In 2021, a substantial increase in the percentage of youth who often felt depressive symptoms was found in the survey conducted by University of the Philippines Population Institute (UPPI). This includes the doubled number of those who often felt loneliness, sadness, and being disliked by other people. Considering that this survey was conducted at the height of the pandemic, the physical and social isolation of people may have further affected the young people’s response. These numbers may also be linked to the huge percentage increase of Filipino youth who have tried ending their lives from 574,000 or 3% in 2013 to almost 1.5 million youth equating to a 7.5% rise in 2021. Of these numbers, 6 out of 10 who have ever thought of committing suicide did not ask anyone for help, and the few who did mostly reached out to their peers and family. Only 4% of them sought professional help which only goes to show that seeking professional help is still highly unpopular (UPPI, 2022).
The female youth is also one of those who are greatly affected with the 2021 Young Adult Fertility and Sexuality Study (YAFS5) discovering that 17% among the 15-24 age range of women have thought of committing suicide, with 44% of them acting upon this thought. This figure also amounts to twice the number of suicide attempts in female youth between 2013 to 2021. Reasons for this may be linked to gender-based issues and violence, bullying, loneliness, lack of physical activity, among others.
Taking into account the conservative-Catholic culture of Filipinos, the suicide rates in the country is still considerably low. However, the staggering numbers of people experiencing mental health problems and suicidal thoughts has become more alarming since the pandemic happened. This calls for better access to mental health services and implementation of the Mental Health Act (Republic Act no. 11036) of 2017 to prevent the increase of people, especially the youth and vulnerable, to experience severe mental health problems leading to the worst case scenario of them ending their lives.
Barriers to Mental Health Access
Firstly, at the macro level, there is to be a shortage of mental health facilities. As of today, there are only two tertiary care psychiatric hospitals which are the National Center for Mental Health (NCMH) in Mandaluyong and Mariveles Mental Hospital in Bataan. Both of these facilities face problems of overcrowding, poorly functioning units, chronic staff shortages, and funding constraints. Although the country’s resources for mental health mostly goes to the financing of care and treatment provided for persons with major mental disorders (psychosis, bipolar disorder, depression), these major mental health facilities continue to struggle as the government’s total expenditure on mental health only sums up to 2.9% of the total government health budget. This has led to limited resources and lack of access to services* such as counseling, consultations, and community-based mental health practices.
Furthermore, based on the Mental Health Atlas (2020) presented by the World Health Organization (WHO), there are only a total of 1,821 mental health professionals that tend to the needs of Filipinos. This means that there are only 1.68% mental health professionals per population of 100,000. The Department of Health (DOH) elaborated on this, specifying that there is only 1 doctor for every 80,000 Filipinos; according to them, this is due to the emigration of trained specialists to other countries and the majority of them working in for-profit services or private practices (DOH, 2012). This figure shows that the Philippines is falling behind its neighboring countries as the WHO recommends 10 psychiatrists per 100,000 population (Lally, 2019).
At the micro level, on the other hand, despite the available public services for mental health, the majority of persons with mental disorders still opt for paid mental health services. This could be linked to the poor management of public mental health facilities and overcrowding of public mental health services channels. Other issues, as mentioned in the study of Lally (2019), is the perceived and internalized stigma that hinders the help-seeking behavior in Filipinos rooting from their conservative culture. This results in them having a difficulty admitting to mental health problems and reaching out for help. Additionally, culturally, Filipinos are family-oriented, most of them turn to their friends and families instead of seeking professional help.
The Government’s Response to the Mental Health Needs of Filipinos
There are steps being done by the national government to respond to the Filipino people’s mental health needs. First and foremost, the Mental Health Act (Republic Act no. 11036) in 2017 was passed in order to establish access to comprehensive and integrated mental health services, while protecting the rights of people with mental disorders and their family members (Lally et al, 2019). The DOH has also launched an 8-point agenda that mentions mental health under one of its priorities namely “Ginhawa ng Isip at Damdamin.” They will be implementing a multi-sectoral approach for mental health with programs and interventions cutting across various sectors such as schools, workplaces, and specific communities that are aimed at high-risk individuals. Along with this, Mental Health is also mentioned as one of the priorities of the Health Promotion Framework Strategy (HPFS) 2030, stating that the goal is to increase and protect the psychosocial and well-being of the people, as well as reduce the burden of mental health disorders and incidence of suicide.
The National Suicide Prevention Strategy is another project being implemented by the national government. This includes psychosocial services such as the NCMH Crisis Hotline called “Kamusta Ka? Tara Usap Tayo” which was launched in 2019. This hotline is available 24/7 to provide psychological first aid. Along with this, the UP Diliman Psychosocial Services (UPD PsychServ) also has free counseling via telephone for frontliners. These projects have opened more channels for people who were struggling mentally during the lockdown period and have led to more progress in widening the access to mental health services. As stated in the study of Harvard University (2023), mental health providers perceive that the barriers to access and treatment stigma have decreased since the advent of COVID-19 due to the transition to teletherapy that ensured care continuity and allowed expanded access to services and service areas.
How do we fill in the gaps?
The lack of mental health professionals per capita to handle the overflowing mental health cases opens more opportunities for other institutions to contribute to addressing the scarcity of services in this sector. There are other existing evidence-based interventions that may be delivered by well-trained lay professionals so as to lessen the workload that is currently burdening the mental health professionals. This will open more channels for other service providers, therefore increasing the spaces available for people who are in need of help.
For instance, FriendlyCare Foundation Inc., has initiated programs to fill in these gaps. In partnership with the Center for Mindfulness - Toronto, they trained facilitators on Mindfulness-Based Cognitive Therapy (MBCT) which is evidence-based, group-based, and delivered by well-trained lay professionals. This targets those who want to avoid relapsing, release old mental habits, and build new ones that will help them better manage their mood. This program is designed as an 8-session program where participants attend a 3-hour session once a week. It has also gone through numerous meta-analyses and has been found to be at par with the effectiveness of antidepressant medication. Along with this, the organization also offers other programs developed for the needs of different sectors such as the Mindfulness for Compassion and Well-being (MCW) that is currently being offered in colleges and universities, such as the University of Philippines Diliman (as a PE elective), University of the Cordilleras, Guang Ming College, and more. They also offer Mindfulness in the Workplace (MWSR) to attend to the mental health needs of those belonging in the workforce.
As the access to mental health services remains a huge problem in the country, it is essential for us to recognize all possible avenues where mental health services can be made available. To be able to prevent the suicide rates from increasing, there is a need for more channels to be made available where people can ask for help. Systemically, our services could be improved with better provision on mental health services, however, as a community, we can move towards a society that is more forward-thinking and open to new approaches such as the mindfulness-based programs of FriendlyCare. By supporting such programs, we are widening spaces where people can take care of their mental health.
FriendlyCare has started narrowing the gaps in the mental health sector, however, we need your help in promoting our services. Help us promote our services at Mindfulness at FriendlyCare! Read more on mindfulnessatfriendlycare.com to see our programs and services. You may also follow our facebook page: Mindfulness at FriendlyCare.
Sources:
https://dmas.doh.gov.ph:8083/Rest/GetFile?id=701365
University of the Philippines Population Institute (2022). 2021 Young Adult Fertility and Sexuality Study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525682/
https://www.who.int/publications/m/item/mental-health-atlas-2017-country...
https://reliefweb.int/report/philippines/affordability-and-stigma-hinder...
https://www.sciencedirect.com/science/article/pii/S1876201823001338
https://newsinfo.inquirer.net/1757982/mental-healthcare-still-inaccessib...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646843/
https://www.who.int/philippines/news/detail/10-09-2020-doh-and-who-promo...
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00040-2/fulltext
https://newsinfo.inquirer.net/1723742/mental-health-crisis-404-student-s...
https://www.uppi.upd.edu.ph/news/2022/pinoy-youth-in-worse-mental-health...