Invest in mental health

Cases of anxiety and depression increased by over 25 percent over the last two years as the world struggled with COVID-19, a scientific brief released early this month by the World Health Organization said. The mental health impact of the pandemic has been far-reaching — even long-term — and has affected everyone one way or the other, the WHO said, with many of these cases found in places that had high daily infection rates and severe lockdowns.

This is true for the Philippines where the government imposed strict lockdowns as COVID-19 infections surged especially last year. According to reports, there was a six-fold rise in Filipinos suffering from depression increasing from about three million before the pandemic to more than 17 million this year.

The average monthly calls received by the National Center for Mental Health (NCMH) through its hotline also peaked from 400 in May 2019 to 1,600 in March last year — or around the time the government reimposed a strict lockdown particularly in Metro Manila after COVID-19 cases surged again. Job losses, deaths in the family, economic uncertainty, and the lockdown that limited people’s movement were among the reasons cited by callers to the NCMH. Suicide-related issues accounted for a third of these calls.

The good news is mental illness has been getting attention, especially through the coronavirus pandemic, with psychologists calling this mix of emotions—including the lack of motivation, stress, and fear that were especially common among medical frontliners and students, women, and children — as normal reactions to abnormal times. Mental health has become part of the national conversation with local podcasts tackling the issue and helping destigmatize the illness.

Lawmakers have also proposed measures to address it, such as House Bill No. 6253, or the Mental Wellness Leave Act, filed by Ang Probinsiyano party list Rep. Alfred delos Santos, which seeks to expand Republic Act No. 11036 or the Mental Health Act. Among others, the bill seeks to provide five or more days of leave on top of the current mandatory vacation and sick leaves for employees in the private sector.

It also requires employers to provide mental health programs to their workers. “Mental health is not a joke … Mental sickness is not the same as any physical illness. A person may look and act normal, but may have serious mental concerns deep inside,” Delos Santos said. He added that mental health should not be taken lightly because it does not have any physical manifestations. Advocates have, in fact, called mental illness a silent pandemic that has spread especially over the last two years.

In a report released last October, the UN Interagency Task Force on the Prevention and Control of Non-communicable Diseases (UNIATF) noted that mental health conditions cost the Philippines P68.9 billion annually, or 0.4 percent of the gross domestic product. This amount is further broken down to P2.7 billion direct costs to the government through health care expenditures and P66.2 billion indirect costs to the economy mainly due to reduced productivity in the workplace because of absenteeism, presenteeism, and premature deaths.

The Investment Case Report on Mental Health in the Philippines, presented last November by the government and UN bodies in the country, outlined a number of recommendations to address the problem including increasing the capacity of health care workers to provide mental health interventions and investing in mental health research and development.

Chronic underinvestment in mental health services, said Brandon Gray of WHO’s mental health and substance use department, became very evident during the pandemic with mental health services widely disrupted, thus decreasing access to essential care for those who needed it. While services were shifted online, those who did not have internet access or were not technologically literate remained isolated. “The decades of underinvestment are showing up now in our lack of preparedness to address the scale of the problem,” Gray said.

WHO director-general Tedros Adhanom Ghebreyesus said that while 30 percent of disability leaves are caused by mental health conditions, only 2 percent of government budgets are earmarked for mental health. He previously urged governments to use the pandemic as an opportunity to build mental health services that are inclusive, community-based, and affordable.

The lifting of remaining COVID-19 restrictions could provide a breather for the mental health of Filipinos who had endured two years of economic uncertainty and lockdowns, but these should be lessons learned for the government, especially for the next administration, to address existing challenges. Ghebreyesus aptly put it: “If ever there was a time to invest in mental health, it’s now.”