President Marcos on Thursday fully supported efforts to amend the 1987

Constitution but the provisions on “economic matters alone” as he strongly rejected

former President Rodrigo Duterte’s call for Mindanao to secede, saying that it would
destroy the nation.

In a speech to the Philippine Constitution Association (Philconsa) during the celebration

of Constitution Day in Makati City, Marcos said that while the Charter offered “no
dynamism or flexibility” regarding the national territory, it is open to economic reforms.

Allow me to make it clear. This administration’s position in introducing reforms for the
Constitution extends to economic matters alone, for those strategically aimed at
boosting our economy. Nothing more,” Marcos said.

His remarks eased lingering doubts that his administration was also considering
changing certain political provisions in the Charter like term limits of elected officials.

In an interview with GMA 7 last month, the President said he was open to discussions
on amending term limits and other political provisions in the Constitution, but “later on.”

In January, Marcos said his immediate concern was easing the Charter’s economic
provisions but that he was against land ownership by foreigners, which many politicians
and business groups were pushing for.

He said his administration was “going to push hard to attract all foreign investments,”
but he will not meddle in the disagreement between the two chambers of Congress
over the people’s initiative for Charter change (Cha-cha).

“I will neither hinder this dialogue nor encroach on the prerogatives of Congress and
the sovereign will of the Filipino people,” the President said, adding that he wanted a
“healthy and democratic debate” on amending the Constitution for the country’s
socioeconomic development.

Philconsa president and Speaker Martin Romualdez, the President’s cousin, praised
his assurance that his support for constitutional amendments was solely for economic
reforms.

“At the risk of being makulit (persistent), we have been saying that we do not advocate
any political amendment,” Romualdez said.

The President noted that many sectors, particularly the businessmen, have pointed to
economic provisions that needed to be changed because these “inhibit our growth
momentum.”

After over 30 years, these “restrictive provisions” now limited growth, foreign investment
and efficient governance, and the country’s economic potential and global
competitiveness, he said.

Reacting on this statement, Romualdez said the President “made it clear that these
provisions hinder the entry of foreign investments and the potential for faster and
inclusive economic growth, which in turn could translate into a better life for every
Filipino.”

In his speech, the President firmly rejected his predecessor’s call for Mindanao to
secede, saying that leaders of the Bangsamoro Autonomous Region in Muslim
Mindanao (Barmm), mostly former Muslim separatist rebels, themselves have
“repudiated this preposterous proposal.”

“The new call for a separate Mindanao is doomed to fail, for it is anchored on a false
premise not to mention a sheer constitutional travesty,” Marcos said.

He “strongly” appealed “to all concerned to stop this call” as it was “a grave violation of
our Constitution.”

“This is not the New Philippines that we are forming, it is in fact destroying our nation,”
he said in Filipino.

It was the first time that the Chief Executive responded to this call by Duterte during a
tirade last week where his predecessor also criticized him for his administration’s push
for Cha-cha.

During a nighttime news conference in Davao City on Jan. 30, Duterte, the first
Philippine president from Mindanao, said he would rather see an independent
Mindanao since it had not developed “after so many presidents” and that there would
be no hope for the country’s south because “there would be another lousy president.”

Earlier, Duterte called Marcos an addict, to which the President responded by

attributing the former leader’s rants to the effects of years of using the opioid fentanyl.

The conflict between the current and the former chief executives blew up after the
confidential funds of Vice President Sara Duterte in the 2024 budget were scrapped
and the former president described the House of Representatives led by Romualdez as
one of the most corrupt institutions in the country.

In the past week, members of Marcos’ Cabinet spoke up against the proposal for
Mindanao’s secession as this would violate the Constitution, specifically the provision
which defines the country’s territory and sovereignty.
Charter Change Bid Moves
Forward in the Philippines
A push is afoot to amend the Constitution
introduced after the 1986 People Power uprising, a
move that is likely to deepen political polarization.

Several initiatives promoting the amendment of the 1987 Philippine Constitution have
garnered the support of the leadership of both houses of Congress, even if the
campaign could further cause political disunity and public dissatisfaction.
There are three ways to change the Constitution: electing delegates in a Constitutional
Convention, Congress convening into a Constituent Assembly, and soliciting signatures
from voters in support of a People’s Initiative. Apparently, the current Charter Change
(ChaCha) bid is serious since all three modes are actively being pursued by various
political forces and legislators.

In March 2023, the House of Representatives passed a resolution supporting the

election of a Constitutional Convention. Before the end of the year, there were reports
of local officials organizing assemblies to get signatures in support of a People’s
Initiative. Surprisingly, the Senate President responded this month by filing a resolution
calling for the review of the economic provisions of the Constitution.

All ChaCha attempts have failed in the past because they encountered strong
resistance from the people, including members of the Senate. Drafted after the 1986
People Power Revolution, the Constitution contained provisions that reflected the
struggle against the dictatorship of Ferdinand Marcos Sr., the father of the country’s
current president. For example, the Constitution strengthened the Bill of Rights,
empowered Congress to review Martial Law declarations, prohibited foreign bases, and
imposed term limits on all elected officials.

Previous ChaCha proponents were mainly politicians and members of the House of
Representatives allied with the ruling party. They were accused of trying to remain in
power through ChaCha by either removing term limits or adopting a parliamentary
government. The latter could mean the abolition of the Senate.
After failing to get public support for ChaCha, recent proposals focused on changing
the economic provisions of the Constitution. Specifically, the agenda is supposedly only
limited to removing the Constitutional restrictions on foreign ownership of land and
corporations. Supporters of “economic ChaCha” blame the Constitution for
discouraging the entry of foreign investment, which they insist will bring progress by
creating more jobs and livelihoods.

Despite this assurance, the “economic ChaCha” didn’t get the backing of Senators and
the public who remained wary about this effort’s real motives and backers. After all,
there’s no certainty that the proposed Constituent Assembly or Constitutional
Convention will only tackle the economic aspects of the Constitution. Aside from this,
laws have been passed in recent years that already allow foreign ownership of public
utilities and services.

That is why the proposed resolution of Senate President Juan Miguel Zubiri, which
seemingly welcomes the “economic ChaCha,” has alarmed members of the opposition.
Senator Risa Hontiveros, a member of the minority, warned that “the ChaCha journey is
treacherous, impractical, divisive, and unwise.” She pointed out in a statement that the
campaign “is triggered by multiple hidden agendas, power struggle, and in-group
bickering.”

She added: “Why are we attempting to solve our economic problems by creating
another problem? Let us not get distracted by the shiny allure of ChaCha, when,
beneath all the gloss, it will only trap us in a never-ending cycle of political
maneuvering.”

But House Speaker Ferdinand Martin Romualdez, the first cousin of the president,
welcomed the Senate resolution while acknowledging that ChaCha is a “sensitive
endeavor.”
He said in a media statement: “The synergy between the Senate and the House in
passing this Resolution will send a strong signal of unity and purpose. It aligns with the
aspirations of the proponents of the ongoing People’s Initiative, who have tirelessly
advocated for constitutional reform.”

What Romualdez didn’t mention was the recent allegations that public funds were used
to “bribe” people into signing the proposed People’s Initiative. Even the president’s
sister, Senator Imee Marcos, publicly condemned the reported use of government
subsidies to hoodwink voters into supporting ChaCha.
The children of former President Rodrigo Duterte also issued statements rejecting
ChaCha. “I am against this people’s initiative as this is not the people’s voice but the
voice of a few who wanted to perpetuate themselves in power,” said Davao
Congressman Paolo Duterte. Vice President Sarah Duterte also released her statement
against ChaCha. The two Dutertes should be reminded, however, that federalism
through ChaCha was advocated when their father was still the country’s president.
Their statements reveal the continuing rift between their side and Speaker Romualdez
and the growing disunity within the ruling coalition.

The strongest challenge against ChaCha was expressed by Catholic leaders who
advised their parishioners not to sign any form supporting the People’s Initiative. A
bigger and broader movement against ChaCha could also develop in the next few
weeks as the nation prepares to mark the People Power anniversary on February 25.
Legislators, including the Senate leadership, have agreed to support the “economic
ChaCha” which means this was done with the support of President Marcos. At the
minimum, ChaCha could energize debates about the roots of the country’s
underdevelopment and whether allowing foreigners to acquire more assets and a
greater role in the economy will spur progress. But ChaCha could also inflame
acrimonious rhetoric, exacerbate political differences, and even ignite destabilization.
Can Marcos and his government afford to take this risk amid rising global tensions and
stability?

CAGAYAN DE ORO CITY – The Philippine Mental Health Association Inc. (PMHA) on Monday
raised the alarm over the “rising epidemic of mental health crisis” in the country.

The group, composed of mental health professionals and advocates, said the situation needs
widespread awareness, support and action.

“We have noticed a sharp increase in mental health concerns during and after the Covid-19
pandemic lockdowns,” PMHA president Dr. Cornelio Banaag Jr. said during a World Mental Health
Day event in this city.

“Mental health-related issues affect Filipinos of all ages and backgrounds - young or old, rich or
poor. It is a silent epidemic that we need to confront head-on,” he added.

In the Philippines, mental illness is becoming a common disability and at least 3.6 million Filipinos
suffer from mental, neurological and substance use disorder, according to the Department of
Health (DOH).
The PMHA said access to mental health services in the country remains limited and unequal due to
stigma and scarce resources.

There is also less than one mental health worker for every 100,000 Filipinos, it added.

PMHA urged a whole-of-society approach to address mental health concerns.

“Mental health is a universal human right,” Banaag said. “We need to make diagnosis, treatment,
and care more accessible to the average Filipino.”

PMHA called for the stronger implementation of the Philippine Mental Health Act or Republic Act
No. 11036, enactment of local mental health ordinances, more funding to expand mental health
services, and a constant public awareness campaign.

“The mental health crisis in the Philippines requires a united effort from all sectors of society –
local and national governments, private sector and the workplace, healthcare providers,
communities, schools, and individuals,” Banaag said. “Everyone has a role to play to improve
Filipinos’ mental wellness.”

The Department of Health (DOH), in collaboration with the World Health Organization
(WHO), today launched the 2024-2028 Philippine Council for Mental Health (PCMH) Strategic
Framework to guide the development and implementation of mental health policies,
programs, and services to address the significant burden of mental illness and improve
mental health and well-being in the country.

In line with “Ginhawa ng Isip at Damdamin,” one of the Health Sector’s 8-Point Action Agenda
Para sa Healthy Pilipinas officially adopted through DOH Administrative Order No. 2023-0115,
various government agencies and key stakeholders worked together in formulating the five-
year strategic plan, which aims to reduce premature mortality, prevent and treat substance
abuse effectively, and reduce the vulnerability of individuals and communities to mental,
neurological, and substance use disorders.

“Today, as we launch the 2024-2028 PCMH Mental Health Strategic Framework, I am

confident that we can address more mental health concerns in the country. With the
contributions of all partner agencies under the PCMH and the guidance of WHO, we can
achieve all the strategies we are set to do as laid out in the new five-year strategic
framework,” said Health Secretary Teodoro J. Herbosa.

Supported by the WHO Special Initiative for Mental Health, the PCMH promotes the basic
right of Filipinos to mental health by implementing mental health policies, strengthening
patient navigation and referral pathways, creating the Mental Health Internal Review Board,
and training media groups on ethical and responsible reporting and portrayal of suicide.

Since the passage of the Mental Health Act in 2018, the Philippines has scaled up mental
health services and quality essential medicines with 362 access sites nationwide dispensing
30 mental health medicines serving 124,246 service users in 2022. The DOH has also
capacitated health and non-health personnel on mental health to further advance the
protection of service users at the primary care level through the continuous implementation
of the Mental Health Gap Action Programme (mhGAP) in local government units. The
National Center for Mental Health’s 24/7 crisis hotlines were also established.

“We commit to implementing pro-equity strategies to ensure access to universal health care
and develop resilient health systems in the country that respond to the mental health and
well-being needs of every citizen,” WHO Representative to the Philippines Dr Rui Paulo De
Jesus said.

To further transform mental health responsive communities, the government implemented

strategies across different agencies and educational institutions, which resulted in 78,449
private establishments with mental health workplace policies to ensure the safety and well-
being of employees; 54 hospitals providing ‘behavioral nudges’ to help health workers cope
with stress; and 273 last-mile elementary schools serving as implementing sites of a
comprehensive range of mental health measures under the Healthy Learning Institutions
(HLI) Framework.

The event also featured the expansion of the PhilHealth Mental Health Benefit Package,
which provides mental health benefits for outpatient services. The primary care package
includes 12 consultations, diagnostic follow-up, psychoeducation, and psychosocial support
provided by mental health outpatient facilities for medicine access sites.

The launch was attended by PCMH Council Members from different agencies including DOH,
Department of Education (DepEd), Department of Labor and Employment (DOLE), and
Department of Interior and Local Government (DILG).

The government must act urgently to protect the health and lives of young people across
the Philippines, Save the Children said, following reports of a shocking number of actual
and attempted suicides among Philippine students in the last academic year.

According to latest figures from the Department of Education, 404 students died by suicide
during the 2021-2022 school year[i], with a staggering 2,147 attempting suicide during the
same time period.

“The mental health crisis in the Philippines is a national emergency. Children and young
people have emerged from the COVID-19 pandemic and the physical and mental health
challenges it brought, into a society that is even more unequal than before the pandemic.

“The government must urgently intervene by investing in mental health services across
healthcare, protection, education and welfare. But ultimately it must do more to support
and protect children from disadvantaged backgrounds and create a more equal society.
Children from all backgrounds and identities have the right to survive, learn and be
protected.”

Save the Children in the Philippines is calling for the following:

- The Department of Health must mainstream mental health services into primary care,
increasing both availability and accessibility of mental health support, and investing in
training staff;

- The Department for Social Welfare and Development must complement social
welfare programmes with child-friendly community-based mental health programmes that
address psychosocial needs of entire families;

- Mental health services should be strengthened to support children with disabilities,

indigenous children, children in alternative care, and other disadvantaged children;

- The Department for Education (DepEd) must develop and implement school-based
mental health programmes to help students cope with stressors arising from the impacts of
the COVID-19 pandemic and other issues such as gender-based violence and bullying.
DepEd must invest in staff who can support students with mental health needs, including
necessary referrals to other professionals, if needed.

Save the Children has been working in the Philippines since 1981 with programmes in
humanitarian response, health and nutrition, education, and children's rights and protection.
As part of its mental health and psychosocial support, the organisation runs programmes in
mental health literacy, including training for parents and caregivers and provision of
materials and technical trainings for teachers.
Mental health has gained increasing attention and awareness in the country in recent years. Issues such as
stigma, discrimination, underinvestment, and lack of public infrastructure are prevalent, significantly
impacting public health. Even after the country has passed its first Mental Health Act and the Universal
Health Care Act, access to mental health services remains limited, especially for the most vulnerable groups.
According to the World Health Organization, there is only one psychiatrist and one psychiatric nurse for
every 200,000 people in the Philippines and only one psychologist for every 1 million, making it hard to
access mental health professionals.[1]

The country observes National Mental Health Week every second week of October pursuant to Presidential
Proclamation 452. It aims to emphasize mental health issues, reduce the stigma surrounding those afflicted
with mental health conditions, and encourage individuals to seek help when faced with mental health
challenges.

Investing in mental health can impact labor productivity. Workers with good mental health and access to
adequate mental health services tend to be more engaged, focused, and efficient at work. However, Delerio
and Dumalaog (2020) revealed that three in four information technology-business process outsourcing (IT-
BPO) companies in the Philippines reported an increasing prevalence of employee burnout or extreme
stress, with additional concerns including sleep difficulties (56.4%) and diminished work performance
(50%). Roughly one-fourth of companies have employees diagnosed with mental health conditions, with
77.3 percent citing anxiety as the most common condition, followed by depression at 63.6 percent and
bipolar disorder at 22.7 percent. Many companies incorporate mental health policies, but about one in five
do so within their general company policies without explicitly mentioning mental health. Barriers to IT-BPO
companies' mental health efforts include the high cost of programs, exclusion from private health
maintenance organization packages, and the pervasive fear of stigma and discrimination.

Funds for mental health services in the country are insufficient and should be given more attention in budget
documents. Cureg et al. (2023) revealed that the National Expenditure Program and the General
Appropriations Act lack specific items for mental health. Policymakers and implementers must have a
shared and integrated vision for mental health care. They should know how community-based mental health
care fits into the existing health system, which includes local health centers, clinics, and hospitals. Also,
these institutions should readily share mental health information. Although the Mental Health Act
emphasizes deinstitutionalization and integrating mental health policies at the local level, there is still a need
to improve its implementation and translate these concepts into practical actions, especially regarding
financing and organizational commitments.

The COVID-19 pandemic placed a great burden on Filipinos, causing economic struggles, isolation, health
concerns, and limited access to healthcare resources, all of which have taken a toll on mental well-being.
The Philippine Statistics Authority reported a 57-percent increase in self-harm rate in 2020 compared to
2019.[2] Yabut et al. (2021) revealed that although mental health programs existed, these appeared
disconnected and lacked strategic collaboration among various stakeholders. They stressed that local
government units (LGUs) should lead in starting a comprehensive mental health program to address
pandemic-related issues. Teachers, church workers, health workers, and community organizers should
undergo training in psychological first aid to support mental health concerns within their communities.

Despite the Mental Health Act's requirement for LGUs to establish primary and community-based mental
health and psychosocial support services (MHPSS) and integrate these into existing healthcare systems,
shortcomings remain evident. Santiago (2020) pointed out that a shortage of qualified personnel and limited
financial resources hinder expanding MHPSS coverage in the Caraga region, especially in areas in dire need
of health services. For instance, Tandag City faces recurrent displacements due to armed conflict and natural
disasters, impacting the well-being of displaced individuals and communities, underscoring the need to
enhance local MHPSS capacities to assist affected residents.

During natural disasters and conflicts, people often face significant psychological challenges. Santiago
(2020) thus underlined that psychosocial interventions must be prioritized for the most vulnerable, such as
children, pregnant women, and the elderly, as they are often unable to anticipate, cope with, resist, and
recover from the impacts of disasters. Early and adequate MHPSS is crucial to help them recover from
traumatic events.

The Socioeconomic Research Portal for the Philippines (SERP-P) has resources tackling mental health.
Below are some of them:

 Between Resilience and Transformation: Mental Health Policies, Interventions, and Challenges in the ITBPO
Sector through the Covid-19 Crisis
 Underscoring the Mental Health Agenda in the Philippines
 Setting Up a COVID-19 Mental Health Response Strategy among Local Government Units
 Localizing Mental Health and Psychosocial Support
 Responding to Psychosocial Needs in Disasters Through Creative Means

For more studies, simply type “mental health” and other related keywords in the Search box of the SERP-P
website.

The WHO Special Initiative for Mental Health, aiming to establish accessible and affordable
mental healthcare, reported insights into the challenges faced by participating countries,
including the Philippines.
These challenges encompass service delivery, governance, workforce, financing, and stigma.
In the Philippines, the prevalence of mental disorders ranged between 11.3% and 11.6%,
with an average annual increase of 2.0%; increasing from 7.0 to 12.5 million Filipinos
diagnosed with a mental disorder between 1990 and 2019.
Anxiety and depression are the prevailing conditions.
Considering these challenges, WHO advocated a strategic approach comprising increasing
political prioritization and funding, developing a sustainable and transformative model of
care, and promoting a collaborative approach to practical context-specific measures.
The enactment of the Philippine Mental Health Act in 2018 signaled a step towards a
comprehensive mental health framework.
Historically, mental health financing was low, accounting for only 5% of the healthcare
budget.
Nevertheless, developments in Philippine mental healthcare are promising, including the
nearly twenty-fold increase in government mental health financing from 57 million to 1
billion between 2022 and 2023.
Moreover, The Philippines is also piloting a mental health package for outpatient settings.
However, timely payment of claims is essential, as reports indicate that reimbursements of
expenditures can be delayed for up to three months.
Therefore, notwithstanding the improvement in mental health financing, it is imperative to
explore sustainable funding sources, including private sector participation.
WHO also introduced the Consolidated Framework for Implementation Research.
This framework systematically assesses the factors influencing mental healthcare
accessibility and affordability, which include intervention, internal and external settings,
individuals, and the process.
Challenges such as focus on tertiary-level services and the complexity of primary mental
health care requirements are observed in the Philippines. Mental health services in the
country are concentrated in psychiatric hospitals and outpatient care services in general
hospitals, with limited integration into primary healthcare and informal community support.
Therefore, interventions should prioritize the establishment of community-based mental
health services, and processes to improve mental healthcare accessibility and affordability.
It is also pivotal to advocate for integrating different levels of care to ensure an efficient and
responsive mental healthcare system. There are approximately 1600 psychologists and 500
psychiatrists in the country, serving about 110 million Filipinos.
Resources in tertiary-level services, including psychiatrists and emergent services, can be
harnessed to facilitate the training of primary care workers and establish referral centers
within communities to cater to individuals in need of specialized care.
In the Philippines, the internal setting of the WHO Framework can refer to the partnership of
WHO, the Department of Health, and the Philippine Council for Mental Health (PCMH), an
agency entrusted with formulating mental health policies and services.
To strengthen this partnership, an array of experts and stakeholders is essential. Leading
mental health researchers can be included in PCMH to more effectively contextualize the
mental health system, considering the limited mental health research available in the
country necessary to inform stakeholders. For instance, Scimago reveals 431 publications
within the psychiatry and mental health category from the Philippines between 1996 and
2022.
This number pales compared to other countries with similar economies and regions (i.e.,
Vietnam, Thailand).
The external setting of the WHO framework encompasses the complex environment
influencing interventions. Filipino culture offers valuable resources to enhance Filipinos'
mental well-being and social support, encompassing tight-knit community structures and
Filipino psychology concepts, such as kapwa.
However, stigma rooted in Filipino culture remains a challenge, with some attributing mental
disorders to personal weaknesses or supernatural causes.

As a result, mental disorders are seen as socially unacceptable, leading Filipinos to turn to
friends and family for assistance and avoid professional mental healthcare.

In the Philippines, advocates have pushed for the Mental Health Act implementation, leading
to programs within communities and sectors.
For example, school-based programs have been introduced over the years.
Nevertheless, enhancing transparency, accountability, support, and incentives is necessary
to ensure the effective implementation of these interventions.
Therefore, it becomes essential to acknowledge and incentivize the contributions of key
actors who advance the understanding and transform the Philippine mental health system.
For example, annual recognitions can incentivize key actors (i.e., researchers and
community-based programs) to further promote mental health system transformation.
Ensuring the quality of personnel who lead community-based interventions in mental health
system development is vital.
However, corruption and nepotism within the Philippines have posed historical and
contemporary challenges.
Strategies to mitigate these challenges could include implementing transparent and well-
defined scoring systems beyond conventional qualifications for prospective administrators
and experts. For instance, the assessment of experts can encompass competency
considerations, such as publications and h-indices, together with non-academic metrics like
professional memberships and clinical experience.
Multi-stakeholder participatory engagement process is crucial for mental health system
transformation in the Philippines.
 Stakeholders' involvement in developing and evaluating outcome indicators can help ensure
that key actors and stakeholders, including service users and providers, caregivers,
administrators, and researchers, are considered. Overall, the increase in mental health
prioritization in the Philippines is promising. However, strengthening current developments
is essential for transforming mental health services. Efficient resource utilization is critical to
a sustainable model of care. Lastly, a shared approach to contextualized interventions, along
with informed stakeholders, is vital to transforming Philippine mental healthcare.