QuestionsQuestions (Republic Act No. 11036)
RA 11036 is known as the “Mental Health Act.”
The State affirms the right to mental health and commits to valuing, promoting, and protecting mental health; making timely, affordable, high-quality, culturally-appropriate mental health care available; ensuring services are free from coercion and accountable to service users; and enabling persons affected by mental health conditions to exercise full human rights and participate in society free from stigma and discrimination.
It is consent voluntarily given by a service user to a treatment plan after full disclosure in plain language of the nature, consequences, benefits, and risks of the proposed treatment, including available alternatives.
It is a medically-determined inability of the service user to provide informed consent, assessed by a mental health professional as inability to understand information about the condition, consequences of decisions, nature/effects/side effects of treatment, or to effectively communicate consent or information about one’s condition.
RA 11036 expressly recognizes the applicability of RA 7277, as amended, to persons with mental health conditions as defined in RA 11036.
Examples: freedom from discrimination and stigmatization; access to evidence-based and affordable mental health services; access to care in the least restrictive environment; humane treatment free from solitary confinement/torture and harmful invasive procedures not backed by evidence; right to confidentiality; right to give informed consent (and withdraw it); right to access clinical records subject to safeguards; right to be informed within 24 hours of admission of rights under the Act; and right to file complaints and seek investigations.
Disclosure is allowed when required by law or a court order; when the service user consents; when a life-threatening emergency exists and disclosure is necessary to prevent harm; when the service user is a minor and the professional reasonably believes the minor is a victim of child abuse; or when disclosure is needed in connection with an administrative, civil, or criminal case against a mental health professional for negligence or breach of ethics, to the extent necessary to adjudicate the issue.
Service users must provide informed consent in writing prior to implementation of any therapy/treatment, including physical or chemical restraint.
It is a signed, dated, and notarized document setting out a service user’s preferences regarding treatment. It may be revoked by a new advance directive or by a notarized revocation.
The legal representative provides support and helps, represents the service user’s interests, receives relevant medical information under the Act, acts as substitute decision-maker when the service user has temporary impairment of decision-making capacity, assists the service user in exercising rights under the Act, and is consulted regarding treatment/therapy.
The Act provides an order: (1) spouse (unless disqualified as stated), (2) non-minor children, (3) either parent by mutual consent if the service user is a minor, (4) chief/administrator/medical director of a mental health facility, or (5) a person appointed by the court.
Supported Decision Making is assisting a service user (who is not impaired) in expressing mental-health related preferences/decisions, with safeguards against undue influence/coercion/abuse. The service user may designate up to three supporters (including the legal representative) who can access medical information, consult regarding proposed treatment, and be present during appointments/consultations.
It must review, monitor, and audit cases involving restraint/confinement/treatment; inspect facilities to ensure no cruel/inhumane/degrading conditions; investigate disputes and involuntary treatment/confinement/ (upon complaint or motu proprio); and take necessary actions to remedy rights violations including recommending administrative/civil/criminal cases.
Treatment/restraint/confinement may be administered/implemented only under safeguards: in compliance with any available advance directives unless immediate risk of serious harm; only to the extent necessary and only while the emergency or impairment persists; upon order of the attending mental health professional reviewed by the internal review board within 15 days and every 15 days thereafter while continuing; and in strict accordance with approved guidelines with clear criteria and full documentation subject to regular external independent monitoring/review/audit by internal review boards.
They must be research-based; responsive to clinical, gender, cultural/ethnic and special needs; provided in the most appropriate and least restrictive setting; age-appropriate; and provided by mental health professionals/workers with accountability.
Mental health services must include mechanisms for suicide intervention, prevention, and response strategies, with attention to youth; 24/7 hotlines must be set up (or strengthened) to assist individuals with mental health conditions, especially those at risk of suicide.
Penalized acts include failure to secure informed consent (outside exceptions), violation of confidentiality, discrimination, and administering inhumane/cruel/degrading/harmful treatment not based on medical/scientific evidence. The penalty upon conviction by final judgment is imprisonment of not less than six months but not more than two years, or a fine of not less than PHP 10,000 but not more than PHP 200,000, or both (as decided by the court).