Today, like most days, Kate* found it difficult to get out of bed and go to school. Gripped by a constant feeling of gloom and anxiety, Kate—a 20-year-old sophomore—has been grappling for months with the effects of her deteriorating mental state. Her grades were slipping, and she found it harder and harder to function normally.

Triggered by a surge of financial, family, and academic problems that came to her all at once, Kate’s mental health was at its all-time low. She decided to seek professional help after realizing that she was having suicidal ideations. 

Come back on the 23rd, the University Health Service (UHS) staff told her. It was more than a month away. There was only one psychiatrist at the UHS, she was told, and her schedule was already filled to the brim with students seeking consultation. 

Elsewhere on the campus, the waiting time for mental health services is no better. Alex*, a 21-year-old engineering student, also felt he needed help. “I found it extremely difficult to focus. It was as if I was always floating. When I realized this, I tried to get help, but I knew it would be difficult and expensive,” he said. 

Hearing about an office offering free psychological services to UP students made him hopeful. “But when I got to PsycServ [UP Diliman Psychosocial Services], I was told that the waiting time was around two to three months,” Alex said.

These stories reflect a systemic ailment plaguing the Philippines where mental health services are extremely difficult to access, said PsycServ clinical manager Claudine Tecson. Confronting this crisis requires not only strengthening the institutions that cater to psychosocial needs but a concerted effort to identify and address the intricate network of factors involved.

Caught Unprepared 

From professionals to even epidemiological data, current knowledge of the mental health situation in the Philippines is incredibly scant, manifesting how the issue is barely prioritized in all institutional levels.

Department of Health (DOH) numbers from 2019 show that there are only about 1,000 psychologists and 600 psychiatrists in the entire country—a far cry from the World Health Organization (WHO) target of having around 11,000 mental health professionals for the Philippine population. 

On the national university’s flagship campus, attempts have been made to address the increasing demand in psychological services. Launched in 2017, PsycServ was a response to what the UP Diliman administration saw as an influx in student mental health issues. It has since catered to around 1,500 students dealing with issues ranging from anxiety to depression.

More recently, the number of students seeking help registered a notable spike. “Dumami mga pumupunta sa amin pero hindi talaga sapat ang resources namin. That’s why we’re hesitant to advertise our services, because our resources are really lacking and we may not be able to cater to all of them given the demand,” Tecson said.

Despite the vital role it plays, PsycServ is still hounded by institutional woes. From having to defend its budget yearly to being understaffed—with most of its psychologists being non-UP contractuals—PsycServ has been struggling to keep up with the students’ needs.

“There was even a point when we considered to stop accepting sign-ups,” Tecson said. “Ideally, the wait time is less than a month, but it has gotten to a point where students had to wait for almost three months in the queue.”

PsycServ has already applied twice to become an institutionalized office. In 2018, the application was reportedly denied due to the university’s budget constraints, which is why PsycServ still operates as a special task force under the Office of the Chancellor. 

Numerous other similar initiatives have since been launched, including mental health weeks, emotional support dogs, wellness centers, and mindfulness seminars.

Kate thinks these measures, though well-meaning, offer only temporary respite and fail to address the root causes of her anxiety. Much as she loves petting the occasional dog visitors in her institute, she said she still would prefer dependable psychosocial services.

For Dr. Ronald Del Castillo, a clinical psychologist who specializes in community mental health, these efforts are welcome, but a systemic approach that incorporates these stopgap measures into everyday university life should be undertaken instead of treating them as the ultimate solution.

“The trick is that we do not treat these as things that only happen during mental health week. In the same way that we recommend regular exercise to promote cardiovascular health, these opportunities for mental wellbeing should also be offered throughout the year. Over time, they will not be seen as something special but rather as a regular part of university life,” Del Castillo said.

Behind the Cries for Help

Del Castillo also pointed out the importance of examining this surge in student mental health issues in the context of how the university treats its students. Due chiefly to the immense pressure students face, education, he says, has become “performative,” with happiness treated as a mere byproduct.

“University life becomes a workhorse, instead of an opportunity to thrive. There is a culture of suffering so that we can self-congratulate ourselves into resilience. There is a culture of production, achievement, and status,” he said.

This is true for Alex, who suffers through “hell weeks” when the workload piles up. “And it’s like a vicious cycle where I can’t do my acads because of my mental state and my poor grades are causing me even more mental distress,” he said. 

Locally, the data on mental health is extremely sparse. The Global Burden of Disease Study in 2016 estimated that around 9 million Filipinos suffer from mental illnesses, with 3.3 million cases of anxiety disorders and 2.6 million of depression. Cases are expected to be underreported, given the lack of Filipino mental health professionals and the stigma associated with psychological illness, according to a 2019 study in the British Journal of Psychiatry. 

Young people aged 15 to 29 suffer the brunt of the mental health crisis, accounting for the majority of reported cases of suicide. In fact, the latest WHO data shows that suicide is now the second leading cause of death, behind accidents, for all young age groups. 

Del Castillo explains that vulnerability to psychological problems intensifies particularly in high-pressure environments like schools. “For many, it is their first time away from home and from the social supports that have cradled them since childhood. Most are navigating a world where they are trying to find their footing,” he said. 

In rural areas in the country—where more than a third are impoverished—the lack of access to mental health services is even more pronounced. UP Diliman’s handling of the situation may be better than other schools where mental health is an alien concept, a silent epidemic sounding no alarm bells.

For Del Castillo, a leadership that expresses genuine concern for the mental wellbeing of students is what UP needs right now. “Let's see vice presidents and chancellors in multiple meetings hashing out a five-year or 10-year strategic plan explicitly and only about mental health and wellbeing. Let's see the movement of resources—financial, human, or otherwise—towards that goal. And then, let's revisit that plan in years’ time and hold them accountable,” he said. ●

*Names have been changed to protect their identities.

This article was first published in print on February 24, 2020. The National Center for Mental Health crisis hotlines are (0917) 899 8727 and (0917) 989 8727. PsycServ can be reached at (0916) 757 3157 while the UHS emergency hotline is 981 8500 loc. 111.