TCI Asia Pacific recently interviewed Janice Cambri from the Philippines. A survivor of psychiatry, her personal history is what propelled her to become a disability rights activist. She founded the first advocate group for persons with psychosocial disabilities in the Philippines after being introduced to the CRPD and TCI Asia Pacific in 2014. She works with a strong identity of a self advocate and draws from her own experience to work towards ending human rights violations of persons with psychosocial disabilities.
A long time leftist activist, it is Janice’s alliance with the leftist movement in the Philippines that has helped shape her intersectional point of view when it comes to understanding disability. She is a strong advocate for more discussions on capitalism and it’s effect on driving the biomedical mental health systems. For many years now, Janice has been involved in national, regional and international level advocacy not only for the rights of persons with psychosocial disabilities but also for the cross disability movement and national political leftist advocacy, often working at the policy level. As a member of TCI Asia Pacific, she has been a strong advocate of the importance of working on intersectional frameworks within the disability movement.
Tell us about yourself and the work that you do.
I am a self-advocate. I am the founder of Psychosocial Disability-Inclusive Philippines. It is the pioneer and sole CRPD inspired advocacy group as well as the first to be recognized as the representative organization of our sector by the national government. I am also part of Anxiety and Depression Support Philippines which is the largest online peer support community in the country. Since mid-2014, I have been serving as resource speaker for psychosocial disability in disability sensitivity trainings for government employees and commercial institutions initiated and conducted by the National Council on Disability Affairs, an attached agency of our nation’s Social Welfare Department. I do cross-disability advocacy as member of the Philippine Coalition on the CRPD. And I also work closely with Psoriasis Philippines (PsorPhil) and the Deaf. I have been instrumental in reclaiming our rightful place in policy making concerning us and in bringing the voice of the CRPD into the mental health legislation. I am a member of the steering committee of TCI Asia Pacific.
Left: Janice in a disability sensitivity training for employees of Department of Labour;
Can you share with us a little bit about your journey and how you joined the disability sector?
I was a naive user of psychiatry for 12 years starting 2002. I was completely unaware of the medical versus human rights model dichotomy though I have been a leftist activist since 1999. Toward the end of 2011, I was invited by peers from the cross disability movement to join the Philippine Coalition on the UN CRPD. At the time, the group did not have any member who had psychosocial disability and had been looking for the longest time. One of them saw my letter to the editor on a newspaper regarding the national mental health institution and immediately reached out. However, I was not steered into the direction of organizing a group for our sector even after the country mission in the Philippines led by then TCI Asia in 2012. Instead, I became part of the Deaf community working as a college professor for the Deaf the same year. Since I was recruited by the Coalition, I never received any formal training on the CRPD. I genuinely understood our cause only after attending my first plenary with TCI Asia in late 2014 in Thailand where I got to meet other mental health and disability activists from other countries in Asia. I was the only one who was not part of an organization of persons with psychosocial disability and I vowed that I would form one when I came back home and I did.
Top Right: Janice at the TCI Asia Plenary meeting in 2014 with other members of TCI Asia; Bottom Right; Janice with the Philippines UN CRPD Coalition at the first CRPD review meeting of the Philippines in Geneva,
What are the basic ideologies that you follow in your work? What drives you to think this way and do this work?
I bear both ideologies from the Left and the human rights model to disability which makes for a great combination. I have been a National Democratic activist for 19 years and we were trained to fight oppression, most especially the systematic ones. I know that a lot of mental distress stems from political, social, economic, and cultural determinants which are also the root causes of why majority of my countrymen are buried in poverty. Capitalism is the main driver of pharmacological treatment becoming the first line of care in mental health. It is behind the insistence of watering down mental health issues as products of a broken brain rather than a direct result of the havoc capitalist exploitation wreaks on millions of human lives. This is the discourse that needs popularization because it is absent in most discussions on mental health and disability. On a personal note, I fell prey to the medical model and coerced medication, a blatant violation of my right to informed consent simply because I did not know any better. I suffered massively from the adverse effects of psychotropic drugs that almost ruined my life. I wish to prevent others from enduring the same fate. I want them to know they have choices and that it is our human right as enshrined in the CRPD.
Can you elaborate on the intersectionality between psoriasis and psychosocial disabilities?
Persons with psoriasis tend to develop mental health issues such as depression, anxiety, and suicidal ideation because of their condition and the severity of discrimination they face from majority of the people who are oblivious to their illness. Psoriasis is an incurable excruciating, debilitating chronic auto immune disease that does not only affect the skin contrary to popular belief but causes other co morbidities such as obesity, diabetes, arthritis, hypertension and higher cardio vascular risk among others so they also may develop physical or orthopedic disability and visual disability later in life. Because one of the major symptoms appear on the skin, it is often mistaken for being contagious or a hygiene problem so people get away from them or treat them with disgust. Some of these painful experiences they endure due to prejudice include being called hurtful names; being quarantined at the airport; being refused services such as spa, haircut or a taxi ride; and being asked to get out of public pools. There are also instances of being abandoned by their spouses or partners. In a world where physical look is given a high premium, most persons with psoriasis are put at a disadvantage. Their choices for treatment are expensive consequently making their out-of-pocket costs high since the government allocates a measly budget for health. Since 2015, I have been privileged to be part of Psoriasis Philippines, the leading organization of the psoriasis community and have helped pave the way for them to embrace their disability identity and be included in the cross disability movement.
Above: (Far right) Janice on World Psoriasis Day 2018 campaigning for full CRPD compliance for persons with psychosocial disabilities with a cross disability group Psoriasis Philippines.
We know you have some experience with campaigning for the CRPD in the mental health legislation in the Philippines. Can you share with us what that was like?
To describe it as an uphill battle would be an understatement. I was practically late in the game. Proposed legislation started way before my time. There was no psychosocial disability organization let alone a movement. Though there were patient organizations, these were usually led by mental health professionals and were clinic or hospital based. Peer support groups were hiding online. The doctors who drafted and lobbied for the bills had all the advantages while we virtually had no machinery to fight. I had no training on CRPD. My organization was at its infancy. Early the following year, I was already in the thick of the fight, writing position papers against the Mental Health bills which contained provisions contravening the CRPD, taking them door to door to senators and congressmen’s offices and talking to our Commission on Human Rights and other concerned agencies. The Bills were ignored during the 16th Congress only to be resurrected in the next one in 2016. Together with Dr. Liza Martinez, a colleague from the Coalition, we fought tooth and nail during the Congressional deliberations invoking the CRPD and other pertinent U.N. documents. We even drafted a substitute Bill if only to counter the current ones. Fortunately, we could rely on inputs of seasoned activists abroad that we consulted. The panelists and legislators in the hearings were shocked that we were criticizing the Bills and that sentiment trickled down among peers and other persons with disabilities who were laboring under the illusion that the legislation was completely to our benefit. In the end, the railroaded Mental Health Law was enacted this year with some of our comments being incorporated. To date, we continue to narrow down the opportunities for oppression by actively participating in the drafting of the law’s Implementing Rules and Regulations set to be released in January 2019. The review of the Mental Health Law became part of the recommendations in the Concluding Observations of the UN CRPD Committee to the Philippines as a result of our parallel report and personal engagement during its first Constructive Dialogue in Geneva, Switzerland last September. It has been extremely trying to the soul. It was exhausting and traumatizing but was definitely worth it. No one can say that we did not put up a good fight and I am proud that we did given the odds stacked against us.
Left: Janice at the Senate hearing on the Mental Health Bill in 2017;
What are the challenges you face advocating for human rights for persons with psychosocial disabilities in the Philippines?
The stigma remains high. For most peers, it is not easy to come out as person with a psychosocial disability let alone do public advocacy. Even among other persons with disabilities we face exclusion. That was a tragic reality I faced during the Mental Health legislation struggle when even supposed CRPD anchored and more seasoned disability leaders abandoned us even when the CRPD was under attack. A lot of peers remain under the huge influence of the mental health professionals and the medical model is the status quo. The nature of our disability also makes it difficult to organize the sector. Most times, physically gathering them together is a herculean task. It does not help that the social movements, including the wider human rights movement, have not embraced the disability cause. My personal limitations also come into play. Doing advocacy work in the last 4 years exacerbated my own mental health condition. The bleak human rights situation under the current government administration and its willful dismissal of its mandate to champion the interests of the majority is also compounding the problem which puts more people at risk of developing mental distress and psychosocial disability.
How has your work with the cross disability movement affected your work with persons with psychosocial disabilities?
It definitely shaped my appreciation for the struggle. Because it enabled me to understand common grounds with other disability constituents, I get the bigger picture. It made me understand that mental health issues are not exclusive to us who were given psychiatric diagnoses. It molded me to be more inclusive. I, myself, am a mother to a child with learning disability so I learned empathy early. My engagement with the cross disability movement also taught me how it is crucial that I educate my peers about the plight of those with other types of disability and what our similarities to them are. My contributions to the passing of the Filipino Sign Language and the inclusion of persons with psoriasis in the government disability social protection program and cross disability movement would be good demonstration of this.
Right: At the Senate Hearing before passing the Filipino Sign Language Bill;
What do you hope for persons with psychosocial disabilities in your country?
I hope that they get wind of the disability and human rights perspective and be part of advocacy.
How has TCI Asia Pacific contributed to your work in the Philippines?
TCI AP facilitated my capacity building as a psychosocial disability advocate which helped establish my credibility. It gave me tools for analysis and has been significantly influential in the position I take in advocacy. The organization also enabled me to expand my network and exposure outside Asia which has been extremely valuable in gaining wisdom. This and the lessons from the learning sessions and brainstorming during plenaries and meetings came very handy during the fight against the Mental Health legislation. It is my tribe. Meeting the members reinforces my will to continue the work which could be a very lonely endeavor at times in the Philippines.
Top Left: Janice at INTAR India 2016; Bottom Right: (Top row, second last, far right) Janice with TCI Asia Pacific’s Steering Committee meet in 2017