Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
First Regular Session

5676

House Bill No.

Introduced by HONORABLE SCOTT DAVIES S. LANETE, M.D.

EXPLANATORY NOTE

Article 2, Section 15 of the 1987 Constitution declares, “The State shall protect and
promote the right to health of the people and instill health consciousness among them.”
Article III, Section 1 likewise declares, “No person shall be deprived of life, liberty, or
property without due process of law, nor shall any person be denied the equal protection of
the laws.”

Numerous articles have surfaced bringing to light the inadequacy of the country’s
mental health care system and the lack of policies that protect people suffering from mental
illness. Those inflicted with a mental illness are often exposed to the ills of society. They are
often discriminated by those of sound mind and treated as if they do not belong to the human
species. Worse, in some cases, they are branded as dangerous and violent individuals making
others avoid contact with them.

As a consequence, people with mental illness and their families generally have low
self-confidence making them unable to fully participate in society. The stigma of being
mentally ill or having a mentally ill relative forces people to retreat into the darkness of their
homes, never wanting to socialize with others

‘These mentally ill people need the State’s help. Thus, there is a need to establish a
program that will ensure that these people’s rights will be protected and that they will be
‘empowered to live normally, just like any person in society.

Hence, this Bill seeks to improve mental heath care services by establishing
guidelines in treatment and handling of persons afflicted with a mental illness. By doing so,
the State will be fulfilling its responsibility in promoting the health of its people and provide
its citizens additional aid in combating illness. Through this Bill, it is envisioned that there
will be an improvement in the mental health care industry that will translate to a happier and
satisfied citizenry.

In fact, the Senate of the Philippines has already passed a similar bill. On 6 October
2016, the Senate of the Philippines voted to approve Senate Bill No. 1190, otherwise known
as the “Philippine Mental Health Act of 2916”, authored by Hon. Risa Hontiveros.


‘The ball is now in the hands of the House of Representatives and this representation,
for purposes of expediency, has adopted in foto Senate Bill No. 1190. Therefore, the

immediate passage of this Bill is sought for.
SCOTT DAVIES S. LANETE, M.D.
Kors va

‘Third District, Province of Masbate


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
First Regular Session

House Bill No. 9876

Introduced by HONORABLE SCOTT DAVIES S. LANETE, M.

AN ACT ESTABLISHING A NATIONAL MENTAL HEALTH POLICY FOR THE
PURPOSE OF ENHANCING THE DELIVERY OF INTEGRATED MENTAL
HEALTH SERVICES, PROMOTING AND PROTECTING PERSONS UTILIZING
PSYCHIATRIC, NEUROLOGIC AND PYSCHOLOGICAL HEALTH SERVICES,
APPROPRIATING FUNDS THEREFOR AND FOR OTHER PURPOSES

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

ARTICLE I
Policy, Objectives, and Definitions
SECTION 1. Short Title. — This Act shall be known as the “Mental Health Act of 2016.”

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

The State thus commits itself to promoting the well-being of its people by, among others,
ensuring that mental health is valued, promoted and protected: mental disorders are
Prevented; and persons affected by these disorders are able to access high quality, culturally
appropriate health and social care in a timely way to, exercise the full range of human rights,
and participate fully in society and at work free from stigmatization and discrimination.

Policies, plans and laws for mental health shall comply with obligations under the United
Nations Convention on the Rights of Persons with Disabilities and other international and
regional human rights conventions. Thus, the State expressly recognizes the applicability of
Republic Act (R.A.) No. 7277, as amended, otherwise known as the "Magna Carta for
Disabled Persons", to persons with mental disorders, as defined herein.

Section 3. Objectives. The objectives of this Act are, as follows:
(a) Strengthen effective leadership and governance for mental health by, among others,

formulating, developing, and implementing national policies, strategies, programs, and
regulations relating to mental health:


() 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;

(©) Protect the rights and freedoms of persons with psychiatric, neurologic, and psychosocial
health needs; and

(d) Strengthen information systems, evidence and research for mental health.
Section 4. Definitions. For the purposes of this Act, the following definitions shall apply:

(@) "Confidentiality" means ensuring that the personal and health information
related to persons with psychiatric, neurologic, and psychosocial health
needs is kept private, safe from access or use by or disclosure to persons or
entities who are not authorized to access, use, or possess such information.

(6) "Discrimination" means any distinction, exclusion or restriction which has
the purpose or effect of impairing or nullifying the recognition or exercise,
onan equal basis with others, of all human rights and fundamental
freedoms.

(c) “Informed Consent" refers to the voluntary acceptance of a plan for
treatment by a service user who is not mentally incapacitated, after full
disclosure by the attending mental health professional of information
regarding the plan of treatment, its risks, benefits, and available
alternatives.

(d) "Legal Representative" refers to a person who is designated by the service user or
appointed by a court of competent jurisdiction, to act as a ‘supported or substitute decision
maker.

(©) “Mental Disorder" 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 psychiatric and neurologic disorders shall be based
on scientifically accepted medical nomenclature.

(0) "Mental Health" refers to a state of psychosocial well-being in which the
individual realizes his or her own abilities, 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.

(g) "Mental Health Facility" refers to any establishment, or any unit of an establishment,
which has, as_— its primary function the _— provision of mental
health care or services.



(h) "Mental Health Professional” refers to a medical doctor, _ clinical
Psychologist, nurse, social worker or any other appropriately trained and
qualified person with specific skills relevant. to the provision of mental
health services.

(@ "Mental Health Services" refer to psychosocial, psychiatric or neurologic activities and
Programs along the whole range of the mental health support spectrum. including
enhancement, prevention, treatment, and aftercare.

(@ "Mental Health Workers" refer to trained personnel, volunteers or advocates engaged in
mental health promotion, providing services under the supervision of a mental health
professional

(k) "Mental Incapacity” refers to medically determined, temporary or permanent inability on
the part of a service user or any other person affected by a mental disorder, to:

(i Understand information given concerning the nature of a mental disorder;

(ii) Understand the consequences of one's decisions and actions on one's
life or health, or the life or health of others;

(iii) Understand information about the nature of the treatment proposed,
including methodology, direct effects, and possible side-effects; and

(iv) Effectively communicate consent to treatment or hospitalization,
or information regarding one’s own condition.

() "Psychiatric Emergencies" refer to conditions Presenting a serious and immediate threat to
the health and well-being of a service user or any other person affected by a mental disorder,
or to the health and well-being of others, such as, but not limited to, threatened or attempted
suicide, acute intoxication, severe depression, acute psychosis, or violent behavior, requiring
immediate psychiatric intervention.

(m) "Psychosocial Problem" 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.

(n) "Service User" refers to a person receiving psychiatric, neurologic, or psychosocial
services or care.

(0) "Substituted Decision Making" is the act of making decisions on behalf of a service user
in situations where the latter has been assessed by a mental health professional to be mentally
incapacitated, consistent with the service user's written directives, if available.

(p) "Supported Decision Making" is the act of assisting a service user who retains decision-
making ability, or who is not otherwise mentally incapacitated as defined herein, in
coherently expressing a mental health-related preference, intention or decision


ARTICLE Il

Rights of Persons with Mental Health Needs, their Families & Legal Representatives,
and Mental Health Professionals

Section 5. Rights of Persons with Mental Health Needs. Without Prejudice to the provisions
of this Act or any other applicable law, a service user or any other person with mental health
needs shall have the right to:

(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 national, ethnic, or social origin of the service user
concemed;

(c) Received evidence-based or informed treatment of the same standard and quality as
that of other persons similarly situated, regardless of age, sex, socioeconomic status, race,
ethnicity or sexual orientation:

(d) Access essential health and social services that enable them to recover and
achieve the highest attainable standard of mental health without risk of
impoverishing themselves or their families;

(e) Receive mental health services at all levels of the health care systems;

(0) _ Receive comprehensive and coordinated treatment that integrates holistic prevention,
promotion, rehabilitation, care and support aimed at addressing mental and physical
health care needs and facilitating recovery, through a multi-disciplinary, user-driven
treatment and recovery plan;

(g) Psychosocial care and clinical treatment in the least restrictive environment and
manner,

(h) Humane treatment free from solitary confinement, torture, and cruel, inhumane,
harmful or degrading treatment;

wo Aftercare and rehabilitation within the community whenever possible for the
purpose of facilitating social reintegration:

@ Adequate information regarding psychosocial and clinical assessments and
available multidisciplinary health services;

(b) Participate in mental health advocacy, policy, planning, legislation, service
provision, monitoring, research and evaluation;

(@ Confidentiality of all information, communications, and records, 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 the third parties without the written consent of the
service user concemed or the service user’s legal representative, unless;

@ Such disclosure or required by law or pursuant to an order issued by a court of
competent jurisdiction;

(i) A life-threatening emergency exists and such disclosure is necessary to prevent harm
or injury to the service user or to other persons;

(iii) ‘The service user is a minor and the attending mental health professional reasonably
believes that the service user is a victim of child abuse:

(iv) Such disclosure is required in connection with an administrative, civil, or criminal
ase against a mental health professional or worker for negligence or a breach of professional
ethics, to the extent necessary to completely adjudicate settle, or resolve any issue or
controversy involved therein; or

(v) Such disclosure is in the interest of public safety or national security.

(@ Give informed consent before treatment or care is provided, including the right to
withdraw such consent. Such consent shall be recorded in the service user’s
clinical record;

(k) Participate in the development and formulation of the psychosocial care or
clinical treatment plan to be implemented:

() Unless the service user has been determined or declared to be mentally
incapacitated, designate or appoint a person of legal age to act as his or legal
representative through a notarized document executed for that purpose. If the
service user has been determined or declared to be mentally incapacitated, or
otherwise fails to designate or appoint a legal representative, the following
persons shall act as the service user’s legal representative, in order of preference

(i) The spouse, if any, unless permanently separated from the service user by a decree
issued by a court of competent jurisdiction, or unless such spouse has abandoned or been
abandoned by the service user for any period which has not yet come to an end:

(ii) Non-Minor Children;

(iii) Either parent appointed by mutual consent, if the service user is not a minor; or
(iv) person appointed by the court.

(m) Legal representation, through competent counsel of the service user's choice. In
case the service user cannot afford the services of counsel, the Public Attorney’s
Office, or a legal aid institution of the service user or representative's choice,
shall assist the service user;


(n) Access to their clinical records unless, in the opinion of the attending mental health
professional, revealing such information would cause harm to the service user’s health or put
the safety of others at risk When any such clinical records are withheld, the service user or
his or her legal representative may contest such decision with the internal review body
created pursuant to this Act authorized to investigate and resolve disputes, or with the
Commission on Human Rights; and

(0) Information, within twenty-four (24) of admission to a mental health facility, of the rights
enumerated in this section in a form and language understood by the service user

Section 6. Rights of Family Members and Legal Representatives. The family members and
duly designated or appointed legal representative of the service user shall have the right to:

(a) Receive appropriate psychosocial support from the relevant government agencies:

(b) With the consent of the concerned service user, Participate in the formulation,
development, and implementation of the service user’s individualized treatment plan;

(©) Apply for release and transfer of the service user to an appropriate mental health facility;
and

(4) Participate in mental health advocacy, policy, planning, legislation, service provision,
monitoring, research and evaluation.

Section 7. Rights of Mental Health Professionals. Mental health professionals shall have
the right to:

(a) A safe and supportive work environment;
() Continuous education and training:
(©) Participate in the planning, development, and management of mental health services:

(4) Contribute to the development and regular review of standards for evaluating mental
health services provided to service users;

(€) Participate in the development of mental health policy and service delivery guidelines:

(0) Except in emergency situations, manage and control all aspects of his or her practice,
including whether or not to accept or decline a service user for treatment; and

(g) Advocate for the rights of a service user, in cases where the service user’s wishes are at
‘odds with those of his family or legal representative.

ARTICLE II
Duties & Responsibilities of Government Agencies

Section 8. Duties and Responsibilities of the Department of Health (DOH). To achieve the
Policy and objectives of this Act, the DOH shall


(a) Formulate, develop, and implement a national mental health program;

(b) Ensure that a safe, therapeutic, and hygienic environment with sufficient privacy exists in
all mental health facilities and, for this purpose, shall be responsible for the regulation,
licensing, monitoring, and assessment of all mental health facilities;

(©) Integrate mental health into the routine health information system and identify, collate,
routinely report and use core mental health data disaggregated by sex and age, and health
outcomes, including data on completed and attempted suicides, in order to improve mental
health service delivery, promotion and prevention strategies;

(d) Improve research capacity and academic collaboration on national priorities for research
in mental health, particularly operational research with direct relevance to service
development and implementation and the exercise of human rights by persons with mental
disorders, including the establishment of centers of excellence:

(©) Ensure that all public and private mental health institutions uphold the right of patients to
be protected against torture or cruel, inhumane, and degrading treatment:

(® 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 affected by mental disorders;

(g) Prohibit forced or inadequately remunerated labor within mental health facilities, unless
such labor is justified as part of an accepted therapeutic treatment program; and

(h) Develop alternatives to _institutionalization, particularly community-based
approaches 0 treatment aimed at receiving patients discharged from
hospitals, meeting the needs expressed by persons with mental health
disorders, and respecting their autonomy, decisions, dignity, and privacy

Section 9. Duties and Responsibilities of the Commission on Human Rights (CHR). The
CHR shall:

(a) Establish mechanisms to investigate, address, and act upon impropriety and abuse in the
treatment and care received by service users, particularly when such treatment or care is
administered or implemented involuntarily;

(b) Inspect mental health facilities to ensure that service users therein are not being subjected
to cruel, inhumane, or degrading conditions or treatment;

(©) _ Investigate all cases involving involuntary treatment, confinement, or care of service
users, for the purpose of ensuring strict compliance with domestic and international standards
respecting the legality, quality, and appropriateness of such treatment, confinement, or care:
and

(d)__ Appoint a focal commissioner for mental health tasked with protecting and promoting
the rights of service users and other persons utilizing mental health services or confined in


mental health facilities, as well as the rights of mental health professionals and workers. The
focal commissioner shall, upon a finding that a mental health facility, mental health
professional, or mental health worker has violated any of the rights provided for in this Act,
take all necessary action to rectify or remedy such violation, including recommending that an
administrative, civil, or criminal case be filed by the appropriate government agency.

Section 10. Duties and Responsibilities of Mental Health Facilities. Mental health facilities
shall:

(a) Establish policies, guidelines, and protocols for minimizing the use of
restrictive care and involuntary treatment;

(b) Inform service users of their rights under this Act and all other Pertinent laws
and regulations;

(©) _ Provide every service user, whether admitted for voluntary or involuntary
treatment, with complete information regarding the plan of treatment to be implemented:

(4) Ensure that informed consent is obtained from service users prior to the
implementation of any medical procedure or plan of treatment or care, except when the
service user concemed is mentally incapacitated, as defined herein:

(©) __ Ensure that involuntarily treatment or restraint, whether physical or chemical,
is only administered or implemented pursuant to the following safeguards and conditions, and
only to the extent that such treatment or restraint is necessary’

(During psychiatric or neurological emergencies;

ii) Upon the order of the services user’s attending physician, which
order must reviewed by a board-certified psychiatrist within one
(month from date issuance, or as soon as possible:

(iii) When all other means of treatment or restraint have proven
“unsuccessful; and

(iv) That such involuntarily medical treatment of restraint shall be: in
strict accordance with guidelines approved by the appropriate
authorities, which must contain clear criteria regulating the
application and termination of such medical intervention; used for
the shortest period of time possible, as assessed by a board-certified
psychiatrist or by the service user's attending physician in the supervision of a
board -certified psychiatrist; and fully documented
and subject to regular external independent monitoring and audit.

(0) Maintain a register containing information on all medical treatments and
Procedures involuntarily administered to service users:

() Ensure that legal representatives are designated or appointed only after the
requirements of this Act and the procedures established for the purpose have been observed,


which procedures should respect the autonomy and preferences of the patient as far as
possible; and

(b) _ Establish an internal review body to monitor and ensure compliance with the
Provisions of this Act, as well as receive, investigate, resolve, and act upon complaints
brought by service users or their families and legal representatives against the mental health
facility or any mental health professional or worker.

ARTICLE IV
Community Mental Health Services

Section 11. Community Mental Health Services. Within the general health care system, the
following mental health services shall be developed and integrated into the primary health
care system at the community level

(a) Basic mental health services , which shall be made available at all local
government units down to the barangay level:

(b) Community resilience and psychological well-being training in all barangays,
including the availability of mental health and psychosocial support services during and after
natural disasters and other calamities;

(©) Training and capacity-building programs for local mental health workers in
Coordination with mental health facilities and departments of psychiatry in general or
university hospitals

(d) Support services for families and co-workers of service users, mental health
professionals, and mental health worker; and

(©) _ Dissemination of mental health information and promotion of mental health
awareness among the general population.

Section 12. Psychiatric, Psychosocial, and Neurologic Services in Regional, Provincial,
and Tertiary Hospitals. All regional, provincial, and tertiary hospitals shall provided the
following psychiatric, psychosocial and neurologic services

() Short-term, in patient hospitals care in a small psychiatric ward for services
user exhibiting acute psychiatric symptoms;

(b) Partial hospital care for those exhibiting psychiatric symptoms or experiencing
difficulties vis-i-vis their personal and family circumstances;

() Out-patient services in close collaboration with existing mental health
programs at primary health centers in the same area;

(d) Home care services for service users with special needs as a result of, among
others, long-term hospitalization, non-compliance with or inadequacy of treatment, and
absence of immediate family;


(e) Coordination with drug rehabilitation centers vis-a-vis the care, treatment, and
rehabilitation of persons suffering from addiction and other substance-induced mental
disorders; and

(© _ 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.

ARTICLE V
Education, Research, and Development

Section 13. Integration of Mental Health into the Educational System. The State shall
ensure the integration of the mental health into the educational system, as follows:

(a) _ Age-appropriate content pertaining to mental health shall be integrated into the
curriculum at all educational levels; and

(b) Psychiatry and neurology shall be a required subjects in all medical and allied
health courses, including post-graduate courses in health.

Section 14. Capacity- Building, Reorientation, and Training. In close coordination with
mental health facilities, and the departments of psychiatry in general and university hospitals,
mental health professionals and workers shall undergo capacity-building, reorientation, and
training to develop their ability to deliver evidence-based, culturally-appropriate and human
rights-oriented mental health services, with an emphasis on the community and public health
aspects of mental health.

Section 15. Research and Development. Research and development shall be undertaken, in
collaboration with academic institutions, psychiatric, neurologic, and related associations,
and non-government organizations, to produce the information, evidence, and research
Necessary to formulate and develop a culturally relevant national mental health program
incorporating indigenous concepts and practices related to mental health.

High ethical standards in mental health research shall be promoted to ensure that: research is
conducted only with the free and informed consent of the persons involved; researchers do
ot receive any privileges, compensation or remuneration in exchange for encouraging or
recruiting participants; potentially harmful or dangerous research is not undertaken; and all
research is approved by an independent ethics committee, in accordance with applicable law.

ARTICLE VI
Miscellaneous Provisions
Section 16. Implementing Rules & Regulations. The Secretary of Health shall issue the

Implementing Rules & Regulations necessary for the effective implementation of this Act
within ninety (90) days from the effectivity thereof.


Section 17. Appropriations. The amount necessary for the initial implementation of the
provisions of this Act shall be charged against the current year’s appropriations of the
Department of Health. Thereafter, five percent (5%) of the annual excise tax on alcohol and
tobacco products collected by the government shall be earmarked for the implementation of
this Act.

Section 18 Separability Clause. If a court of competent jurisdiction declares any provision
of this Act unconstitutional or invalid, the remaining provisions not affected thereby shall
continue to be in full force and effect

Section 19. Repealing Clause. All laws, decrees, executive orders, department or
memorandum orders and other administrative issuances or parts thereof which are
inconsistent with the provisions of this Act are hereby modified, superseded or repealed
accordingly.

Section 20. Effectivity. This Act shall take effect fifteen (15) days after publication in the
Official Gazette or in at least two (2) newspapers of general circulation.

APPROVED.