Paying attention to mental health

It’s true that mental illness is no longer a taboo topic that can only be discussed in whispers. The COVID-19 pandemic, which has increased anxiety and cases of other mental health issues, has indeed helped bring it to the national conversation and made the public more open-minded and aware that it is a condition that must be treated like any other disease. But it is also true that barriers remain, foremost of which is the steep cost of treatment that makes it still unaffordable to many poor Filipinos.

At least 3.6 million Filipinos, based on 2020 data from the Department of Health, suffer from mental illness and this number is most likely to have increased in the past three years. Yet, per findings of a study by the Harvard Humanitarian Initiative recently published in this paper, many Filipinos struggling with mental health issues still refuse or hesitate to seek treatment because they believe it is too expensive. It does not help that despite progress made in raising public awareness, there remains a stigma to mental illness, and it is still generally considered a lesser priority, especially among the marginalized sectors, compared to getting a job or putting food on the table—even if these factors contribute to the general well-being.

It should not be enough that the government raises public awareness about the importance of mental health but it also must put much-needed resources to help those who cannot afford treatment get the necessary medical attention. However, as figures from the national government’s annual budget would show, mental health remains an underserved sector. While there has been a 100-percent increase from the P1 billion budget in 2019, pre-pandemic, to P2.15 billion this year, this amount is a mere drop in the bucket compared to the billions earmarked for confidential and intelligence funds whose purpose is not as transparent.

To determine the importance that the government gives to mental health, one only has to take a look at the dreadful and abysmal conditions at the National Center for Mental Health (NCMH). Aside from NCMH, the Mariveles Mental Hospital in Bataan is the only other tertiary hospital that offers psychiatric care in a country with a 110 million population. Between them, there are only 4,700 beds available for psychiatric patients. It is no surprise that satellite hospitals affiliated with the NCMH across the country are overcrowded and face chronic funding problems that make it difficult to recruit staff or maintain facilities. In addition, based on World Health Organization data, for every 100,000 population, there are only 1.08 mental health beds in general hospitals, 46 out-patient facilities, four community residential facilities, and 0.41 psychiatrists. As a 2019 study published in the National Center for Biotechnology Information put it, mental health care in the Philippines “remains poorly resourced.”

The responsibility does not rest on the national government alone as local government units (LGUs) have been delegated the delivery of mental health services under a decentralized system. Under Section 38 of Republic Act No. 11036 or the Mental Health Act, LGUs are tasked to “establish or upgrade hospitals and facilities with adequate and qualified personnel, equipment and supplies to be able to provide mental health services and to address psychiatric emergencies.” Under this law, LGUs must also ensure that those in geographically isolated areas should have access to such services by providing home visits or mobile health care clinics. But this set-up, as the Philippine Council for Mental Health noted in a publication in 2019, “has yielded very little positive results in the past years i.e., inadequate, inaccessible, ineffective mental health services.” This is especially true for poorer LGUs that can barely fund other basic services and would have to depend on the national government to provide additional funding so they could fulfill their mental health mandate. Still, LGUs must step up and be more proactive in initiating mental health programs in their communities by coordinating with local schools and churches. LGUs, at their level, have more access to crucial information i.e., who needs counseling or treatment and can offer support immediately. By spreading awareness about mental health and making services more accessible at the grassroots, they can also lessen the stigma around it.

The need for a more collaborative and strategic approach to mental health has become even more urgent as the world faces the impact of the COVID-19 pandemic on mental health, especially among the youth who grew up during this period. The recent increase in cases of bullying, suicide, and other mental disorders is a manifestation that mental health is equally important. If left underfunded, this would cost the country’s economic and health sectors billions more than the government has been prepared to spend or what it could afford.