Mental health is a very crucial issue that needs to be understood by all in its proper context. Can you give us a sort of primer on mental health and explain how important it is in our life?
J. Siason: According to the World Health Organization (WHO), “mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.” It is an essential part of health and well-being that supports our “abilities to make decisions, build relationships, and shape the world we live in.” Moreover, “mental health is a basic human right. And it is crucial to personal, community and socio-economic development.”
While the WHO is very clear on the definition of mental health, this topic remains something greatly misunderstood by a lot of our countrymen. The stigma associated with mental health in our local context only demonstrates that a lot of Filipinos lack proper and factual information about mental health. Consequently, the social gap between the public and mentally ill people is becoming wider. Because of misconceptions and negative beliefs surrounding mental health issues, people often suffer in silence and don’t seek treatment.
Mental health is more than the absence of mental disorders. The WHO emphasizes that mental health is an “integral part of health”; indeed, there is no complete health without considering also its mental aspect. Mental health handles stress, and affects how people make decisions and relate to other people. It influences the way people look at themselves, their lives, and other people in their lives. If a person experiences mental health problems, his mood, behavior and way of thinking could be affected.
What are the most common mental health problems in Filipinos, and what are their causes?
J. Siason: Depression is the most common mental health condition in the Philippines. In 2017, there were about 3.3 million cases of depressive disorders (3.3% of the population). It is characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, tiredness, and poor concentration. Depression may be continuous or recurrent, substantially impairing people’s ability to function at work or school and to cope with daily life. It can lead to suicide. Depression is often triggered by a mix of genetic, psychological and environmental factors; studies show that the risk of becoming depressed can be increased by life events such as poverty, death of a loved one, physical illness or abuse.
Anxiety is another common mental health condition in the Philippines, with about 3 million cases of anxiety disorders (3.1 % of the population) in 2017. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor. For some people, anxiety may be linked to an underlying health issue.
Identifying the various issues that cause mental health problems, what can be done to address more concretely the mental health problems plaguing the lives of many Filipinos?
J. Siason: Although there is still an enormous gap in addressing mental health issues in the Philippines, we need to acknowledge that there has been progress in terms of addressing this concern. Signed on June 20, 2018, Republic Act No. 11036 known as the Mental Health Act is; “An Act Establishing a National Mental Health Policy for the Purpose of Enhancing the Delivery of Integrated Mental Health Services, Promoting and Protecting the Rights of Persons Utilizing Psychiatric, Neurologic and Psychosocial Health Services, Appropriating Funds Therefore, and for Other Purposes.”
Moreover, initiatives on spreading mental health awareness from private and public organizations are being made to a greater degree to help the public improve and expand their understanding of mental health conditions and increase access to healthcare for those who need it. An example of this are the helplines (also called hotlines or crisis lines) that offer immediate mental health support to the public for free. I, myself, have volunteered as a helpline responder. I was happy to provide a safe space for callers who needed to talk, unpack their burdens and receive support by actively listening to them, helping them process their emotions, and working with them to determine meaningful steps forward.
We, Filipinos, are known for our being “secretive” or shy about expressing what we are undergoing in order not to cause trouble among family members or our circle of friends. How can we help those who are hindered by this?
J. Siason: As children, we have been often told to ask for help whenever we have difficulty doing a task. This simple act seems to get harder as we get older. Moreover, as we progress in life, there is a somewhat unspoken expectation that we need to figure things out, pull ourselves together when engulfed by our emotions, and face every struggle head-on, ALL BY OURSELVES. The hard truth is just because we’re “adults” doesn’t mean we don’t need help anymore. Ideally, whenever we are overwhelmed, we should feel that we can reach out to our family members, friends, and those of our support network when we need to. Although this is not always true for most of us, let us keep in mind that HELP IS AVAILABLE. We just need to be properly informed and open to the idea — accept that we all need someone to help us go through those turbulent moments, to learn how to navigate rough waters. Asking for Help is NOT weakness but strength.
If I wish to offer my help to people I know who are struggling with mental health issues, how should I do it? Can I accompany people with mental health problems even if I do not have the necessary skills to do it?
J. Siason: Accompanying people regarding their mental health journey is an art that can be learned. Before we encourage people to seek professional help, accompaniment must begin with ourselves. I am sure you would agree with me when I say that NO ONE is immune to physical and mental illness. Therefore, in order to journey with someone who is struggling with mental health challenges, it is fundamental that we first develop an informed, compassionate, and accepting approach to persons with mental illness.
In the mental health profession, we recognize a need for counseling when people begin experiencing mental distress, and when their strategies to cope become ineffective. To accompany someone is to go somewhere with him or her, to “break bread together” (share a meal), to be present on a journey with a beginning and an end. There’s an element of mystery, of openness, of trust, in accompaniment. The companion, the accompagnateur, says: “I’ll go with you and support you on your journey wherever it leads. I’ll share your fate for a while — and by ‘a while,’ I don’t mean a little while. Accompaniment is about sticking with a task until it’s deemed completed — not by the one that accompanies, but by the person being accompanied.” (Farmer, 2013, p. 234)
True enough, there is still much to be done in this advocacy to serve people greatly affected by mental health issues. How can we work together to be mental health advocates? Any suggestions for those who may be interested in joining this very timely advocacy?
J. Siason: Numerous prejudices surround mental health and mental illnesses. Most of the time, it is a result of ignorance by many who do not have a deep and clear understanding of the subject. However, younger generations and more educated people seem to be more tolerant. A previous encounter and interaction with a patient challenged by some form of mental illness also reduce stigma and fear, which further increases awareness of the situation in which these people find themselves (Yuan et al, 2017). And lastly, individuals who are made aware that they have full support, including a positive outlook, from their respective families, friends, and co-workers, have a better possibility to normally resume their family life and work, notwithstanding the challenges of the mental illness that might affect them. If we work together, we can provide accurate information for everyone. This will lead to a better understanding of what mental health is, and thus, PUT AN END TO THE STIGMA.
Romeo Pelayo Vital
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REFERENCES:
Depression and other common mental disorders, Global health estimates; Global burden of disease study 2015. Geneva: World Health Organization; 2017
Farmer, P. (2011, October 24). Re-imagining accompaniment: Global health and liberation theology—Conversation between Paul Farmer and Father Gustavo Gutiérrez. Ford Family Series, Notre Dame University, South Bend, IN, USA.
Yuan, Q., Seow, E., Abdin, E. et al. Direct and moderating effects of personality on stigma towards mental illness. BMC Psychiatry 18, 358 (2018). https://doi.org/10.1186/s12888-018-1932-3
