Editor's note: This article contains discussion of suicide and details about similar mental health conditions. The Department of Health’s crisis hotline can be reached at 1553 (landline); 0966-351-4518 and 0917-899-USAP (8727) (Globe/TM); and 0908-639-2672 (Smart/Sun/TNT).

Slumped in front of the laptop screen for more than a day already after finishing her school outputs and commission works, Jane’s* attention drifts away from her online class meeting as she spends the remainder of her energy crying. This is how she described her usual days as a grade 9 student last school year; trudging through every laborious moment with heaviness in her chest, rife with uncertainties and fear of what may come after.

Jane’s plights are shared among many other students in basic education. This prompted 775,962 students to seek guidance counseling in 2021, according to a report by the Department of Education (DepEd) presented in a Senate panel in February. DepEd also revealed that 404 learners died of suicide during school year 2021-2022, while 2,147 students attempted to do so.

Experts point at the pandemic as one of the main possible contributing factors to the spike in the number of suicides and cases of mental health problems among students in the country. “The COVID-19 pandemic is a major contextual factor because it created changes to the students’ social environment,” explained Jeryl Tan, a senior lecturer of psychology at UP Diliman (UPD).

For Jane, the previous school year drove her mental health to plummet to its lowest level yet because of severed social ties due to isolation and worsened economic disposition. Being devoid of an environment conducive to healing also punctuated the repercussions of those conditions. She fears that she has become entirely unrecognizable from the person she used to be before the pandemic.

Owing to the lackluster mental health measures promulgated by DepEd and the national government, high school students’ psychological condition further deteriorates in the face of inaccessible health care and unaddressed social and economic concerns.

“Disasters such as the current pandemic lay bare systemic ineffectuality and injustices that were already there to begin with. The pandemic highlights and even exacerbates these,” Divine Love Salvador, an associate professor of clinical psychology at the UPD Department of Psychology, told the Collegian. “They (children) bore the brunt of our society’s and government’s failure to create educational environments that are punctuated by caring and compassion where students are nurtured towards not just academic excellence but a sense of wholeness and thriving in life.”

Precarious Spaces

Beset with problems with their mental health, high school students are often left to grapple with inefficient institutional support supposedly geared toward addressing their concerns. With no idea who to turn to, they are plunged into intensified despair and a feeling of precarity in environments where support systems should be in place.

Counseling across educational institutions persists to be replete with issues that hinder students from accessing them. For one, there is an enduring misconception about the role of guidance offices in schools. “May notion pa rin ang students na kapag guidance, papagalitan sila, nakakatakot,” shared Jomari Rualo, a guidance teacher at Krus Na Ligas High School (KNLHS).

This apprehension hampered Jane from confiding in the guidance office at Marikina Science High School. According to her, no widespread effort was made on the part of the guidance office to orient them on the framework of their services and to assuage the anxieties felt by the students that they might be invalidated once they opt to open up.

“These cultural norms shape relationship behaviors and interactions with children and could create a climate of fear and distrust. In this climate, no child will ever disclose what they are going through. And therefore, if we do not have access to their internal worlds, we cannot begin to know what to help and support them about and how to do so,” Salvador said.

The problems of the counseling system ultimately stem from being severely undermanned and underequipped. Per DepEd data, there is only one counselor per 14,000 students whereas the global ideal ratio is to have one counselor per 250 students. In addition, only 19 percent of more than 5,300 guidance counselor-authorized posts in the department have been filled.

One of the reasons behind the lack of counselors is the high qualifications being demanded in a position with such low pay. A registered guidance counselor with a master’s degree would only receive around  P25,000 at the entry level. This is the reason why, according to Salvador, pursuing allied mental health professions is de-incentivized.

To make up for the lack of guidance counselors, schools like KNLHS designate teachers to head the guidance office and offer mental health services to students. This, despite the Guidance and Counseling Act of 2004 stipulating that only licensed and registered counselors may give these services to students.

As a consequence, teachers who are assigned to this position have to juggle their teaching load with the added role of an acting counselor. This may also pose harm to students who are being advised by those who were not necessarily trained to do so.

When guidance offices then confront high-risk problems that include suicidal ideations, Rualo shared that one of their practices is to refer these students to external psychometricians. Yet, for the likes of Jane who have already gone as far as harming themselves, the problem of access to these professionals remains to be a significant barrier.

Persistent Barriers

The cycle goes as such: Socioeconomic plights exacerbate students’ mental health problems while simultaneously hindering them from being able to access the services in the country needed to remedy these issues.

Since Jane has a single mother who is the sole breadwinner of their household, their family went through financial hurdles at the onset of the pandemic which she cited as one of the main stressors that have befallen her. This is what eventually pushed her to start an artwork commission business to help in her own way to make ends meet. As an effect, Jane had to brave through many sleepless nights just to finish her deliverables both in school and her work.

The disaster of a pandemic that exacerbated economic hardships magnified the feeling of insecurity among people, which resulted in an environment that is less tenable for the advancement of one’s well-being, according to Salvador.

Inequitable access to mental health care bars the likes of Jane from addressing their concerns. She could not even bring herself to get consulted by professionals due to fear of the costs this entailed, let alone receive the interventions needed to allay her situation.

This is the problem that the Mental Health Act of 2018 aimed to address. Sections 15 and 16 of the law guarantee the provision of mental health services and facilities at the community level that are accessible and affordable, while section 24 states the need for schools to institute a complement of mental health professionals.

Five years after its passage, the multi-agency group, Philippine Council for Mental Health, which the law created continues to lack a unified framework for their mental health response. During a Congress briefing last February to address the spike in the number of suicide among students, agencies under the council only presented fragmented plans that were not in coordination with each other.

 The legislation, albeit gave a framework for the creation of expansive mental health care, must account for the economic restraints due to the continuing challenges of underfunding, a shortage of mental health specialists, and inadequately developed community mental health services, according to a 2019 study by psychiatrists John Lally, John Tully, and Rene Samaniego. 

Community of Care

Approaches to mental health care must be predicated on the principle of democratizing access while also providing a holistic solution to derail the systemic characteristics underpinning many of the risk factors.

“It’s important to directly address suicide through the creation of sustainable prevention and postvention services and programs and ensuring democratic access to these,” Salvador said. An essential tenet of this is the creation of mechanisms at the grassroots which can only be propelled through a sufficient budget allocation to the Department of Health, local government units’ mental health services as stipulated in the Mental Health Act, and educational institutions’ psychosocial infrastructure.

To this end, an integrative approach among educational institutions and the national government must be adopted, said Tan. This comes with active collaboration and participative deliberations between schools and their stakeholders to figure out the best course of action regarding the particular situations of every locality.

For Rualo and Jane, efforts must emphasize robust community-building where a safe environment for learners can be fostered so that they may have avenues to air their grievances and sentiments. This calls for a shift in cultures that must be embedded in the pedagogy. “We cannot think and talk about mental health and wellbeing without thinking and talking about philosophy, ethics, values such as justice and peace, and so-called virtues of living,” said Salvador.

As Jane now transitions along with her peers to physical classes, the longstanding dilemmas hounding the mental health and psychosocial services system in basic education—and the nation at large—must be uprooted. After all, the lasting consequences of this nationwide concern will bleed into the generations to come, leaving an indelible impact on children who will carry it for the rest of their lives. ●

*Not her real name. The source has asked the Collegian to conceal her real name due to the sensitive topic of the article.