One more signature left before the Philippine Mental Health Bill is officially ratified. The president is expected to give his final approval of the bill anytime soon. Nevertheless, it is true that the mental health movement in the Philippines is still in its formative years, and once the bill gets officially turned into law, implementation of the bill cannot be expected to run smoothly right away. The primary reason for this is that most Filipinos continue to perpetuate the stigma about mental illnesses. Mood disorders such as depression are still being trivialized, while psychotic disorders are ridiculed. But where does this deeply-rooted stigma come from?
My personal take is that it’s not that they don’t believe that mental illness exist; it’s that they believe, or were made to believe, that they can’t do anything about it, so they choose to deny experiencing it or having ever encountered it.
It is ignorant to deny that poverty affects the mental health of someone immersed in it. Needless to say, it will ultimately affect the reinforcement of the mental health movement in the country. As this is a third-world country with citizens mostly from lower- to middle-class, it’s not new to encounter Filipinos who tend to set aside mental health in order to prioritize “more practical” things such as providing for their families, food, maintenance for shelter and basic education. It may be harmful to neglect mental health, as it is a vital aspect of one’s overall well-being, but this mindset remains undeniably prevalent.
My mother once talked to me about my mental disorders, saying “we cannot afford to be sick”—in a literal sense—and I actually agree with her. I often find myself wanting to stop medications and counselling because I know that therapy demands a bit too much financially.
This is not isolated to mental health; most Filipinos from the lower to middle class would go to health centers for consultations and assessments only when their symptoms are already severe. Otherwise, self-prescription of generic medications remain commonly done as healthcare in the country is still seen as inaccessible to most—even though there are free consultations and medications in selected centers, these centers are often jam-packed day-to-day.
Because of this, usual ways of coping can come in the form of vices, which further worsens one’s state of mind. An example of this is substance abuse, which is a widespread social ill in the Philippines and has been the primary aim of incumbent President Rodrigo Duterte to fix throughout his term. However, his work mostly relies on the perspective that the drug problem is a criminal act as it is a mental health issue.
In some cases, neglected mental well-being manifests through a problematic personality seen among dysfunctional families with abusive parents or partners, or in troubled persons. Cases such as these are often dismissed as mere immorality, but in fact follow symptoms of mental illnesses as stated in DSM-V. Again, we go back to the reason why they opt not to get diagnosed and treated.
Something in relation to poverty that can also be mentioned is how Filipinos are predominantly religious, and how the church remains to be influential in matters that should only concern the state, such as the implementation of the reproductive health law and family planning, which the church is firmly against, thus its weak implementation. The effects of this insufficient implementation directly affects poverty as it results in overpopulation, and thus it influences the state of mental health of those from the lower to middle class.
The church can also be traced as the root of the misconception that mental health is a matter of personal resilience and strong faith, which is harmful when the underlying connotation is that resilience and faith alone can cure illnesses of the mind. Although faith does help some people cope, it actually is not connected to mental health. Mental illnesses aren’t healed by prayers, nor are they cured by the unhealthy coping mechanisms that trigger destructive behavior.
These factors greatly fuel the stigma: mental illnesses are taken as something that heals through time without the need for medical aid. Consequently, people who have a difficult time coping are viewed lowly, as weak or overdramatic.
Breaking this deeply-rooted stigma will take time and so much effort, and the presence of advocacy organizations at the forefront of the mental health movement is truly commendable. The Mental Health Law should make a great difference, especially in educating the public and offering free and accessible healthcare. But ultimately, we should stop treating mental health as an issue separate from other sociopolitical factors, as they are and will always be in a loop of cause and effect.
Photo: John Christian Fjellestad