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Republic of the Philippines iS RECEIVED “2
HOUSE OF REPRESENTATIVES = pare 1S UL 205
Quezon City, Metro Manila 5 TIME _/: 6m
BY eA
Twentieth Congress Y
First Regular Session

HOUSE BILL NO! 188

Introduced by Hon, Alexandria P. Gonzales

EXPLANATORY NOTE

Adolescence is a crucial period for developing social and emotional habits important for
mental well-being, These include adopting healthy sleep patterns; exercising regularly;
developing coping, problem-solving, and interpersonal skills; and learning to manage emotions.
Protective and supportive environments in the family, at school and in the wider community
are important.

Mental health conditions, such as childhood epilepsy, developmental disabilities,
depression, anxiety, and behavioral disorders, are major causes of illness and disability among
young people, Worldwide, 10% of children and adolescents experience a mental disorder, but
the majority of them do not seek help or receive care. Suicide is the fourth leading cause of
death in 15-19-year-olds'.

Approximately 40% of the total Philippine population is comprised of Filipinos below
18 years of age. Among Filipino children aged 5 to 15, 10% to 15% are affected by mental
health problems, Reported suicide rates in the Philippines have been increasing over the past
several decades, particularly among young people, with the latest estimate (in 2015) indicating
17% of young people aged 13-15 had attempted suicide*.

‘The consequences of failing to address adolescent mental health conditions extend to
adulthood, impairing both physical and mental health and limiting opportunities to lead
fulfilling lives as adults. While the Mental Health Act was passed in 2018, with the goal of
improving the delivery of integrated mental health services and promoting and protecting the
rights of people who use psychosocial health services, the provisions for the mental health of
children and adolescents were too broad and undefined.

"adolescent mental health key facs. World Health Organization. 2021. Available from: hitps/vw who inlnews-roomitack-
‘shees/detai/adolescent-mental-health. Accessed May 25, 2022.

2 Global school-based student survey: Philipines 2015 fact sheet, Word Health Organization, 2015, Availabe from:
-nps:lwww. who intncds/survellancelgshs/PIH2015_ fact sheet pdt. Accessed May 26, 2022.

> Goberstein E, Wen H, Miler BF. Coronavirus disease 2019 (COVID-18) and mental health for children and adolescents. JAMA Pediatr.
-2020;174(9):819-20. do: 10.1001/jamapediatrcs.2020.1456.

“Prevention and management of mental health conditions in the Piippines. The case for investment, Manila: World Heath Organization
Regional Ofice for the Western Pacific; 2021,



This bill takes the initial steps toward emphasizing the importance of focused mental
health services and programs for children and adolescents. This seeks to provide programs and
strategies that include mechanisms for promotion and prevention, appropriate response and
interventions, and adequate psychosocial care and support, aimed at addressing mental health
care needs of children and adolescents within a local community.

Given the foregoing concerns, the passage of this bill is earnestly sought.

ALEXAI [A P. GONZALES:


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

Twentieth Congress
First Regular Session

HOUSE BILL NO* 1884

Introduced by Hon. Alexandria P. Gonzales

ANACT
TO ESTABLISH ACCESSIBLE AND AGE-APPROPRIATE MENTAL HEALTH SERVICES FOR
CHILDREN AND ADOLESCENT POPULATION, EMPHASIZING THEIR UNIQUE NEEDS
AND CONDITIONS, APPROPRIATING FUNDS THEREFOR AND FOR OTHER PURPOSES

Be itenacted by the Senate and House of Representatives of the Phil

spines in Congress assembled:

Chapter I
GENERAL PROVISIONS

Section 1. Short Title. — This Act shall be known as the “Lusog Kaisipan ng Pag-
asa ng Bayan Act.”

Sec. 2. Declaration of Policy. — The State shall protect and promote the right to
health of the people and instill health consciousness among them. In order to value the
physical, moral, spiritual, intellectual, and social well-being of children and adolescents,
the State shall adopt an integrated and comprehensive approach to health development,
recognizing their vital role in nation-building. The State shall prioritize the needs of the
children and adolescents, particularly the disabled and vulnerable individuals, by
strengthening the provisions of proper care, health support, and special protection
against circumstances prejudicial to their growth and development.

To this end, the State shall, as a matter of policy, provide quality, affordable and
geographically accessible mental health services and programs to children and
adolescents within local communities of cities and municipalities.

Sec. 3. Objectives. — The objectives of this Act, with respect to the city and
municipal local governments, are as follows:

(a) Improve access to mental health services at the primary level of
care for the purpose of attaining a person-centered, recovery-
oriented, and rights-based coordinated care;

(b.) _ Intensify the promotion of mental wellness, prevention of mental
health conditions, and protection of the rights of service users in a


(c)

(a)

{e)

wider societal framework;

Strengthen the services for screening and early detection of mental
health conditions which are sensitive and responsive to the
developmental stage of children and adolescents with a goal of
providing timely and affordable interventions;

Heighten the mechanisms for suicide intervention, prevention, and
response strategies, including the setting up of, or linking with,
twenty-four-seven (4/7) crisis hotlines; and

Institutionalize an intersectoral collaboration with various
stakeholders and agencies, including the participation of
representatives from local youth organizations, to ensure effective
community-based mental health service delivery.

Sec. 4. Scope and Coverage. — This Act shall apply to local governments and
health care institutions that provide health care and social services to persons under the
age of eighteen. For purposes of this Act, the term “under the age of 18" shall also
include those persons who have attained the age of 18 years but are suffering from
mental health conditions, either congenital or acquired, that render them completely
reliant on another person for a living and support.

Sec. 5. Definition of Terms. — For purposes of this Act, the following terms
shall be defined as follows:

(a)

(b)

(c)

“Mental Health,” as defined in Republic Act (RA) No. 11036, refers
toa 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;

“Mental Health Condition,” as defined in Republic Act (RA) No.
11036, 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;

“Psychosocial Problems,” as defined in Republic Act (RA) No.
11036, refers to 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;

(d) “Suicide prevention” refers to a collection of efforts to reduce the
risk of suicide, including the recognition of risk factors, warning
signs, and underlying conditions as well as the methods, strategies,
and best practices for preventing suicidal thoughts and acts.

(e) “Catchment area,” as defined in this Act, refers to area in relation
to human geography, from which a location, such as a city or
municipality, a service institution, or local facility, attracts a
specified population that uses its services and economic
opportunities as established by government agencies or
organizations for the provision of services.

(£) “Health Care Provider Network (HCPN)” refers to an interlinking of
a group or cluster of primary care providers and facilities with
secondary and/ or tertiary care providers within defined
geographic or political boundaries, for purposes of delivering an
integrated, coordinated, and efficient health care services.

Chapter I
ACCESS TO MENTAL HEALTH SERVICES

Sec. 6. Local Ordinance, — All cities and municipalities shall enact a local
ordinance on the subject of mental health, consistent with existing relevant national
policies and guidelines, for effective implementation of mental health care and wellness
policy within their respective territorial jurisdiction.

The League of Cities, or of Municipalities as the case maybe, of the Philippines
shall serve as a forum in adopting coordinated and integrated measures for the delivery
of mental health services, including the formation or improvement of accessible
healthcare provider networks and linkages for mental health.

Sec. 7. Catchment Areas. — All local government units shall serve as
“catchment areas” for mental health issues and conditions. As catchment area, the LGU
shall, at a minimum, shall provide availability of common psychotropic medications,
adequate human resource for community services, local service budget for child and
adolescent mental health, and sustainable working relationships between services
(intersectoral collaboration).

Sec. 8. Mental Health Facilities for Child and Adolescents. — Wherever
possible, child and adolescent mental health services should be located separately from
general child and adolescent health facilities, as well as separately from adults, because


children and adolescents can experience fear and intimidation if they are treated
alongside adults. Emphasis shall be on a commitment to the mainstreaming of care
services for children and adolescents with mental disorders in community settings.

A municipality, in particular, shall develop or improve its primary health care or
community mental health care facilities with skilled health care workers and necessary
equipment and supplies predicated on its determination of necessity based on well-
supported data provided by its local health office. These facilities must be able to
provide the primary level of public health care model, such as:

(a) Promotion of mental wellness and primary prevention of mental
disorders;

(b.) Screening and identification of young people at risk of for mental
health problems (including suicidal tendencies);

(c) Short-term counselling services for young people and their
families;

(d) Basic management of common mental disorders and psychiatric
emergencies;

(e) _ Follow-up and support for young people with chronic mental
conditions;

(£) Linking with other local and provincial sectors and NGOs in cross-
sectoral prevention and promotion initiatives.

Sec. 9. Mental Health Care Provider Networks. — Each LGU shall create a
directory of all available mental health care facilities for persons with mental health
conditions. A cluster of cities and/or municipalities, in collaboration with the provincial
or regional health facilities, shall establish a multi-sectoral stakeholder network
through which service users can be referred to facilitate access to mental health
facilities, professionals, workers, and other service providers for appropriate care.

Likewise, a directory of location of access sites for the Medicine Access Program
for Mental Health (MAP-MH), Malasakit Centers, and PhilHealth-accredited health
facilities shall be regularly updated and readily available to service users.

Sec. 10. Informal Community Mental Health. — An informal community care
shall also be developed in collaboration with families, barangays, schools, workplaces,
and local non-governmental organizations with a focus of services on promotion of
mental health and parental and youth education about general health and mental health

issues.


Sec. 11, Intersectoral Communication. — Each city and municipal local
government shall improve its communication strategies between the health and
education systems to facilitate early recognition and the implementation of appropriate
school-based interventions for children and adolescent with mental health concerns.

Sec. 12. Psychotropic Medicines for Children and Adolescents. — Each city
and municipal local governments shall ensure the availability of psychotropic medicines
and other therapeutic interventions within its territorial jurisdiction. Primary care
physicians shall be able to prescribe psychotropic medications for children and
adolescents when clinically indicated, and generally as part of a more comprehensive
management plan. Every effort shall be made to ensure that both the child or adolescent
and his or her family understand and agree with a recommendation that medication is
indicated, When prescribing and dispensing these medications, safety precautions must
also be imposed.

Sec. 13. Coordinated Training and Capacity Development Programs. — Each
city and municipality shall coordinate with appropriate national government agencies
and other stakeholders its need for training programs to improve the ability of local
government mental health care providers. The Department of the Interior and Local
Government (DILG), as member of the Philippine Council for Mental Health, shall ensure
that these programs are consistent with the national strategies and programs for mental
health and that each LGU is part of an existing and/or functioning healthcare provider
network.

Chapter II
INTERSECTORAL MENTAL HEALTH PROGRAMS

Sec. 14. Role of the Council for the Welfare of Children. — To ensure
sustained, integrated activity across different sectors and government agencies, the
Council for the Welfare of Children (CWC) shall identify a focal person to coordinate the
implementation, monitoring, and evaluation of mental health policies, programs and
measures for children and adolescents. The focal person shall also foster collaboration
between the different sectors concerned, such as education, welfare, religion, housing,
correctional services, police, and other social services, as the mental wellbeing of
children and adolescents is influenced and significantly impacted by a myriad of societal
factors.

Sec. 15. “Meaningful” Child Participation. Child participation and
empowerment in decision-making affecting their lives shall be promoted in several
settings. The extent of child participation through children’s associations or
organizations shall be established in order to consider the determinants of a
“meaningful” child participation. Local Youth Development Councils shall formulate
standards and procedural guidelines for this purpose.



Sec. 16. Responsibilities of Families and Communities. — The families and
communities shall support the local government programs by actively participating in
various projects for mental health for children and adolescents, such as in mental health
advocacy, policy planning and public consultations, feedbacks for service provisions,
and formulation of psychosocial care programs.

Sec. 17. Academic and Educational Institutions. — The DILG, in partnership
with the DepEd, must design a guidance program to assist the parents, teachers, health
care workers, and carers in addressing the mental health needs of children and
adolescents in and out of the school premises. These guidance programs, or packages,
must be evidence-based, age-appropriate, and socially inclusive. As far as practicable,
representatives from local youth organizations shall be a participant in the
development and implementation of these guidance packages.

The following topics shall be discussed in Filipino, local dialect, or lay terms as
part of the guidance program: (a) the brain and how it functions; (b) psychological and
emotional development; (c) the effects of stress and how to effectively cope stress; (d)
common mental health conditions in children and adolescents, including preventive and
early intervention strategies and programs; (e) available health facilities and support
programs, including crisis hotlines and suicide support groups; (f) special needs of
children and adolescents who are victims of abuse, neglect, and those in conflict with
the law; and (g) valuing mental health by reducing stigma and discrimination.

Sec. 18. Social Welfare and Mental Health. — Each city and municipality shall
also provide or facilitate access to public housing facilities, vocational training and skills
development programs, and disability or pension benefits. Priority programs should be
given to vulnerable populations such as orphans, children with chronic medical illness,
those with learning disabilities, refugees, the mentally handicapped, physically, sexually,
or emotionally abused or neglected children, and children or youth in conflict with the
law.

Sec. 19. Research. — Each city and municipal local government shall adopt a
network of institutions involved in child and adolescent mental health research, which
can serve as research and training resource centers. They shall also develop an
inventory of potential sources of funding for research or dedicate a proportion of
research funding available to child and adolescent epidemiological and health services
research.

Sec. 20. Mental Health Data and Information. — All local government units
shall coordinate with the National Center for Mental Health, as the national repository
of mental health research and information, to improve the collection of information and
data, the undertaking of research studies, and the evaluation of policies and services on
mental health, thereby further enhancing the standards and delivery of care services
and programs.


Chapter IV
MISCELLANEOUS PROVISIONS

Sec. 21. Monitoring, Evaluation, and Reporting of Mental Health Programs.
— The DILG, through the CWC, shall monitor the implementation of the program and
report its status to the PCMH at least once every three (3) years. The PCMH, via the DOH
Annual Report, shall publish a full report of these programs and services in compliance
with the provisions of the Mental Health Act and this Act.

Sec. 22. Appropriations. — The amount necessary for the needs analysis and
other preliminary determination on the necessity to establish or upgrade mental health
services shall be charged against the current appropriated funding of each LGU
concerned and any subsequent funding shall be included in the Annual General
Appropriation Act. The LGU shall set aside funds from any available local revenue in an
amount deemed appropriate by the local officials concerned for the operation and
maintenance of the appropriate mental health care facilities and/or services.

Sec, 23. Separability. — Should any provision of this Act be declared invalid or
unconstitutional, the validity or constitutionality of the remaining provisions shall not
be affected thereby.

Sec. 24, Repealing Clause. — All laws, decrees, letters of instructions,
resolutions, orders, ordinances, or parts thereof which are inconsistent with the

provisions of this Act, are hereby repealed, amended, or modified accordingly.

Sec. 25. Effectivity Clause. — This Act shall take effect fifteen (15) days after its
publication in at least two (2) newspapers of general circulation.

Approved,