Senators admitted on Tuesday that there are “issues” in the implementation of Republic Act (RA) 11036 or the Philippine Mental Health Act.

Senator Christopher Lawrence Go cited the distressing situation at the National Center for Mental Health (NCMH) in Mandaluyong City.

Senator Raffy Tulfo conducted a surprise ocular inspection at the NCMH in early April after receiving a tip on the worsening condition of the hospital.

“Ako rin po ay ilang beses na bumisita sa ilang mental health facilities noon at saksi po ako sa kawawang kalagayan ng mga pasyente doon (I have visited numerous times some mental health facilities before and I witnessed the pitiful situation of the patients there),” Go, chair of the Committee on Health and Demography, said during the panel’s oversight hearing.

“The state of the National Center for Mental Health is in need of utmost attention and improvement to preserve the basic right of all Filipinos to healthcare. How can we decongest NCMH in order to improve its current state? Where can we transfer recovered patients who have nowhere to go,” he asked.

In a news release, Tulfo reported a female ward that smelled of feces and urine, made even awful by the smell of garbage dumped outside.

The Forensic Ward that houses patients with pending cases was cramped, has inadequate ventilation and only has two ceiling fans.

Former president Rodrigo Duterte signed RA 11036 on June 20, 2018, a bill principally authored by Senator Risa Hontiveros.

The law establishes the National Mental Health Policy directed towards improving the mental health of Filipinos and underscores the right of all to mental health care.

Specifically, it aims to provide mental health services to the community level and integrate mental health and wellness programs to the grassroots.

RA 11036 also seeks to improve facilities and promote mental health education in schools and workplaces.

Senator Sherwin Gatchalian, who chairs the Committee on Basic Education, said he will soon sponsor a bill that will go deeper into the mental health and wellness programs of basic education institutions.

“This hearing is timely because in Section 23 of RA 11036, it’s mentioned there explicitly that the integration of mental health into the education system is mandatory as described in the law. But if you read the law very carefully, it gave you a broad framework on what to go into. But on the detail of what programs; who will implement the programs; what are the bottlenecks to implement the programs are missing,” Gatchalian noted.

The lawmaker explained that his bill will complement RA 11036 to address the bottlenecks and identify the agency which will implement the mental health and wellness programs in schools.

“We all know that we have 60,000 schools nationwide but we only have 1,500 registered guidance counselors in our country. So, obviously there is a massive shortage in terms of the personalities who implement mental health programs in our schools,” Gatchalian said.

Stigma

During the hearing, Go and Gatchalian stressed the importance of addressing mental health like other health concerns.

Sadly, Go said many still fail to recognize the signs and symptoms, especially among the youth.

“Palagi itong iniiwasang pag-usapan dahil kadalasan nahihiya sila sa posibilidad na ma-discriminate sila ng tao. Umpisa pa lang ng pandemya, marami na pong naiiulat na nakaka-experience ng depression dahil marami talagang naapektuhan, nawalan ng kabuhayan, nawalan ng mahal sa buhay (This issue is being avoided because many are ashamed of the possibility that they will be discriminated by people. During the start of pandemic, many were reported to have experienced depression, those who lost their livelihood, their loved ones),” Go said.

He also cited the Department of Education report that 404 learners from public schools committed suicide and 2,147 learners attempted to take their own lives in 2021.

Gatchalian noted that mental health is “not well understood” by ordinary people who sometimes think sleeping or eating will take their problems away.

“It’s actually deeper than that,” he said. “We have to admit that mental health is severe condition in our country not only for those who can afford medical treatments but also for our less fortunate constituents who need government intervention in order to deliver assistance to them.”

Implementation

The 2023 national budget approved PHP1.86 billion for mental health medicines and PHP12 million for mental health awareness campaign and establishment of a hotline under the Department of Health (DOH).

It includes a special provision for the improvement of benefit packages of the Philippine Health Insurance Corporation, including mental care.

“It is therefore my continuing call for stronger government interventions particularly on the provision of psychosocial services,” he said.

Dr. Razel Nikka Hao, DOH Disease Prevention and Control Bureau director, reported to the committee that since RA 11036 was passed, 62 of their personnel were trained on Basic Institutional Review Board (IRB); 51 as future trainers for IRB; 1,556 completed the World Health Organization Quality Rights e-training; 28 with Lived Experiences completed the course on mental health advocacy and leadership (pilot implementation); and over about 40 media practitioners were trained on responsible and ethical reporting and portrayal of suicide (pilot implementation).

Hao also reported there are already 362 access sites nationwide covering 27 priority mental health medicines with over 124,000 service users in 2022.

“The health facilities ratified network has included 75 mental health facilities across the country. 23 of which to be specialty care centers, 52 as acute and custodial care facilities. We also currently maintain with NCMH the mental health hotline with over 53,000 community calls from 2019 to 2022,” she said. (PNA)