Understanding mental health
We are all familiar with the cliched images of the insane — the mentally unstable, the psychotic, and the depressed. The foremost example has to be “Sisa,” a character in Jose Rizal’s “Noli Me Tangere,” the poor mother of two altar boys, Crispin and Basilio, who disappeared without explanation. The most common depiction of Sisa is of a disheveled woman, wandering the town and wilderness, calling out “Crispin!” “Basilio!” and eventually driven to insanity.
Sisa is both exceptional and common, her story and her behavior typical of many Filipinos driven to desperate straits by both poverty and deprivation and deep loss; but whose inner turmoil and outward appearance do not always conform to Sisa’s example.
There are many Sisas in our midst. Sen. Risa Hontiveros — who as chair of the Senate health committee led the passage of the mental health bill through the chamber earlier this year — has said the Philippines has the highest number of depressed people in Southeast Asia. One in five adult Filipinos, she added, has some form of mental illness, primarily schizophrenia, depression and anxiety. Moreover, the number of suicides here has “steadily risen” over the years, with the World Health Organization reporting 2,558 Filipino suicides, averaging seven suicides a day.
Add to this a number of conditions, including natural disasters that occur with dismaying regularity, that impact adversely on people’s lives. Aside from calamities that affect large swathes of the population, other causes of stress include forced displacement, terrorism and armed conflict, migration, and violence. Surely, the prevailing fear and tension caused by the “war on drugs” cannot but have a jarring impact on our people’s mental equilibrium.
A piece of good news in this dismaying landscape of mental health is the imminent passage of a mental health law that changes the paradigm from law enforcement and incarceration to respect for rights and proper and humane treatment. The Senate, voting 19-0, passed the bill last May. In the House, things are looking up with the able shepherding of Rep. Helen Tan, chair of the health committee, after it was passed by the appropriations committee (headed by Davao Rep. Carlo Nograles, who, in the words of advocate Dr. June Pagaduan-Lopez, did not “have any second thoughts about the value of the bill and [approved] it without batting an eyelash.”)
For sure, it has not been a smooth and easy road to imminent passage.
As Dr. Pagaduan-Lopez tells it, “there have been no less than 16 attempts” to pass a mental health law here, despite the fact that the Philippines is one of the less than 30 percent (of countries) in the world without mental health legislation.
All previous local attempts to pass such a law, she adds, under the leadership of Dr. Lourdes Ignacio, “have been mostly pushing for the creation of a mental health council” based on an EO signed by President Fidel Ramos. “It never took off,” says Dr. Pagaduan-Lopez, because “the DOH for obvious reasons does not like the creation of super body.”
Dr. Pagaduan-Lopez herself got involved in the lobbying effort in 2013 when she was asked to head the committee on advocacy and legislation and media by the Philippine Psychiatric Association and lead the drafting of a new mental health bill.
“I had been gently and persistently nagged about this by (the late) Sen. Letty Shahani since I met her as a young psychiatrist working in the moral recovery program and the anti-rape bill. So I could not not accept the job.”
In 2014, the country hosted two Healthy Mind Summits organized by Dr. Ed Tolentino Jr. with the support of DOH. On these occasions, the association presented “the first version of our ‘rights-based’ legislation” using guidelines issued by WHO and, says Dr. Pagaduan-Lopez, based on her experience as an expert member of the UN High Commission on Human Rights.
But this was just the start of the effort to have a mental health law passed, with barriers put up by both local and foreign groups with vested interests and even ideological positions. (More on this in Friday’s column.)
