PHILIPPINE MENTAL HEALTH ACT: IMPLEMENTATION CHALLENGES AHEAD
will the mental health law be any different?
Since 1995 the country has had about 15 significant health reforms—with the “sin tax” and reproductive health laws two of the most well known. When the Mental Health Act was signed into law in June 2018, it entered into that long list of major policy changes. However, like its predecessors, there is little-to-suggest that the new legislation will make significant transformative change in the mental health care system. These barriers can be broadly divided into two areas—the health policy space to which the new law is entering and the gaps in policy formulation.
In the Philippines major health reforms are plagued by implementation problems. Despite increased benefit payments and increased fiscal space for health, reforms have had little impact on financial risk protection. Catastrophic spending is very much still a reality for many Filipino families. In addition, the Department of Health faces strains in effectively using its budget. Bureaucratic delays in procurement, protracted construction of health facilities, and poor coordination are just a few of the challenges facing the ability of the DOH to maximize its financial resources. Lack of trained staff, poor or limited equipment and supplies, program implementation problems—these are added challenges. This is the health and health care space to which the Mental Health Act is entering.
The other significant barrier is the gap in the policy formulation of the new law itself. The law and its proponents underscore its community-based approach and its emphasis on “culturally appropriate” interventions. A closer read of the legislation suggests both are only partially accurate. The tenets of community-based mental health is not well integrated into the new law. In addition, the development of the law offered a significant opportunity to prioritize sikilohiyang Pilipino. This was missed: the law continues the long tradition of the “service paradigm” approach to health care.
This project will further explore these barriers.