By Brian M. de la Cerna
With no vaccine or cure in sight for the coronavirus disease 2019, government across the globe are now more focused on mobilizing public health and protecting their respective economies. However, people seem to forget that another health problem is looming over the horizon brought about by the COVID-19 pandemic.
Health professionals are reporting a spike in mental problems since people were forced into lockdowns at home to contain the pandemic and millions had already lost their lives. Fear and anxiety brew over the atmosphere about this new disease and what could happen can be overwhelming and beyond one’s control. Public health emergencies may cause the health, safety, and well-being of the individuals and the community as a whole.
In the Philippines, suicide prevention hotlines reported a doubling of calls for help when Metro Manila and the rest of Luzon were placed under enhanced community quarantine. The calls for help cut across age groups, from youth to senior citizens, according to mental health advocates. This problem stemmed from and worsened due to the increase of work from home arrangements and the online delivery of classes. Moreover, public measures, such as social distancing and self-isolation, can cause loneliness and fear in people which, in turn, increases anxiety and stress.
The National Center for Mental Health (NCMH) has recorded a spike in suicide related-calls of 33 monthly calls from January to March 2020, 66 in April, 80 in May, 112 in June, and 115 in July. The survey conducted by the Social Weather Station (SWS) revealed that nine in ten Filipinos were stressed due to COVID-19 pandemic.
Truly, our mental health must never be compromised for it plays an important role in our overall health and well-being. It encompasses how we think, feel, and act. Our mental health is as important as our physical health.
We must urge now the Philippine government to give special attention to mental wellness and the full implementation of Republic Act 11036, otherwise known as the Mental Health Act, which was enacted into law on June 29, 2018. This law, the first in the country, provides a rights-based mental health legislation. Indeed a milestone for the Philippines in the history of psychiatry.
All regions down to the barangay level are mandated to provide psychiatric, psycho-social and neurologic services, including hotlines and other mechanisms for suicide prevention, with special attention on the youth. However, compulsory treatment is limited to hospital settings, and the Act does not provide for compulsory community treatment.
The law gives a pathway for the Department of Education (DepEd), Commission on Higher Education (CHED), and Technical Education and Skills Development Authority (TESDA) to incorporate age-appropriate content pertaining to mental health in the curriculum and mental health programs must be integrated into the education system.
It also recognizes that employers should be made partners with the state, to enable affordable and timely access to professional help, since the mental well-being of their employees has a direct impact on their productivity. Furthermore, Section 35 defines the duties and responsibilities of the Department of Labor and Employment (DOLE) and Civil Service Commission (CSC) utilizing the capacity of the employment sector to develop guidelines and standards on appropriate and evidence-based mental health programs for the workplace.
The Department of Social Welfare and Development (DSWD) refers service users to mental health facilities, professionals, workers, and other service providers for appropriate care, and to provide or facilitate access to public or group housing facilities, counseling, therapy, and livelihood training and other available skills development programs.
As stipulated in the law and as mentioned before, there must be responsive mental health services at the appropriate level, particularly at the city, municipal, and barangay levels. Technically, this law places every LGU at the frontline of promoting the well-being of people by ensuring that: mental health is valued. Section 27 of the law mandates for the capacity building of Barangay Health Workers (BHWs). LGUs, with technical assistance from DOH shall be responsible for their training. Also, the DOH shall provide assistance to LGUs with logistics needed by BHWs and other volunteers to properly execute their functions: as first emergency responders.
Question is, however, where are we now with the implementation of the Philippine Mental Health Act?
The budget season has finally started with both houses of Congress carrying out a series of deliberations to scrutinize the country’s financial plan for the year 2021. And then again, the current administration thru its Department of Budget and Management (DBM) has manifested its misplaced priorities. With the existing pandemic, the Philippine government should have already learned its lesson: put the money where its mouth is, and that is to bolster and shore up the country’s health care system. DBM approved a lower budget for the Department of Health (DOH), and that alone already speaks volumes about how the current administration constantly ignores the realities on the ground.
Rep. Stella Quimbo appealed to DOH during the budget deliberation after the latter gave low priority to the psychological well-being of Filipinos, as evidenced by the budget per capita it allocated for its mental health program. P615 million was only set aside for the provision of drugs for mental illnesses. On DOH’s defense, DBM did not approve their proposed additional expenses worth P73 billion for their medicine access program. Also, DBM has yet to authorize DOH’s recruitment of eight mental health office personnel pursuant to Section 43 of the Mental Health Act.
Given the proposed financial spending of DOH for next year, how does it plan to strengthen the country’s health care system with the awful funding cut?
With the ill-effects of COVID-19 pandemic bringing our fellow Filipinos down to their knees, the government still choose to prioritize its military modernization program and desperate efforts and initiatives to contain internal insurgency, despite economic constraints stemming from COVID19 pandemic. Surely, President Rodrigo Duterte’s fixation on the perceived enemies of the state is beyond the pale, to the extreme that it undermines the outcry of his countrymen.
Mental health care remains an under-resourced and neglected aspect of health care in the Philippines. And that is a fact. With the law and its corresponding IRR in place, until now we still lack a formal structure in which to entirely enforce the provisions of the law and to enshrine the rights of those people with mental illness, their families, and the rights and responsibilities of mental health professionals and government in relation to mental health.
And lastly, one of the crucial and noteworthy provisions of RA 11036 is its giving birth to a policy shift in the approach of the State towards drug abuse. Section 18 requires regional, provincial, and tertiary hospitals to provide psychiatric, psychosocial, and neurologic services in coordination with drug rehabilitation center vis-a-vis the care, treatment, and rehabilitation of persons suffering from addiction and other substance-induced mental health conditions.
While the said law is a significant step to comprehensively address, at a national and local level, the mental health needs of the population, yet after lapse of a considerable period of time, the Philippine government has failed to fully and properly enforce the Philippine Mental Health Act.
We should encourage DOH, as the lead agency, together with its partner agencies to take advantage of online platforms, such as social media and other technologies, which may provide free and greater access to mental health care and psychosocial support.
It isn’t always easy to manage stress, worry, anxiety, or sadness by all yourself. Connect with a friend, a parent, a teacher, or a trusted adult about how you are feeling and they may be able to help you. Sometimes just by simply connecting with someone else, you will feel better.
And if you feel like giving up, try to reach out. I was also wearing the same shoes that you are wearing now. I personally understand how it feels going to the psychiatrist seeking treatment, while people think of you as “buang.” It may be quite hard to ask for some professional help due to social stigma, challenged by the stereotypes and prejudice that result from misconceptions about mental illness, but you deserve to heal, too. You must: for you still have to wander the wonders of the world.
Be kind to yourself to reach out and call the free crisis hotlines that are available nationwide:
NCMH -1553, 0917-899-8727, (02) 7-898-8727
Philippine Red Cross – 1158
In-Touch Crisis Line – 8-893-7603, 0917-8001123, 0922-8938944
