In 2018, the Philippines took a historic step by passing Republic Act No. 11036, also known as the Mental Health Act. It was a law that mental health advocates had long fought for, a recognition that mental health care is a fundamental human right, not just a privilege for those who could afford it.
The law aims to decentralize mental health services, integrate mental health care into primary health facilities and ensure that every Filipino can access psychiatric treatment, medication and psychosocial support. It also seeks to combat stigma and mandate mental health programs in schools and workplaces.
But how effective has it been? Has it delivered on its promises, or does it remain more of a symbolic victory than a functional reform?
To answer these questions, we spoke to two key figures in mental health advocacy: Dr. Edgardo Tolentino, international fellow at the American Psychiatric Association, and currently a technical consultant to the DOH’s National Mental Health Program; and Sally Bongalonta, vice-president of the Alliance of Filipino Families for Mental Health, and a passionate advocate for community-based mental health programs.
A mental health system takes shape but more doctors gravely needed
One of the most visible impacts of the Mental Health Act has been the increased awareness and recognition of mental health as a legitimate public health concern.
“We have come a long way from the days when mental health was dismissed as ‘just in the mind’ or a problem that only privileged people talked about,” says Dr. Tolentino. “The law has helped remove some of the stigma surrounding mental illness, and that’s a major step forward.”
A crucial component of the law was integrating mental health services into local health centers, making psychiatric care more accessible to Filipinos outside of Metro Manila.
“Before the law, mental health care was highly centralized, with most treatment facilities located in major cities,” Dr. Tolentino explains. “We are seeing a push to integrate mental health services into barangay health units. Local doctors are being trained in basic psychiatric care, and we have started seeing more community-based initiatives that support patients.”
While these improvements look good on paper, the reality on the ground tells a more complex story.
One of the biggest challenges — if not the biggest — in implementing the Mental Health Act is the severe shortage of mental health professionals in the Philippines.
The World Health Organization’s (WHO) recommends 1 psychiatrist per 10,000 people. The Philippines has more than 600 licensed psychiatrists for a population of over 119 million. That’s about 200,000 people to a psychiatrist.
This shortage means that even though more health centers now acknowledge mental health concerns, many lack the trained professionals needed to provide proper diagnosis and treatment. “Mental health cases require time and specialized care. A standard medical consultation lasts about ten to 15 minutes, but a proper psychiatric consultation can take 30 minutes to an hour. This is not something that overburdened primary care doctors can sustain.”
The result? Many patients receive only partial treatment and some are misdiagnosed, some are given prescriptions without proper follow-ups, while others are turned away due to a lack of available professionals.
Medication access: A step forward, but sustainability issues, challenges remain
One of the key victories of the Mental Health Act has been improving access to medication for patients. Government subsidy programs now provide free or low-cost drugs. “This is a huge win,” says Bongalonta. “In the past, many patients would go without medication simply because they couldn’t afford it. Now, at least, there is some government support to ensure that they can continue treatment.”
However, Dr. Tolentino cautioned that medication access remains uneven across the country. There are still shortages, he states, “and mental health conditions require long-term medication. Government assistance is helpful, but we need to ensure consistent supply chains so that patients don’t suddenly find themselves without their medication.”
Another issue is public hesitation in using psychiatric medication. “There’s still a stigma,” Dr. Tolentino points out. Many families are reluctant to put their loved ones on psychiatric drugs because of misconceptions. Some think the medications are addictive, others believe they “change a person’s personality.”
“Public education is crucial in addressing these fears.”
One element that was designed to address fears is the Mental Health Act’s mandate for workplaces and educational institutions to implement mental health programs — a provision meant to reduce stigma and provide support in environments where stress and mental health struggles are common.
However, Dr. Tolentino warns that enforcement still has been inconsistent, and would like to see continued improvement on this front. The idea is great but challenges remain.
“In workplaces, we often see mental health policies written into HR manuals, but the implementation is another story,” Dr. Tolentino notes. “Employees hesitate to seek mental health services out of fear that it will affect their employment. Some companies provide consultations, but workers feel uncomfortable accessing them because of privacy concerns.”
Similarly, mental health support in schools remains limited. “The Department of Education (DepEd) and the Commission on Higher Education (CHED) are supposed to ensure that schools have mental health programs,” says Bongalonta. “But guidance counselors are overburdened. Some schools have only one counselor for thousands of students, which makes it impossible to provide adequate support.”
The concept of care farming: a community-based mental health solution
One innovative approach to mental health rehabilitation in the Philippines is care farming — a program that integrates agriculture, livelihood, and therapy to help patients recover.
Bongalonta is part of an initiative that transformed a day center for psychiatric patients into a care farm where individuals could engage in productive, therapeutic activities. “We saw that when patients had something to do — when they planted crops, took care of animals, or engaged in small businesses—they felt a sense of purpose,” she says.
“It helped them reintegrate into society and even earn a small income.”
The program, structured around three core components, combines psycho-education and spirituality, helping patients and families understand mental health; livelihood training, providing patients with financial independence through small businesses; and mental health services, including counseling and psychiatric consultations, all with LGU support.
“This model works because it treats mental health holistically,” Bongalonta explains. “It’s not just about taking medicine — it’s about rebuilding a person’s life.”
The road ahead: strengthening the Mental Health Act
While the Mental Health Act was a landmark achievement, Dr. Tolentino and Bongalonta agree that more work must be done to make mental health care accessible, effective and sustainable in the Philippines.
“There are three major areas that still need urgent improvement,” says Dr. Tolentino. “First, we need to increase the number of mental health professionals. The shortage of psychiatrists, psychologists and trained counselors is one important factor to consider.”
The doctor suggests possible solutions. “We need stronger incentives — scholarships, training programs, and government funding — to encourage more people to enter the field.”
He also emphasizes the need for more structured community-based mental health programs. “It’s not enough to just have a mental health desk in barangay centers,” he explains. “We need fully operational mental health units within local health offices. This means having trained professionals on-site, not just referrals to distant hospitals.”
Finally, Dr. Tolentino highlights the importance of consistent government funding and support to ensure the program’s sustainability. “The Mental Health Act is a great law,” he says.
“But a law is only as strong as its implementation. If we don’t allocate enough budget for it, if we don’t hire enough professionals, and if we don’t fully integrate mental health care into our primary health system, then we will continue to have gaps in treatment.”
Despite the challenges, Dr. Tolentino remains hopeful. “We have taken the first steps, which is important,” he concludes.
“Now, we need to keep the momentum going. Mental health care is a right — not a privilege.” – Rappler.com