S. No. 1354
H. No. 6452
Republic of the Philippines
Congress of the Philippines
Metro Manila
Seventeenth Congress
Second Regular Session
Begun and held in Metro Manila, on Monday, the
twenty-fourth day of July, two thousand seventeen.
[REPUBLIC ACT No. 11036]
AN ACT ESTABLISHING A
NATIONAL MENTAL HEALTH
POLICY FOR THE PURPOSE OF
ENHANCING THE DELIVERY OF INTEGRATED MENTAL HEALTH SERVICES, PROMOTING AND
PROTECTING THE RIGHTS OF PERSONS UTILIZING PSYCHIATRIC, NEUROLOGIC, AND
PSYCHOSOCIAL 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:
CHAPTER I
GENERAL PROVISIONS
SECTION 1. Short
Title. - This Act shall be known as the "Mental Health Act"
SEC. 2.
Declaration of Policy. - The State affirms the basic right of all
Filipinos to mental health as well as the fundamental rights of people who
require mental health services.
The State commits itself to
promoting the well-being of people by ensuring that: mental health is valued,
promoted and protected; mental health conditions are treated and prevented;
timely, affordable, high-quality, and culturally appropriate mental health care
is made available to the public; mental health services are free from coercion
and accountable to the service users; and persons affected by mental health
conditions are able to exercise the full range of human rights, and participate
fully in society and at work, free from stigmatization and discrimination.
The State shall comply strictly
with its obligations under the United Nations Declaration of Human Rights, the
Convention on the Rights of Persons with Disabilities, and all other relevant
international and regional human rights conventions and declarations. The
applicability of Republic Act No. 7277, as amended, otherwise known as the
"Magna Carta for Disabled Persons", to persons with mental health conditions,
as defined herein, is expressly recognized.
SEC. 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;
(b) 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;
(c) Protect the rights and
freedoms of persons with psychiatric, neurologic, and psychosocial health
needs;
(d) Strengthen information
systems, evidence and research for mental health;
(e) Integrate mental health care
in the basic health services; and
(f) Integrate strategies
promoting mental health in educational institutions, the workplace, and in
communities.
SEC. 4.
Definitions. - As used in this Act, the following terms are defined
as follows:
(a) Addiction refers to a primary
chronic relapsing disease of brain reward, motivation, memory, and related
circuitry. Dysfunctions in the circuitry lead to characteristic biological,
psychological, social, and spiritual manifestations. It is characterized by the
inability to consistently abstain impairment and behavioral control, craving,
diminished recognition of significant problems with one's behavior and
interpersonal relationships and a dysfunctional emotional response;
(b) Carer refers to the person,
who may or may not be the patient's next-of-kin or relative, who maintains a
close personal relationship and manifests concern for the welfare of the
patient;
(c) Confidentiality refers to
ensuring that all relevant information related to persons with psychiatric,
neurologic, and psychosocial health needs is kept safe from access or use by,
or disclosure to, persons or entities who are not authorized to access, use, or
possess such information;
(d) Deinstitutionalization refers
to the process of transitioning service users, including persons with mental
health conditions and psychosocial disabilities, from institutional and other
segregated settings, to community-based settings that enable social
participation, recovery-based approaches to mental health, and individualized
care in accordance with the service user's will and preference;
(e) Discrimination refers to any
distinction, exclusion or restriction which has the purpose or effect of
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. Special measures
solely to protect the rights or secure the advancement of persons with
decision-making impairment capacity shall not be deemed to be discriminatory;
(f) Drug Rehabilitation refers to
the processes of medical or psychotherapeutic treatment for dependency on
psychoactive substances such as alcohol, prescription drugs, and other
dangerous drugs pursuant to Republic Act No. 9165, otherwise known as the
“Comprehensive Dangerous Drugs Act of 2002". Rehabilitation process may
also be applicable to diagnosed behavioral addictions such as gambling,
internet and sexual addictions. The general intent is to enable the patient to
confront his or her addiction/s and cease substance abuse to avoid the
psychological, legal, financial, social, and physical consequences. Treatment
includes medication for co-morbid psychiatric or other medical disorders,
counseling by experts and sharing of experience with other addicted
individuals;
(g) Impairment or Temporary Loss
of Decision-Making Capacity refers to a medically-determined inability on the
part of a service user or any other person affected by a mental health
condition, to provide informed consent. A service user has impairment or
temporary loss of decision-making capacity when the service user as assessed by
a mental health professional is unable to do the following:
(1)
Understand information concerning the nature of a mental health condition;
(2)
Understand the consequences of one's decisions and actions on one's life or
health, or the life or health of others;
(3)
Understand information about the nature of the treatment proposed, including
methodology, direct effects, and
possible side effects; and
(4) Effectively communicate consent to
treatment or hospitalization, or information regarding one's own condition;
(h) Informed Consent refers to
consent voluntarily given by a service user to a plan for treatment, after a
full disclosure communicated in plain language by the attending mental health
service provider, of the nature, consequences, benefits, and risks of the
proposed treatment, as well as available alternatives;
(i) Legal Representative refers
to a person designated by the service user, appointed by a court of competent
jurisdiction, or authorized by this Act or any other applicable law, to act on
the service user's behalf. The legal representative may also be a person
appointed in writing by the service user to act on his or her behalf through an
advance directive;
(j) Mental Health refers to a
state of well-being in which the individual realizes one's own abilities and
potentials, 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;
(k) Mental Health Condition
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 neurologic and
psychiatric conditions shall be based on scientifically-accepted medical
nomenclature and best available scientific and medical evidence;
(l) Mental Health Facility refers
to any establishment, or any unit of an establishment, which has, as its
primary function, the provision of mental health services;
(m) Mental Health Professional
refers to a medical doctor, psychologist, nurse, social worker or any other
appropriately-trained and qualified person with specific skills relevant to the
provision of mental health services;
(n) Mental Health Service
Provider refers to an entity or individual providing mental health services as
defined in this Act, whether public or private, including, but not limited to,
mental health professionals and workers, social workers and counselors, peer
counselors, informal community caregivers, mental health advocates and their
organizations, personal ombudsmen, and persons or entities offering nonmedical
alternative therapies;
(o) Mental Health Services refer
to psychosocial, psychiatric or neurologic activities and programs along the
whole range of the mental health support services including promotion,
prevention, treatment, and aftercare, which are provided by mental health
facilities and mental health professionals;
(p) Mental Health Worker refers
to a trained person, volunteer or advocate engaged in mental health promotion,
providing support services under the supervision of a mental health
professional;
(q) Psychiatric or Neurologic
Emergency refers to a condition presenting a serious and immediate threat to
the health and well-being of a service user or any other person affected by a
mental health condition, or to the health and well-being of others, requiring
immediate medical intervention;
(r) 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;
(s) Recovery-Based Approach
refers to an approach to intervention and treatment centered on the strengths
of a service user and involving the active participation, as equal partners in
care, of persons with lived experiences in mental health. This requires
integrating a service user's understanding of his or her condition into any
plan for treatment and recovery;
(t) Service User refers to a
person with lived experience of any mental health condition including persons
who require, or are undergoing psychiatric, neurologic or psychosocial care;
(u) Support refers to the
spectrum of informal and formal arrangements or services of varying types and
intensities, provided by the State, private entities, or communities, aimed at
assisting a service user in the exercise of his or her legal capacity or
rights, including: community services; personal assistants and ombudsmen;
powers of attorney and other legal and personal planning tools; peer support;
support for self-advocacy; nonformal community caregiver networks; dialogue
systems; alternate communication methods, such as nonverbal, sign,
augmentative, and manual communication; and the use of assistive devices and
technology; and
(v) Supported Decision Making
refers to the act of assisting a service user who is not affected by an
impairment or loss of decision-making capacity, in expressing a mental health-related
preference, intention or decision. It includes all the necessary support,
safeguards and measures to ensure protection from undue influence, coercion or
abuse.
CHAPTER II
RIGHTS OF SERVICE USERS AND OTHER STAKEHOLDERS
SEC. 5. Rights of
Service Users. - Service users shall enjoy, on an equal and
nondiscriminatory basis, all rights guaranteed by the Constitution as well as
those recognized under the United Nations Universal Declaration of Human Rights
and the Convention on the Rights of Persons with Disabilities and all other
relevant international and regional human rights conventions and declarations,
including 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 nationality, ethnic, or social
origin;
(c) Access to evidence-based
treatment of the same standard and quality, regardless of age, sex,
socioeconomic status, race, ethnicity or sexual orientation;
(d) Access to affordable
essential health and social services for the purpose of achieving the highest
attainable standard of mental health;
(e) Access to mental health
services at all levels of the national health care system;
(f) Access to comprehensive and
coordinated treatment integrating holistic prevention, promotion,
rehabilitation, care and support, aimed at addressing mental health care needs
through a multidisciplinary, user-driven treatment and recovery plan;
(g) Access to psychosocial care
and clinical treatment in the least restrictive environment and manner;
(h) Humane treatment free from
solitary confinement, torture, and other forms of cruel, inhumane, harmful or
degrading treatment and invasive procedures not backed by scientific evidence;
(i) Access to aftercare and
rehabilitation when possible in the community for the purpose of social
reintegration and inclusion;
(j) Access to adequate
information regarding available multidisciplinary mental health services;
(k) Participate in mental health
advocacy, policy planning, legislation, service provision, monitoring, research
and evaluation;
(l) Confidentiality of all information,
communications, and records, in 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 third parties without the written consent of
the service user concerned or the service user's legal representative, except
in the following circumstances:
(1)
Disclosure is required by law or pursuant to an order issued by a court of
competent jurisdiction;
(2)
The service user has expressed consent to the disclosure;
(3)
A life-threatening emergency exists and such disclosure is necessary to prevent
harm or injury to the service user or to other persons,
(4)
The service user is a minor and the attending mental health professional
reasonably believes that the service user is a victim of child abuse; or
(5)
Disclosure is required in connection with an administrative, civil, or criminal
case 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;
(m) Give informed consent before
receiving treatment or care, including the right to withdraw such consent. Such
consent shall be recorded in the service user's clinical record;
(n) Participate in the
development and formulation of the psychosocial care or clinical treatment plan
to be implemented;
(o) Designate or appoint a person
of legal age to act as his or her legal representative in accordance with this
Act, except in cases of impairment or temporary loss of decision-making
capacity;
(p) Send or receive uncensored
private communication which may include communication by letter, telephone or
electronic means, and receive visitors at reasonable times, including the
service user's legal representative and representatives from the Commission on
Human Rights (CHR);
(q) Legal services, through
competent counsel of the service user's choice. In case the service user cannot
afford the services of a counsel, the Public Attorney's Office, or a legal aid
institution of the service user or representative's choice, shall assist the
service user;
(r) 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 board created pursuant to this Act authorized to
investigate and resolve disputes, or with the CHR;
(s) Information, within
twenty-four (24) hours of admission to a mental health facility, of the rights
enumerated in this section in a form and language understood by the service
user; and
(t) By oneself or through a legal
representative, to file with the appropriate agency, complaints of
improprieties, abuses in mental health care, violations of rights of persons
with mental health needs, and seek to initiate appropriate investigation and
action against those who authorized illegal or unlawful involuntary treatment
or confinement, and other violations.
SEC. 6. Rights of
Family Members, Carers and Legal Representatives. - Family members,
carers 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;
(c) Apply for release and
transfer of the service user to an appropriate mental health facility; and
(d) Participate in mental health
advocacy, policy planning, legislation, service provision, monitoring, research
and evaluation.
SEC. 7. Rights of
Mental Health Professionals. - Mental health professionals shall
have the right to:
(a) A safe and supportive work
environment;
(b) Participate in a continuous
professional development program;
(c) Participate in the planning,
development, and management of mental health services;
(d) Contribute to the development
and regular review of standards for evaluating mental health services provided
to service users;
(e) Participate in the
development of mental health policy and service delivery guidelines;
(f) 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 or her family or legal representative.
CHAPTER III
TREATMENT AND CONSENT
SEC. 8. Informed
Consent to Treatment. - Service users must provide informed consent
in writing prior to the implementation by mental health professionals, workers,
and other service providers of any plan or program of therapy or treatment,
including physical or chemical restraint. All persons, including service users,
persons with disabilities, and minors, shall be presumed to possess legal
capacity for the purposes of this Act or any other applicable law, irrespective
of the nature or effects of their mental health condition or disability.
Children shall have the right to express their views on all matters affecting
themselves and have such views given due consideration in accordance with their
age and maturity.
SEC. 9. Advance
Directive. - A service user may set out his or her preference in
relation to treatment through a signed, dated, and notarized advance directive
executed for the purpose. An advance directive may be revoked by a new advance
directive or by a notarized revocation.
SEC. 10. Legal
Representative. - A service user may designate a person of legal age
to act as his or her legal representative through a notarized document executed
for that purpose.
(a) Functions. A service user's
legal representative shall:
(1)
Provide the service user with support and help; represent his or her interests;
and receive medical information about the service user in accordance with this
Act;
(2)
Act as substitute decision maker when the service user has been assessed by a
mental health professional to have temporary impairment of decision-making
capacity;
(3)
Assist the service user vis-Ã -vis the exercise of any right provided under this
Act; and
(4)
Be consulted with respect to any treatment or therapy received by the service
user. The appointment of a legal representative may be revoked by the
appointment of a new legal representative or by a notarized revocation.
(b) Declining an Appointment. A
person thus appointed may decline to act as a service user's legal
representative. However, a person who declines to continue being a service
user's legal representative must take reasonable steps to inform the service
user, as well as the service user's attending mental health professional or
worker, of such decision.
(c) Failure to Appoint. If the
service user fails to appoint a legal representative, the following persons
shall act as the service user's legal representative, in the order provided
below:
(1)
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;
(2)
Non-minor children;
(3)
Either parent by mutual consent, if the service user is a minor;
(4)
Chief, administrator, or medical director of a mental health care facility; or
(5)
A person appointed by the court.
SEC. 11. Supported
Decision Making. - A service user may designate up to three (3)
persons or "supporters”, including the service user's legal
representative, for the purposes of supported decision making. These supporters
shall have the authority to: access the service user's medical information;
consult with the service user vis-Ã -vis any proposed treatment or therapy; and
be present during a service user's appointments and consultations with mental
health professionals, workers, and other service providers during the course of
treatment or therapy.
SEC. 12. Internal
Review Board. - Public and private health facilities are mandated to
create their respective internal review boards to expeditiously review all
cases, disputes, and controversies involving the treatment, restraint or
confinement of service users within their facilities.
(a) The Board shall be composed of the
following:
(1)
A representative from the Department of Health (DOH);
(2)
A representative from the CHR;
(3)
A person nominated by an organization representing service users and their
families duly accredited by the Philippine Council for Mental Health; and
(4)
Other designated members deemed necessary, to be determined under the
implementing rules and regulations (IRR).
(b) Each internal review board
shall have the following powers and functions:
(1)
Conduct regular review, monitoring, and audit of all cases involving the
treatment, confinement or restraint of service users within its jurisdiction;
(2)
Inspect mental health facilities to ensure that service users therein are not
being subjected to cruel, inhumane, or degrading conditions or treatment;
(3)
Motu proprio, or upon the receipt of a written complaint or petition filed by a
service user or a service user's immediate family or legal representative,
investigate cases, disputes, and controversies involving the involuntary
treatment, confinement or restraint of a service user; and
(4)
Take all necessary action to rectify or remedy violations of a service user's
rights vis-Ã -vis treatment, confinement or restraint, including recommending
that an administrative, civil, or criminal case be filed by the appropriate
government agency.
SEC. 13.
Exceptions to Informed Consent. - During psychiatric or neurologic
emergencies, or when there is impairment or temporary loss of decision-making
capacity on the part of a service user, treatment, restraint or confinement,
whether physical or chemical, may be administered or implemented pursuant to
the following safeguards and conditions:
(a) In compliance with the
service user's advance directives, if available, unless doing so would pose an
immediate risk of serious harm to the patient or another person;
(b) Only to the extent that such
treatment or restraint is necessary, and only while a psychiatric or neurologic
emergency, or impairment or temporary loss of capacity, exists or persists;
(c) Upon the order of the service
user's attending mental health professional, which order must be reviewed by
the internal review board of the mental health facility where the patient is
being treated within fifteen (15) days from the date such order was issued, and
every fifteen (15) days thereafter while the treatment or restraint continues;
and
(d) That such involuntary
treatment or 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, and fully
documented and subject to regular external independent monitoring, review, and
audit by the internal review boards established by this Act.
CHAPTER IV
MENTAL HEALTH SERVICES
SEC. 14. Quality
of Mental Healih Services. - Mental health services provided
pursuant to this Act shall be:
(a) Based on medical and
scientific research findings;
(b) Responsive to the clinical,
gender, cultural and ethnic and other special needs of the individuals being
served;
(c) Most appropriate and least
restrictive setting;
(d) Age appropriate; and
(e) Provided by mental health
professionals and workers in a manner that ensures accountability.
SEC. 15. Mental
Health Services at the Community Level. - Responsive primary mental
health services shall be developed and integrated as part of the basic health
services at the appropriate level of care, particularly at the city, municipal,
and barangay level. The standards of mental health services shall be determined
by the DOH in consultation with stakeholders based on current evidences.
Every local
government unit (LGU) and academic institution shall create their own program
in accordance with the general guidelines set by the Philippine Council for
Mental Health, created under this Act, in coordination with other stakeholders.
LGUs and academic institutions shall coordinate with all concerned government
agencies and the private sector for the implementation of the program.
SEC. 16.
Community-based Mental Health Care Facilities. - The national
government through the DOH shall fund the establishment and assist in the
operation of community-based mental health care facilities in the provinces,
cities and cluster of municipalities in the entire country based on the needs
of the population, to provide appropriate mental health care services, and
enhance the rights-based approach to mental health care.
Each
community-based mental health care facility shall, in addition to adequate
room, office or clinic, have a complement of mental health professionals,
allied professionals, support staff, trained barangay health workers (BHWs),
volunteer family members of patients or service users, basic equipment and
supplies, and adequate stock of medicines appropriate at that level.
SEC. 17.
Reportorial Requirements. - LGUs through their health offices shall
make a quarterly report to the Philippine Council for Mental Health through the
DOH. The report shall include, among others, the following data: number of
patients/service users attended to and/or served, the respective kinds of
mental illness or disability, duration and result of the treatment, and
patients/service users' age, gender, educational attainment and employment
without disclosing the identities of such patients/service users for
confidentiality.
SEC. 18.
Psychiatric, Psychosocial, and Neurologic Services in Regional, Provincial, and
Tertiary Hospitals. - All regional, provincial, and tertiary
hospitals, including private hospitals rendering service to paying patients,
shall provide the following psychiatric, psychosocial, and neurologic services:
(a) Short-term, in-patient
hospital care in a small psychiatric or neurologic ward for service users exhibiting
acute psychiatric or neurologic symptoms;
(b) Partial hospital care for
those exhibiting psychiatric symptoms or experiencing difficulties vis-Ã -vis
their personal and family circumstances;
(c) Out-patient services in close
collaboration with existing mental health programs at primary health care
centers in the same area;
(d) Home care services for
service users with special needs as a result of, among others, long-term
hospitalization, noncompliance with or inadequacy of treatment, and absence of
immediate family:
(e) Coordination with drug
rehabilitation centers vis-Ã -vis the care, treatment, and rehabilitation of
persons suffering from addiction and other substance-induced mental health conditions;
and
(f) 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.
SEC. 19. 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;
(c) Provide every service user,
whether admitted for voluntary treatment, with complete information regarding
the plan of treatment to be implemented;
(d) Ensure that informed consent
is obtained from service users prior to the implementation of any medical
procedure or plan of treatment or care, except during psychiatric or neurologic
emergencies or when the service user has impairment or temporary loss of
decision-making capacity;
(e) Maintain a register
containing information on all medical treatments and procedures administered to
service users; and
(f) 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.
SEC. 20. Drug
Screening Services. - Pursuant to its duty to provide mental health
services and consistent with the policy of treating drug dependency as a mental
health issue, each local health care facility must be capable of conducting
drug screening.
SEC. 21. Suicide
Prevention. - Mental health services shall also include mechanisms
for suicide intervention, prevention, and response strategies, with particular
attention to the concerns of the youth. Twenty-four seven (24/7) hotlines, to
provide assistance to individuals with mental health conditions, especially
individuals at risk of committing suicide. shall be set up, and existing
hotlines shall be strengthened.
SEC. 22. Public
Awareness. - The DOH and the LGUS shall initiate and sustain a
heightened nationwide multimedia campaign to raise the level of public
awareness on the protection and promotion of mental health and rights
including, but not limited to, mental health and nutrition, stress handling,
guidance and counselling, and other elements of mental health.
CHAPTER V
EDUCATION, PROMOTION OF MENTAL HEALTH IN EDUCATIONAL INSTITUTIONS AND
IN THE WORKPLACE
SEC. 23.
Integration of Mental Health into the Educational System. - The
State shall ensure the integration of 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 required subjects in all medical and allied health courses, including
post-graduate courses in health.
SEC. 24. Menial
Health Promotion in Educational Institutions. - Educational
institutions, such as schools, colleges, universities, and technical schools,
shall develop policies and programs for students, educators, and other
employees designed to: raise awareness on mental health issues, identify and
provide support and services for individuals at risk, and facilitate access,
including referral mechanisms of individuals with mental health conditions to
treatment and psychosocial support.
All public and private
educational institutions shall be required to have a complement of mental
health professionals.
SEC. 25. Mental
Health Promotion and Policies in the Workplace. - Employers shall
develop appropriate policies and programs on mental health in the workplace
designed to: raise awareness on mental health issues, correct the stigma and
discrimination associated with mental health conditions, identify and provide
support for individuals at risk, and facilitate access of individuals with
mental health conditions to treatment and psychosocial support.
CHAPTER VI
CAPACITY BUILDING, RESEARCH AND DEVELOPMENT
SEC. 26. Capacity
Building, Reorientation, and Training. - In close coordination with
mental health facilities, academic institutions, and other stakeholders, mental
health professionals, workers, and other service providers shall undergo
capacity building, reorientation, and training to develop their ability to
deliver evidence-based, gender-sensitive, culturally-appropriate and human
rights-oriented mental health services, with emphasis on the community and
public health aspects of mental health.
SEC. 27. Capacity
Building of Barangay Health Workers (BHWs). -- The DOH shall be
responsible for disseminating information and providing training programs to
LGUs. The LGUs, with technical assistance from the DOH, shall be responsible
for the training of BHWs and other barangay volunteers on the promotion of mental
health. The DOH shall provide assistance to LGUs with medical supplies and
equipment needed by BHWs to carry out their functions effectively
SEC. 28. Research
and Development. - Research and development shall be undertaken, in
collaboration with academic institutions, psychiatric, neurologic, and related
associations, and nongovernment organizations, to produce the information,
data, and evidence 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 not 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.
Research and
development shall also be undertaken vis-Ã -vis nonmedical, traditional or
alternative practices.
SEC. 29. The
National Center for Mental Health (NCMH). - The NCMH, formerly the
National Mental Hospital, being the premiere training and research center under
the DOH, shall expand its capacity for research and development of
interventions on mental and neurological services in the country.
CHAPTER VII
DUTIES AND RESPONSIBILITIES OF GOVERNMENT AGENCIES
SEC. 30. 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. In coordination with relevant
government agencies, create a framework for Mental Health Awareness Program to
promote effective strategies regarding mental health care, its components, and
services, as well as to improve awareness on stigmatized medical conditions;
(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;
(c) 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,
implementation, and the exercise of human rights by persons with mental health
conditions, including the establishment of centers of excellence;
(e) 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;
(f) 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 health conditions;
(g) Prohibit forced or
inadequately remunerated labor within mental health facilities, unless such
labor is justified as part of an accepted therapeutic treatment program;
(h) Provide support services for
families and co-workers of service users, mental health professionals, workers,
and other service providers;
(i) Develop alternatives to
institutionalization, particularly community, recovery-based approaches to
treatment aimed at receiving patients discharged from hospitals, meeting the
needs expressed by persons with mental health conditions, and respecting their
autonomy, decisions, dignity, and privacy;
(j) Ensure that all health
facilities shall establish their respective internal review boards. In
consultation with stakeholders, the DOH shall promulgate the rules and
regulations necessary for the efficient disposition of all proceedings, matters,
and cases referred to, or reviewed by, the internal review board;
(k) Establish a balanced system
of community-based and hospital-based mental health services at all levels of
the public health care system from the barangay, municipal, city, provincial,
regional to the national level; and
(l) Ensure that all health
workers shall undergo human rights trainings in coordination with appropriate
agencies or organizations.
SEC. 31. Duties
and Responsibilities of the Commission on Human Rights (CHR). - The
CHR shall:
(a) Establish mechanisms to
investigate, address, and act upon complaints of 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;
(c) 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 actions to rectify
or remedy such violation, including recommending that an administrative, civil,
or criminal case be filed by the appropriate government agency.
SEC. 32.
Investigative Role of the Commission on Human Rights (CHR). - The
investigative role of the CHR as provided in the pertinent provisions of this
Act shall be limited to all violations of human rights involving civil and
political rights consistent with the powers and functions of the CHR under
Section 18 of Article XIII of the Constitution.
SEC. 33. Complaint
and Investigation. – The DOH, CHR and Department of Justice (DOJ)
shall receive all complaints of improprieties and abuses in mental health care
and shall initiate appropriate investigation and action.
Further, the CHR
shall inspect all places where psychiatric service users 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. The CHR may, motu proprio, file a
complaint against erring mental health care institutions should they find any
noncompliance, based on its investigations.
SEC. 34. Duties
and Responsibilities of the Department of Education (DepED), Commission on
Higher Education (CHED), and the Technical Education and Skills Developmeni
Authority (TESDA). - The DepED, CHED and TESDA shall:
(a) Integrate age-appropriate
content pertaining to mental health into the curriculum at all educational
levels both in public and private institutions;
(b) Develop guidelines and
standards on age-appropriate and evidenced-based mental health programs both in
public and private institutions;
(c) Pursue strategies that
promote the realization of mental health and well-being in educational
institutions; and
(d) Ensure that mental health
promotions in public and private educational institutions shall be adequately
complemented with qualified mental health professionals.
SEC. 35. Duties
and Responsibilities of the Department of Labor and Employment (DOLE) and the
Civil Service Commission (CSC). - The DOLE and the CSC shall:
(a) Develop guidelines and
standards on appropriate and evidenced-based mental health programs for the
workplace as described in this Act; and
(b) Develop policies that promote
mental health in the workplace and address stigma and discrimination suffered
by people with mental health conditions.
SEC. 36. Duties
and Responsibilities of the Department of Social Welfare and Development
(DSWD). - The DSWD shall:
(a) Refer service users to mental
health facilities, professionals, workers, and other service providers for appropriate
care;
(b) Provide or facilitate access
to public or group housing facilities, counselling, therapy, and livelihood
training and other available skills development programs; and
(c) In coordination with the LGUs
and the DOH, formulate, develop, and implement community resilience and
psychosocial well-being training, including psychosocial support services
during and after natural disasters and other calamities.
SEC. 37. Duties
and Responsibilities of the Local Government Units (LGUS). - The
LGUs shall:
(a) Review, formulate, and
develop the regulations and guidelines necessary to implement an effective
mental health care and wellness policy within the territorial jurisdiction of
each LGU, including the passage of a local ordinance on the subject of mental
health, consistent with existing relevant national policies and guidelines;
(b) Integrate mental health care
services in the basic health care services, and ensure that mental health
services are provided in primary health care facilities and hospitals, within
their respective territorial jurisdictions;
(c) Establish training programs
necessary to enhance the capacity of mental health service providers at the LGU
level, in coordination with appropriate national government agencies and other
stakeholders;
(d) Promote
deinstitutionalization and other recovery-based approaches to the delivery of
mental health care services;
(e) Establish, reorient, and modernize
mental health care facilities necessary to adequately provide mental health
services, within their respective territorial jurisdictions;
(f) Where independent living
arrangements are not available, provide or facilitate access to public housing
facilities, vocational training and skills development programs, and disability
or pension benefits;
(g) Refer service users to mental
health facilities, professionals, workers, and other service providers for
appropriate care; and
(h) Establish a multi-sectoral
stakeholder network for the identification, management, and prevention of
mental health conditions.
SEC. 38. Upgrading
of Local Hospitals and Health Care Facilities. -- Each LGU, upon its
determination of the necessity based on well-supported data provided by its
local health office, shall establish or upgrade hospitals and facilities with
adequate and qualified personnel, equipment and supplies to be able to provide
mental health services and to address psychiatric emergencies: Provided, That
people in geographically isolated and/or highly populated and depressed areas
shall have the same level of access and shall not be neglected by providing
other means such as home visits or mobile health care clinics, as needed:
Provided, further, That the national government shall provide additional
funding and other necessary assistance for the effective implementation of this
provision.
CHAPTER VIII
THE PHILIPPINE COUNCIL FOR MENTAL HEALTH
SEC. 39. Mandate.
- The Philippine Council for Mental Health, herein referred to as the Council,
is hereby established as a policy-making, planning, coordinating and advisory
body, attached to the DOH to oversee the implementation of this Act,
particularly the protection of the rights and freedom of persons with
psychiatric, neurologic, and psychosocial needs and the delivery of a rational,
unified and integrated mental health services responsive to the needs of the Filipino
people.
SEC. 40. Duties
and Functions. - The Council shall exercise the following duties:
(a) Develop and periodically
update, in coordination with the DOH, a national multi-sectoral strategic plan
for mental health that further operationalizes the objectives of this Act which
shall include the following:
(1) The
country's targets and strategies in protecting the rights of Filipinos with
mental health needs and in promoting mental health and the well-being of
Filipinos, as provided in this Act;
(2) The
government's plan in establishing a rational, unified and integrated service
delivery network for mental health services including the development of health
human resources and information system for mental health; and
(3) The
budgetary requirements and a corollary investment plan that shall identify the
sources of funds for its implementation;
(b) Monitor the implementation of
the rules and regulations of this Act and the strategic plan for mental health,
undertake mid-term assessments and evaluations of the impact of the
interventions in achieving the objectives of this Act;
(c) Ensure the implementation of the policies
provided in this Act, and issue or cause issuance of orders, or make
recommendations to the implementing agencies as the Council considers
appropriate;
(d) Coordinate the activities and
strengthen working relationships among national government agencies, LGUs, and
nongovernment agencies involved in mental health promotion;
(e) Coordinate with foreign and
international organizations regarding data collection, research and treatment
modalities for persons with psychiatric, neurologic and substance use disorders
and other addictions;
(f) Coordinate joint planning and
budgeting of relevant agencies to ensure funds for programs and projects
indicated in the strategic medium-term plan are included in the agency's annual
budget;
(g) Call upon other government
agencies and stakeholders to provide data and information in formulating
policies and programs, and to assist the Council in the performance of its
functions; and
(h) Perform other duties and
functions necessary to carry out the purposes of this Act.
SEC. 41.
Composition. - The Council shall be composed of the following:
(a) Secretary of DOH as
Chairperson;
(b) Secretary of DepED;
(c) Secretary of DOLE;
(d) Secretary of the Department
of the Interior and Local Government (DILG);
(e) Chairperson of CHR;
(f) Chairperson of CHED;
(g) One (1) representative from
the academe/research;
(h) One (1) representative from
medical or health professional organizations; and
(i) One (1) representative from
nongovernment organizations (NGOs) involved in mental health issues.
The members of
the Council from the government may designate their permanent authorized
representatives.
Within thirty
(30) days from the effectivity of this Act, the members of the Council from the
academe/research, private sector and NGOs shall be appointed by the President
of the Philippines from a list of three (3) nominees submitted by the
organizations, as endorsed by the Council.
Members
representing the academe/research, private sector and NGOs 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 position vacated by a member of the Council shall
only serve the unexpired term of said member.
SEC. 42. Creation
of the DOH Mental Health Division. - There shall be created in the
DOH, a Mental Health Division, under the Disease Prevention and Control Bureau,
staffed by qualified mental health specialists and support staff with permanent
appointments and supported with an adequate yearly budget. It shall implement
the National Mental Health Program and, in addition, shall also serve as the
secretariat of the Council.
CHAPTER IX
MENTAL HEALTH FOR DRUG DEPENDENTS
SEC. 43. Voluntary
Submission of a Drug Dependent to Confinement, Treatment and Rehabilitation.
- Persons who avail of the voluntary submission provision and persons charged
pursuant to Republic Act No. 9165, otherwise known as the "Comprehensive
Dangerous Drugs Act of 2002”, shall undergo an examination for mental health
conditions and, if found to have mental health conditions, shall be covered by
the provisions of this Act.
CHAPTER X
MISCELLANEOUS PROVISIONS
SEC. 44. Penalty
Clause. - Any person who commits any of the following acts shall,
upon conviction by final judgment, be punished by imprisonment of not less than
six (6) months, but not more than two (2) years, or a fine of not less than Ten
thousand pesos (P10,000.00), but not more than Two hundred thousand pesos
(P200,000.00), or both, at the discretion of the court:
(a) Failure to secure informed
consent of the service user, unless it falls under the exceptions provided
under Section 13 of this Act:
(b) Violation of the
confidentiality of information, as defined under Section 4(c) of this Act;
(c) Discrimination against a
person with a mental health condition, as defined under Section 4(e) of this
Act; and
(d) Administering inhumane,
cruel, degrading or harmful treatment not based on medical or scientific
evidence as indicated in Section 5(h) of this Act.
If the violation
is committed by a juridical person, the penalty provided for in this Act shall
be imposed upon the directors, officers, employees or other officials or
persons therein responsible for the offense.
If the violation
is committed by an alien, the alien offender shall be immediately deported
after service of sentence without need of further proceedings.
These penalties
shall be without prejudice to the administrative or civil liability of the
offender, or the facility where such violation occurred.
SEC. 45.
Appropriations. - The amount needed for the initial implementation
of this Act shall be charged against the 2018 appropriations of the DOH for the
following: maintenance and other operating expenses of the national mental
health program, capital outlays for the development of psychiatric facilities
among selected DOH hospitals, and formulation of the strategic plan for mental
health.
For the
succeeding years, the amount allocated for mental health in the DOH budget and
in the budget of other agencies with specific mandates provided in this Act
shall be based on the strategic plan formulated by the Council, in coordination
with other stakeholders. The amount shall be included in the National
Expenditure Program (NEP) as basis for the General Appropriations Bill (GAB).
SEC. 46.
Implementing Rules and Regulations (IRR). - The Secretary of Health,
in coordination with the CHR, DSWD, DILG, DepED, CHED, TESDA, DOLE, CSC and
together with associations or organizations representing service users and
mental professionals, workers, and other service providers, shall issue the IRR
necessary for the effective implementation of this Act within one hundred twenty
(120) days from the effectivity thereof.
SEC. 47.
Separability Clause. - If any provision of this Act is declared
unconstitutional or invalid by a court of competent jurisdiction, the remaining
provisions not affected thereby shall continue to be in full force and effect.
SEC. 48. 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.
SEC. 49.
Effectivity. - This Act shall take effect fifteen (15) days after
its publication in the Official Gazette or in at least two (2) newspapers of
general circulation.
Approved,
(SGD) PANTALEON D. ALVAREZ
Speaker of the House
(SGD) AQUILINO “KOKO” PIMENTEL
III
President
of the Senate of Representatives
This Act which is a consolidation
of Senate Bill No. 1354 and House Bill No. 6452 was finally passed by the
Senate and the House of Representatives on February 12, 2018.
(SGD)CESAR STRAIT PAREJA
Secretary General House of Representatives
(SGD) LUTGARDO B. BARBO
Secretary of the Senate
RODRIGO ROA DUTERTE
President of the Philippines
Approved: JUNE 21, 2018
REPUBLIC OF THE PHILIPPINES
PRRD 2016 - 006324
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Note - this is the revised version the former post where the RA was numbered RA110361. The correct number is RA 11036. Our apologies. Please let us know also should you find typo errors in the encoding.
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An Act Establishing a National Mental Health Policy for the Purpose of Enhancing the Delivery of Integrated Mental Health Services, Promoting and Protecting the Rights of Persons Utilizing Psychiatric, Neurologic, and Psychosocial Health Services, Appropriating Funds Therefor, and for Other Purposes
Mental Health Act
