While Filipinos have been slow to acknowledge the existence and importance of mental healthcare, let alone the need to manage it professionally, it would seem we are finally getting somewhere.

Bit by bit, mental health is being normalized, leading to widespread awareness, creation of relevant policies and its natural inclusion in regular conversations both in media and everyday life.

But as we start to take great strides in accepting the need to take care of our mental well-being and handle our mental health issues, so grows the demand for services that address these needs—something our current infrastructure is very much having difficulty to provide.

As late as last year, the disparity between demand and availability remain at a staggering two or three mental health professionals for every 100,000 Filipinos (the World Health Organization recommends 10 psychiatrists per 100,000 population).

Undoubtedly, closing this gap should be top priority, but it cannot happen overnight. For now, with the ever-growing urgency for such services—especially with the pandemic taking a huge toll on people’s mental health—we ask: Who takes care of the caretakers?

Greatest instrument

Mental health workers often preach self-care. With the stresses they face in their field, it is imperative that they practice what they preach.

“As we often hear, we cannot pour from an empty cup,” said Dr. Carolina Uno-Rayco, national executive director of the Philippine Mental Health Association. “It is important, even necessary, for us to have a self-care routine because we are our greatest instrument in helping others. If we are not feeling good about ourselves, if we cannot care for ourselves well, it will be extremely challenging—even almost impossible, to genuinely care for others.”

“Our clients also look up to us as their model and if we do not walk the talk, it will be difficult for us to lead them toward the path of wholeness and healing,” she added.

For Uno-Rayco, waking up while everyone else is still asleep makes her feel the most herself. “It’s just me. All the things that I want to do for myself, I do during this time because there is no distraction.”

It’s when she does her morning prayer and reflection to help her clear her head as a “spiritual preparation for the day.” If weather permits, the psychologist does her “awe walk,” which involves getting into a state of overwhelming wonder and openness while taking a stroll, acknowledging being in the presence of something larger than oneself that transcends understanding.

Close to nature

“I am blessed to live in an area that is close to nature and so I walk around the village if time and weather permit,” added Uno-Rayco.

She prepares herself for the day psychologically by listing all the things she needs to do so she doesn’t forget anything. “These can be small or huge things. It gives me a sense of fulfillment and improves my confidence knowing that I have accomplished something, big or small, during the day.”

For Dr. Rea Celine Villa, Mind You senior psychologist, her motivation to serve helps surpass the stress she experiences through her work and advocacy.

Pivoting to psychology three years ago, she left her comfort zone in education to heed the call to help fellowmen struggling during the pandemic. “Those who were ok suddenly got hit with depression or anxiety, so I think the pandemic is an event where it made my purpose clearer: to serve a bigger purpose for Filipinos, to help. I became a psychologist because, day in and day out, I want to serve the Filipino people the best I could by giving therapy by psychoeducation.”

According to Villa, being a psychologist is hard in the sense that they absorb the challenges of other people. It’s not as if she can cry or break down while conducting therapy, she said, so she had to develop self-care routines.

Live your own life

After a session with a patient, she leaves whatever happened behind. “You have to live your own life again, and then onto the next. You have to learn to segmentize your life, your 24 hours. Like once work is done, you have your own me time.”

“I cannot keep on advising people to do something that I myself don’t do. I need to also apply what I say, so it starts with self-care,” Villa said.

“At night, I watch series or movies for me to express the emotions that have piled up. So I laugh, I cry, which helps me balance things out: While I get certain emotions during therapy, I am able to purposively let it out,” she added.

Psychiatrist Dr. Kathyrn Tan has been working at National Center for Mental Health for 12 years and even volunteered during the height of the pandemic to lead the Pre-admission Unit, a countermeasure for COVID-19 that was established in 2020. Two years of being a frontliner and working 24/7, however, caught up to her and she requested to be taken off the team last year.

That is not to say she has slowed down. Despite living with muscular dystrophy—an incurable heritable condition that is rare among females, and leads to progressive weakness and loss of muscle mass—Tan is still very much known for working overtime. But that is because she enjoys working, which shows that self-management can come in various forms.

Five things

According to her, her self-care routine boils down to five things: (1) keeping things simple and living below her means; (2) taking care of herself and putting herself first; (3) having an attitude of gratitude; (4) making an effort to improve herself; and (5) living with a purpose.

“If I don’t need it, I won’t buy it,” Tan said, adding that her outfit was practically a uniform because she just buys the same shirts and pants in different colors. She admits to liking online shopping and name brands, but not as much as she used to and she now goes more for quality than flashiness. She also likes investing to help her prepare for the future.

Even as she works six days a week, she makes sure to make time for herself, which means time for meals, Netflix and her rescue cats. She makes sure to take cold showers, keep her teeth clean and maintain her weight through a pescetarian and plant-based diet (since she is unable to exercise).

For her, even simple gestures as saying “please” and “thank you” are part of her self-care. She feels a rush when she is able to show her appreciation for what others do for her just as much as she does when she is able help other people. But she said it is also important to be able to say no.

Her advocacies also play a part in caring for her wellbeing: A firm believer of climate change, she tries not to feed into fast fashion; she also subscribes to “adopt, don’t shop” ideals; and tries to pay it forward when she can.

She is constantly trying to improve herself. Every year, she makes a list of what she can do to that end. Her attention deficit disorder keeps her from enjoying books, but she listens to podcasts and lectures, and she plans out academic goals she wants to achieve by yearend.

Whatever her situation, she tries to feel content. “Acceptance is the key to happiness,” Tan said. Five years ago, she got a tattoo of Wonder Woman to signify her will to keep fighting to keep walking.

When it comes to self-care, one size does not necessarily fit all. Tan said the first thing to do is to know oneself. Of course, there are the basics: physical health, good physical activity, alone time, sun exposure, adequate sleep and food choices. Beyond that, she said to “get a lot of information, and see what applies to you.”