Council shall meet at least once a month or as
frequently as necessary to discharge its duties and functions. The Council shall
be convened by the Chairman or upon written request of at least three (3) of its
members. The presence of a majority of the members of the council shall
constitute a quorum.

SECTION 21. Per Diem. The members of the Council shall receive reasonable
per diems and transportation allowance as may be fixed by the Council for any
meeting actually attended.

SECTION 22. Executive Director. The Council shall appoint an Executive
Director who shall serve for a term of three (3) years. The Executive Director
shall be eligible for one (1) reappointment and shall be removed from office
except in accordance with existing laws.

The Executive Director shall have the following duties and functions:
a. Act as Chief Executive Officer of the Council and assume full
responsibility in implementing its purposes and objectives;

b. Maintain a close and functional relationship with the Department of
Health and other government and private entities concerning mental
health care;

c. Formulate, develop, and implement, subject to the approval of the
Council, measures that will effectively carry out the policies laid down by
the Council;

4) Bxeente and administer all annraved nolicies nrncrams and measnres



and allocate appropriate resources for their implementation;

e. Recommend to the Secretary of Health the appointment of personnel of
the Council including supervisory, technical, clerical and other personnel
in accordance with the staffing patterns and organizational structure
approved by the Council; and,

f, Represent the Council in all of its official transactions or dealings and
authorize legal contracts, annual reports, financial statements, and other
documents.

SECTION 23. Salary. The Executive Director shall receive a salary to be fixed
by the Council in accordance with the Salary Standardization Law.

SECTION 24. Advisory Board. The Philippine Council for Mental Health
Council shall the create advisory board consisting of Mental Health care users,
caregivers and professionals, representatives of the DOH as well as visiting
bodies under national and international obligations of the State.

SECTION 25. Implementing Rules and Regulations. Within (90) days from
the effectivity of this Act, the Secretary of Health shall, in coordination with the
Council, formulate the rules and regulations necessary for the effective
implementation of this Act.

SECTION 26. Appropriation. The initial amount of Php Fifty Million pesos
(Php 50 000.00) is hereby appropriated for the initial implementation of this
Act. Thereafter, any amount as may be necessary to carry out the provisions of
this Act shall be included in the General Appropriations Act. Regional hospitals
shall be provided with financial support to maintain their own Mental Health
Unit capable of catering to 50 to 100 patients. Local Government Units should
require business establishments to donate from one to three percent (1% to
3%) of their gross sales to support the Mental Health Program of the City.
Donations will be treated as tax shelter by the BIR.

SECTION 27. Separability Clause. If any provision of this Act is held invalid
or unconstitutional, the remainder of the Act or the provision not otherwise
affected shall remain valid and subsisting.

SECTION 28. Repealing Clause. Any law, presidential decree or issuance,
executive order, letter of instruction, administrative rule or regulation contrary
to or inconsistent with the provisions of this Act is hereby repealed, modified or
amended accordingly.

SECTION 29. Effectivity. This Act shall take effect fifteen (15) days upon its
publication in at least two (2) national newspapers of general circulation.

Approved: