Composite image made from stock photos by JEROME CRISTOBAL / INQUIRER.net
MANILA, Philippines — Many Filipinos struggling with mental health problems refuse or hesitate to seek treatment because they believe it is too expensive or they are too ashamed to seek help, despite advances in public access to mental health care over the past two years.
These are some of the findings of a recent study performed by the Harvard Humanitarian Initiative (HHI) in cooperation with the Philippine Psychiatric Association and Psychological Association of the Philippines, which sought to measure gains in mental health care during the pandemic.
The study hoped to identify barriers to mental health care among Filipinos, of whom more than 25 percent reported moderate to severe anxiety during the pandemic.
At least 145 psychiatrists and psychologists across the country participated in the study published in the June 2023 issue of the Asian Journal of Psychiatry.
Among other findings, a majority of the respondents (65 percent) said they felt that issues of accessibility and stigmatization of mental illness had decreased since the pandemic.
In a recent interview with the Inquirer, Ateneo Bulatao Center director Karina Therese Fernandez said this was in part due to Filipinos experiencing collective stress, making them more “open-minded” about the gravity and importance of mental health care.
“But while we’ve made strides, we still have to make more improvements in making sure that mental health care is healing and helpful instead of driving further stigma,” she said.
Role of telemedicine
Many respondents also emphasized how telemedicine helped continue care and expand services to other previously untouched areas, while others attributed this to increasing public awareness of mental health as the public grappled with the COVID-19 pandemic.
Vincenzo Bolletino, program director of HHI Resilient Communities, said the study’s findings “were promising in that they suggest that in the face of widespread challenges posed by pandemics or disasters there is a reduction in stigma related to seeking mental health care.”
“Further, greater accessibility to mental health care services through telehealth create opportunities for providing care for those that may not otherwise seek support because of distance, travel costs, or other similar barriers,” he added.
However, an overwhelming 97.9 percent of mental healthcare providers perceived a rise in mental health concerns among help-seeking Filipinos during the pandemic, a period marked by lockdowns and mobility issues, especially in its first year.
‘Crazy, weak’
Moreover, 97.2 percent also saw an increase in anxiety-afflicted patients, followed by depression (97.2 percent), bipolar and related disorders (49 percent), trauma disorders (46.2 percent), and suicide risk behaviors (44.1 percent).
Meanwhile, many mental health professionals found that patients hesitate or refuse to seek help because of the high costs of mental health care (40 percent).
About a third also said they felt ashamed or worried that they would be seen as “crazy” (31 percent) or “weak” (30.3 percent). Others said they were concerned about what their peers might say.
Apart from cost, many were also concerned about traveling to appointments or not knowing where to get professional care.
‘Fixing something broken’
Others reported a previous bad experience with professional care or expressed fear of side effects from medications or being put in in-patient care.
For these reasons, according to Fernandez, Filipinos must unlearn the prejudice that seeing a mental health professional is tantamount to “fixing something that’s broken.”
“We need to instill in people [the idea] that seeking help isn’t just fixing something but to enhance one’s well-being,” she said, adding: “We are not bringing people with disorders back to normal, but we’re helping people to become better people, more happier, foster better relationships and bringing out the best versions of themselves.”
The HHI study also found that a number of Filipinos tend to think that their mental health problems would get better untended or dislike talking about their feelings, emotions, or thoughts.
Fernandez said such unwillingness might be embedded in both community and work cultures, in which people are under pressure to be productive all the time.
More gov’t funding
To address these, the respondents recommended increasing both the number and training of mental health providers and staff; better internet connectivity; as well as more government funding for mental health care.
Greater awareness for services to better reach communities is also needed, the study said.
Overall, the researchers said, the findings “provide a valuable snapshot of the mental health needs and context in a difficult-to-access and under-resourced setting from providers’ perspectives.”