Philippine Mental Health Law PDF

ED 114 Special Topics in Education  Proposed more than 3 years ago, the Philippine Mental Health Act was passed in the congress and senate in 2017 (Senate Bill No. 1354, 2017) a...

ED 114 Special Topics in Education  Proposed more than 3 years ago, the Philippine Mental Health Act was passed in the congress and senate in 2017 (Senate Bill No. 1354, 2017) and signed into law on 21 June 2018  Prior to this bill, the Philippines were one of a minority of countries with no mental health legislation.  Clinicians lacked guidance on legal and ethical aspects of their practice, and patients' rights were not clearly defined – for example, the usual practice was for patients who lacked capacity to be ‘signed in’ by a next of kin.  The passing of this bill is a major milestone in the history of psychiatry in the Philippines.  The bill, the first in the country's history, provides a rights-based mental health legislation.  It mandates for the provision of psychiatric, psychosocial and neurological services in all hospitals, and basic mental health services in community settings.  Compulsory treatment is limited to hospital settings, and the Act does not provide for compulsory community treatment. Under its provisions, the Philippine Mental Health Act protects the rights of patients as follows:  a right to freedom from discrimination, right to protection from torture, cruel, inhumane, and degrading treatment;  right to aftercare and rehabilitation;  right to be adequately informed about psychosocial Key facts about Mental Disorders and clinical assessments;  right to participate in the treatment plan to be  1 in every 8 people in the world live with a mental implemented; disorder  right to evidence-based or informed consent; right  Mental disorders involve significant disturbances in to confidentiality; thinking, emotional regulation, or behaviour  and right to counsel, among others.  There are many different types of mental disorders  Effective prevention and treatment options exist  The Act also incorporates rights for ‘concerned  Most people do not have access to effective care individuals’, incorporating patient relatives and mental health professionals. Mentl Disorders  In this context, a mental health professional refers to a medical doctor, psychologist, nurse, social  A mental disorder is characterized by a clinically worker or any other appropriately-trained and significant disturbance in an individual’s cognition, qualified person with specific skills relevant to the emotional regulation, or behaviour. provision of mental health services (section 4 of the  It is usually associated with distress or impairment in Act). important areas of functioning.  The Act highlights the need to provide psychosocial  There are many different types of mental disorders. support to family members of the patient if required  Mental disorders may also be referred to as mental and, with informed patient consent, to include them health conditions. in the planning of treatment for the patient.  The latter is a broader term covering mental  It further recognizes the role of mental health disorders, psychosocial disabilities and (other) professionals, protecting their right to participate in mental states associated with significant distress, mental health planning and development of services, impairment in functioning, or risk of self-harm. and ensuring that they have a safe working  In 2019, 1 in every 8 people, or 970 million people environment, access to continuing education and around the world were living with a mental disorder, autonomy in their own practice. with anxiety and depressive disorders the most  Additionally, and with some foresight, the Act seeks common. to integrate mental health into the educational  In 2020, the number of people living with anxiety system by promoting mental health programs in and depressive disorders rose significantly because schools and other organizations of the COVID-19 pandemic.  Mental healthcare remains an underresourced and  Initial estimates show a 26% and 28% increase neglected aspect of healthcare in the Philippines. respectively for anxiety and major depressive Until now, the country has lacked a formal structure disorders in just one year. in which to enshrine the rights of those people with mental illness, their families, and the rights and Anxiety Disorders responsibilities of mental health professionals and government in relation to mental health.  In 2019, 301 million people were living with an  The Philippine Mental Health Act of 2017 has created anxiety disorder including 58 million children and an environment for the organization and provision of adolescents. hospital- and community-based mental healthcare in  Anxiety disorders are characterized by excessive fear the Philippines, while providing specific legislative and worry and related behavioural disturbances. checks to ensure the rights of patients receiving  Symptoms are severe enough to result in significant mental healthcare and treatment are protected. distress or significant impairment in functioning.  The Philippine Mental Health Act of 2017 is therefore a major step forward for mental health in the There are several different kinds of anxiety disorders, Philippines and a milestone for psychiatry in the such as: country. Significant logistical challenges remain in generalised anxiety disorder (characterised by the successful implementation of this legislation, but excessive worry), the Act is a significant step with the provision to panic disorder (characterised by panic attacks), comprehensively address, at a national and local social anxiety disorder (characterised by level, the mental health needs of the population. excessive fear and worry in social situations),  separation anxiety disorder (characterised by  Symptoms may include persistent delusions, excessive fear or anxiety about separation from hallucinations, disorganized thinking, highly those individuals to whom the person has a disorganized behaviour, or extreme agitation. deep emotional bond), and others.  People with schizophrenia may experience persistent difficulties with their cognitive functioning.  Effective psychological treatment exists, and  Yet, a range of effective treatment options exist, depending on the age and severity, medication may including medication, psychoeducation, family also be considered. interventions, and psychosocial rehabilitation. Depression Eating Disorders  In 2019, 280 million people were living with  In 2019, 14 million people experienced eating depression, including 23 million children and disorders including almost 3 million children and adolescents. adolescents (1).  Depression is different from usual mood fluctuations  Eating disorders, such as anorexia nervosa and and short-lived emotional responses to challenges in bulimia nervosa, involve abnormal eating and everyday life. preoccupation with food as well as prominent body  During a depressive episode, the person experiences weight and shape concerns. depressed mood (feeling sad, irritable, empty) or a  The symptoms or behaviours result in significant risk loss of pleasure or interest in activities, for most of or damage to health, significant distress, or the day, nearly every day, for at least two weeks. significant impairment of functioning.  Anorexia nervosa often has its onset during Post-Traumatic Stress Disorder (PTSD) adolescence or early adulthood and is associated with premature death due to medical complications  The prevalence of PTSD and other mental disorders or suicide. is high in conflictaffected settings.  Individuals with bulimia nervosa are at a significantly  PTSD may develop following exposure to an increased risk for substance use, suicidality, and extremely threatening or horrific event or series of health complications. events.  Effective treatment options exist, including family- based treatment and cognitive-based therapy. It is characterised by all of the following: Disruptive Behaviour and Dissocial Disorders 1) re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares);  40 million people, including children and adolescents, were living with conduct-dissocial disorder in 2019 2) avoidance of thoughts and memories of the event(s), (1). or avoidance of activities, situations, or people  This disorder, also known as conduct disorder, is one reminiscent of the event(s); and of two disruptive behaviour and dissocial disorders, the other is oppositional defiant disorder. 3) persistent perceptions of heightened current threat.  Disruptive behaviour and dissocial disorders are characterized by persistent behaviour problems such  These symptoms persist for at least several weeks as persistently defiant or disobedient to behaviours and cause significant impairment in functioning. that persistently violate the basic rights of others or  Effective psychological treatment exists. major ageappropriate societal norms, rules, or laws.  Onset of disruptive and dissocial disorders, is Schizophrenia commonly, though not always, during childhood.  Effective psychological treatments exist, often  Schizophrenia affects approximately 24 million involving parents, caregivers, and teachers, cognitive people or 1 in 300 people worldwide. problem-solving or social skills training.  People with schizophrenia have a life expectancy 10- 20 years below that of the general population.  Schizophrenia is characterized by significant impairments in perception and changes in behaviour. Neurodevelopmental disorders Health Systems and Social Support  Neurodevelopmental disorders are behavioural and  Health systems have not yet adequately responded cognitive disorders, that arise during the to the needs of people with mental disorders and are developmental period, and involve significant significantly under resourced. difficulties in the acquisition and execution of  The gap between the need for treatment and its specific intellectual, motor, language, or social provision is wide all over the world; and is often poor functions in quality when delivered.  Neurodevelopmental disorders are behavioural and  For example, only 29% of people with psychosis and cognitive disorders, that arise during the only one third of people with depression receive developmental period, and involve significant formal mental health care difficulties in the acquisition and execution of  People with mental disorders also require social specific intellectual, motor, language, or social support, including support in developing and functions maintaining personal, family, and social relationships.  ADHD is characterized by a persistent pattern of  People with mental disorders may also need support inattention and/or hyperactivity-impulsivity that has for educational programs, employment, housing, and a direct negative impact on academic, occupational, participation in other meaningful activities. or social functioning.  Disorders of intellectual development are characterized by significant limitations in intellectual functioning and adaptive behaviour, which refers to difficulties with everyday conceptual, social, and practical skills that are performed in daily life.  Autism spectrum disorder (ASD) constitutes a diverse group of conditions characterized by some degree of difficulty with social communication and reciprocal social interaction, as well as persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities.  Effective treatment options exist including psychosocial interventions, behavioural interventions, occupational and speech therapy.  For certain diagnoses and age groups, medication may also be considered. Who is at risk from developing a mental disorder?  At any one time, a diverse set of individual, family, community, and structural factors may combine to protect or undermine mental health.  Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability, and inequality – are at higher risk.  Protective and risk factors include individual psychological and biological factors, such as emotional skills as well as genetics.  Many of the risk and protective factors are influenced through changes in brain structure and/or function.