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=The Proposed "National Mental Health Act of 2009": A Critical Evaluation =



PSYCH11 Paper (Group 5)
Date Received: September 19, 2009**
 * Received by: Erlinda Manarin (UP Manila LC Coordinator)

Introduction
  Cases of mental disorder are widespread in the Philippines. Patients and their families alike are affected by the afflicting mental illness emotionally, mentally, and financially. Persistent economic crisis in the country along with its topographic vulnerability to disaster makes the Filipino Citizenry vulnerable to mental illnesses and disorders. Natural disasters, tragic events and experiences, death of love ones, child abuse, and domestic violence may affect one’s behavior and may later manifest symptoms of having mental disorder. Recently, our country suffered from economic crisis, political instability and recession which greatly affected millions of Filipinos. It has been a constant problem of the Philippines for a long time but its excruciating effect was felt on the last part of 2007 up to present. Filipinos are groaning more and more because of poverty. Specially in the current economic climate there are reports of cases like suicide and killing of their own families for lose of hope and fear that they might not provide a good living and future to them. Just in time with the global recession, rising poverty, and intensifying pressure from current demands, the Philippine House of Representatives have finally drafted the bill to focus on the rising cases of mental health and illness- House Bill 6679, also known as the National Mental Health Care Act of 2009.

The said bill, filed by House Speaker Prospero Nograles and Representative Arthur Pingoy, is the country’s first attempt of legislation focusing on mental health and illness. Review of current laws in the Philippines shows that issues related to mental health are only touched upon by several codes, rules and procedures but there had been no single legislation addressing mental health as a primary topic, (Review of Existing Mental Health Laws and Legislation). The proposal came six years after the World Health Organization issued the Mental Health Legislation Policy and Service Guidance Package in 2003 and four years after the WHO-AIMS (World Health Organization Assessment instrument for Mental Health Systems) in 2005.  Good mental health means balancing the social, physical, spiritual and emotional aspects of one’s life. To maintain good mental health include getting sufficient sleep, eating well, keeping fit, making time to do the things you enjoy, spending time with friends, laughing, volunteering, giving and accepting compliments, really listening to others, and not being too hard on yourself when you make mistakes. Mental health should be given priority because it “represents one of the last frontiers in the improvement of the human condition.”[|[1]]

Mental health is the state of well-being in which an individual is able to fulfill his potential in every stage of his development at work and in his relationships, copes with day to day and extraordinary stresses of life and contributes to his community[|[2]].

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 causes manifested by genetic, biochemical abnormalities and associated medical conditions and psychosocial factors in the environment which impacts on the individual.[|[3]] 

 Around the world, a reported 75% of countries have mental health legislation. (revie of related mental health laws). However, according to research, countries spend little on mental health, especially developing countries. Developing contries like the Philippines spends as less as 1% of their Gross Domestic Product while developed countries spend about 5% of their GDP.

This paper is concerned primarily with checking House Bill 6679’s compliance with The WHO Mental Health Policy and Service and Guidance package (WHO,2003). The package provided practical information to assist countries to improve the mental health situation in the country’s/ region’s citizenry. The paper secondarily aims to produce some contrasts with some mental health legislations in other countries deemed successful with lowering incidence of mental health disorders. 

[|[1] ]  //Awake! //, April 8, 2008, p. 29  [|[2] ] <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 10pt;"> House Bill 6679, par. 2 <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 10pt;"> [|[3] ] <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 10pt;"> House Bill 6679, par. 3 <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 10pt;">

II. Mental Health and the Government <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 10pt;"> According to the World Health Organization (2007), "Mental health is not just the absence of mental disorder. It is defined as 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 a contribution to her or his community".

The National Mental Health Program Mental of the National Center for Disease Prevention and Control under the Department of Health (DOH) states that mental health is an integral component of total health. Issues on mental health includes not only the traditional mental disorders but as important are the concerns of target populations vulnerable to psychosocial risks brought about by extreme life experiences (e.g. disasters, near death experiences, heinous and violent crimes, internal displacement brought about by religious and civil unrest) as well as the psychosocial concerns of daily living (e.g. maintaining a sense of well being in these difficult times) (DOH, 2007).

The 1987 Philippine Constitution states on Article XIII, Section 11 that the "State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost. There shall be priority for the needs of the under-privileged, sick, elderly, disabled, women, and children. The State shall endeavor to provide free medical care to paupers." This is our country's responsibility to it's constituent. As a member of this nation, citizens have the right to have access to goods, health and other social services that are affordable or even free. However, in the Philippines’ laws, it can be noted that no legislation has been directly concerned with mental health as an isolated concerned but was just incorporated in codes and rules subordinate to other primary concerns. For instance, Family code of 1988, article 45 paragraph 2, In this code, mental disorder is to be a valid ground for annulment. Also in the case of Act No. 3815, as amended (1926): The revised Penal Code, wherein an imbecile or insane person was exempted from any criminal liability and be confined in a mental institution.

WHO has outlined the guidance package so that legislation be made to protect the rights of the people with mental health disorders who are vulnerable to face social stigma, discrimination and marginalization in all societies. The organization had made it clear that common misconceptions, like the danger of mental health patient to society, should not be allowed to influence mental health legislation. Legislation is also expected to play an important role on the promotion of mental health and the prevention of mental disorders

WHO identifies two ways of forming Mental Health Legislation. It can be in the form of consolidated legislation which makes the provisions easy to adopt and enactment without the need for multiple amendmentsto existing laws. The process alone of drafting, adopting and implementing this type of legislation provides opportunity to raise public awareness about mental health and illnesses. However, the concerning part of which is that consolidated legislation can also give way to further segregation of mental health patients.

One way to avoid such discrimination, according to WHO, is to insert mental health provisions related to mental health into other legislations. On the other hand, this is advantageous in aspects where the consolidated type would be successful.

<span style="color: red; font-family: 'Arial','sans-serif'; font-size: 10pt;">It should be cited, however, that even though there are distinctions, the Organization says that one is better than the other and the complexity of mental health problems would most likely be addressed by a combination of the two. WHO also reiterates that mental health legislation should not just be a one-time event but a continuing process that should suit the call of the times with initiative to amend existing provisions (review of existing mental health laws). <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 10pt;"> III. The Problem of Mental Health in the Philippines The number of psychiatric beds in the Philipppines is .09 per 10,000 individuals as compared to 0.6 and 28.4 per 10,000 individuals in Iraq and Japan respectively. 77% of these beds in the Philippines are located in the National Capital region (NCR). As result of low budget appropriations, psychopharmacologic medicines in the Philippines, though listed in the county’s list of essential drugs, are often in short supply. Eventhough there is a mental health policy signed and promulgated during in 1998 which outlines the creation the Philippine Council for Mental Health, it is still being hampered primarily by a miniscule budget, that is 0.02% of the country’s total health budget, which is only 3% of the country’s GDP. The said council never convened (Reyes,_ __)A factor being seen why the country giving little attention, and funding to mental health illnesses is the Citizenry’s traditional belief that mental illness is a form of evil possession, sorcery, or bad //karma//. (__ __[]__ __)__

__ IV. Existing Government Programs on Mental Health V. Mental Health Programs VI. Salient Points of House Bill 6679: Mental Health Act of 2009

On The Provisions Directed to Mental Health Care __ On Promoting Deinstitutionaliization of Mental Health Care __ = <span style="color: red; font-family: 'Arial','sans-serif'; font-size: 12pt;"> <span style="color: red; font-family: 'Arial','sans-serif'; font-size: 12pt; font-weight: normal;">Quite obviously, the deinstitutionalization, or the treatment of mental disorders outside of mental hospitals and bringing them back into their community before they became mentally afflicted, aims to reduce the social stigma and myths associated with mental disorders. On a more in-depth view of this move, social stigma and exclusion that comes with other people’s preoccupation just reinforces their problems, pushing them further into isolation, then into further illness. Dr. Benedetto Serrano, Director of the WHO Mental Health and Substance Abuse Department, said that aside from the accessibility of community mental health care to severe patients, this particular kind of environment is more effective in taking care of patients’ needs compared when they to be in a confined asylum setting. Still according to him, human right violations would be lessened ( <span style="color: red; font-family: 'Arial','sans-serif'; font-size: 12pt;">Community mental health services will lessen social exclusion, says WHO <span style="color: red; font-family: 'Arial','sans-serif'; font-size: 12pt; font-weight: normal;">). This may be quite true as family, friends, and the community in general would be in check what professionals and attendants are doing as compared to when patients would be confined in asylums which are dominated by people unrelated to the patient beyond the public eye. Whence, they are unchecked and cannot be controlled by anyone but their own conscience. = = As a country taking its time from developing, this provision of the bill helps financially. As previously mentioned, WHO has proven that the integration of mental health care in the community setting makes treatment faster. This, then, would lessen costs in treatment and operational costs that can be expected to be of proportion to the size of the institution (i.e, bed capacity and trained mental health professionals and workers) whence a patient to be maintained. Putting patients in outpatient care and live with their own communities, except in cases where there “exists a serious likelihood of danger of harming himself or others”, would also allow mental health professionals and workers to extend their practice to more needy patients because they can draw their attention away from them when the patients go home with their families or friends. = = = <span style="color: red; font-family: 'Arial','sans-serif'; font-size: 12pt;"> Latest word count on KFMT41’s posting: approximately 1,876 <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 12pt;"> <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18pt;">

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