The year 2018 was a milestone for mental health, as President Duterte signed the Mental Health Law (RA No. 11036) that would provide affordable and accessible mental health services to Filipinos.
The law secures the rights of people with mental health illness to receive humane treatment; provides mental health services to villages; requires local government units, schools and companies to push for awareness to remove the stigma surrounding mental health; integrates psychiatric, psychosocial and neurologic services in regional, provincial and tertiary hospitals; and stipulates that treatment and medication be covered by PhilHealth.
The 2018 World Happiness Report ranked the Philippines No. 71—up from No. 72 last year—out of 156 countries. But according to the World Health Organization fact sheet for 2017, suicide is the second leading cause of death among 15- to 29-year-olds. In 2016, more than 79 percent of suicides worldwide occurred in low and middle-
Schools like Ateneo de Manila University launched programs for Care students (Critical Attention Required), and have had a faculty mentors’ group since 2016. Each college department has one or more trained, designated mentors. Training includes spotting signs of mental health disorder and knowing what to say or do.
Dr. Queena Lee-Chua, Ph.D., faculty coordinator for Care students, said they focus on mental health issues such as depression, bipolar and other mood disorders, generalized anxiety, panic, phobias, obsessive-compulsive disorders, self-harm, including eating and body dysmorphic disorders, attention deficits with or without hyperactivity, Asperger’s syndrome, borderline personality disorders, addiction, schizophrenia and more.
“Aside from training faculty, our sessions are also open to staff,” Chua said. “Administrative assistants interact with students daily and are aware of their issues. We have also trained our security personnel to respond to emergency cases, which they have conscientiously done.”
There are licensed guidance counselors and psychologists who refer more serious and urgent cases to other professionals, such as psychiatrists, for treatment. “At the heart of it all, the aim is to have students realize that they are loved—no matter their achievements, their appearance, their social media likes,” she said.
There are wellness programs and mental health awareness programs in place for students. The Associate Dean for Academic Affairs advises and guides students with mental health issues that have hindered academic performance, while the Student Sanggunian promotes mental health awareness on campus. It has been holding a Mental Health Awareness Week for the past two years.
“Traditionally, professors are tasked to guide them academically, toward a career, and a grounded sense of self, hopefully to be of service to the community,” Chua said. “But now, many of us have to become substitute parents, listening and guiding and advising many students in pain way beyond office hours, including weekends and holidays.”
She said Ateneo is probably the first, or perhaps the only school in the country, with a protocol for handling mental health cases.
But what about smaller schools with limited or no budget at all?
“Create awareness among teachers and among school personnel,” said Dr. Ma. Lourdes “Honey” A. Carandang, Ph.D., clinical psychologist and National Social Scientist. “From my experience, no program will be sustained if we just talk to the students. This should involve the entire community— parents, students, teachers, school guards and staff.”
Carandang pointed out that many schools are not making mental health issues a priority. “But mental health program is essential for anything they want to do. A curriculum cannot be carried out without addressing mental health issues,” she said.
The first step for any school, however, is to take care of the teachers themselves and their entire mental and physical health. “Approach them on how to take care of themselves. How can you teach them skills they don’t even value? Their dignity must be upheld, and they must be treated in a respectful way,” Carandang said.
When respect is in place, only then should schools train teachers to become first responders, to develop a deep and mindful listening attitude. But first, teachers have to know that the schools care for them. “It takes a whole systemic approach,” she said.
It’s about preventive measures, Carandang noted. Promote mental health, not mental illness. “The way you discipline and treat students can foster mental health. Recognize the strength and self-worth of students.”
There aren’t enough counselors in schools, Carandang said, so train the whole system so that counselors won’t feel overwhelmed.
A national program
It was also a good year for cancer patients, as the Senate passed a bill last November seeking to establish a Philippine Cancer Center, and to institutionalize a national control program. The Senate approved Bill No. 1850 that seeks to address gaps in cancer care and integrate policies for its prevention, detection, correct diagnosis, treatment, palliative care, pain management and survivorship or end-of-life care.
The bill will also work on minimizing the incidence of preventable cancer cases, and will establish a National Integrated Cancer Control Council with the sole focus of implementing programs that will provide comprehensive, accessible and affordable cancer treatments for all cancer patients.
The National Integrated Cancer Control Act will give cancer patients a choice. They will have access to equitable and affordable cancer treatment and care, especially for underprivileged and marginalized Filipinos.
There are up to eight deaths per day for childhood cancer and up to 11 new cases and seven deaths every hour for adult cancer in the country, according to the Cancer Coalition of the Philippines. This computes to approximately 110,000 new cancer cases and over 66,000 cancer deaths each year, according to the Department of Health. Cancer is the third leading cause of adult death in the Philippines, and fourth in child morbidity.
Under the bill, PhilHealth should expand the benefit packages to include screening, detection, diagnosis, treatment assistance, supportive care, survivorship follow-up care and rehabilitation, and end-of-life care for all types and stages of cancer in both adults and children. When the bill is passed into law, all health maintenance organizations (HMOs) will be required to cover genetic counseling and testing, cancer screening, diagnostic and palliative care.