Mainstreaming mental health

The title of the bill on mental health, which has been passed by the Senate and faces imminent passage in the House, is quite a mouthful: “An Act Establishing a National Mental Health Policy for the Purpose of Enhancing the Delivery of Integrated Mental Health Services, Promoting and Protecting Persons Utilizing Psychiatric, Neurologic and Psychosocial Health Services, Appropriating Funds Therefor and for other Purposes.” Whew!

Dr. June Pagaduan Lopez, who was a key figure in the lobbying drive for passage, says, obviously, that the proposed law is “comprehensive” and covers “not only psychiatric and neurologic conditions but also psychosocial problems resulting from lifestyle, stresses of daily living, natural calamities, violence, drug use and all other traumatic experiences in life.”

For Sen. Risa Hontiveros, main sponsor (with principal author Sen. Tito Sotto) of the Senate version of the bill, the Mental Health Act aims to bring mental health issues to the mainstream of Philippine society and consciousness. It’s time, she told an interviewer of CNN Philippines, to bring out mental health from the shadows of shame and stigma where they have been buried. People with mental health problems, she noted, are stigmatized and discriminated against.

For one, said Hontiveros, the bill seeks to “empower further the Department of Health to bring [the program] down as far as it can go,” maybe even down to the barangay level. While in schools, she said, “let’s mainstream mental health in the curriculum.”

What do advocates mean when they describe the mental health measure as being “rights-based”?

From the beginning, said Lopez, it “invokes the rights of the stakeholders, particularly its beneficiaries and the
duties of the state in protecting and servicing these rights.”

Some in the health sector, she noted, “are more used to the so-called ‘Public Health Approach’ which uses the para-digm of disease prevention and control.” But she emphasized that “there should be no contradiction actually” since “the rights-based approach emphasizes the ‘do no harm’ principle which upholds that any public health measure no matter how effective should, above all, not be a violation of individual human rights.”

Those opposing the measure included a group called “Survivors of Psychiatry,” which Lopez described as a global conglomeration of antipsychiatry groups “such as the well-funded Scientology group,” whose most prominent member is actor Tom Cruise. “They are well resourced and have their galamay (minions) all over the world, including the UN,” she said. “Their position has been rebutted by the American Medical Association and the World Psychiatric Association as preposterous and clinically uninformed.”

Surprisingly, some psychiatrists themselves are opposed to the bill. “Why am I making our lives more difficult?” Lopez said she was asked often by members of her profession. “True, in this country a psychiatrist in cooperation with any legal guardian or spouse may commit anyone to involuntary treatment in the hospital for any unlimited time, and this is a worldwide and gross violation of the rights of those who may or may not have mental disorders because very few guidelines exist.”

Even as international bodies have said involuntary confinement may be necessary in some cases, especially when informed consent is difficult if not impossible to obtain, a middle ground is still deemed necessary.

“We realized that the rights of carers, facilities and mental health professionals [should] also be protected,” Lopez said, citing instances when “mental health professionals and facilities have also been threatened and harassed by litigious patients who resent having been admitted by their relatives even if there was justification for doing so.”

Through the years, what Lopez called a “rainbow of sponsors” have backed the bill since its early days in the legislature. This just goes to show that despite the many varied and clashing political colors in our midst, a “political rainbow” can emerge for the betterment of our children and generations to come.