Years ago, when we underwent health examinations at the Infirmary before admission to any program in the University, we only worried about registering a normal body mass index, negative X-ray results, and no serious physical illness. Once we cleared these initial obstacles, we got the coveted stamp of “healthy” on our green health certificate.
But is this all there is to being healthy? How do we define and set standards on overall health and well-being?
What is mental health?
The World Health Organization (WHO) defines overall health as a concurrence of complete physical, mental, and social well-being, versus the commonplace notion of health being the absence of sickness or disease. While we consciously work on being physically healthy, and with Filipinos being naturally social people, we often overlook this critical dimension of health.
To the WHO, the state of your mind is an integral and essential component of your health, which covers the growth and realization of your goals and abilities, how you cope with stress, and being a productive member of your community. Your mental health can be affected by many social, psychological, and biological factors.
The WHO recommends that national mental health policies be more comprehensive in a manner that not only focuses on the prevention of mental health problems and disorders, but also promotes an environment where people can thrive and maintain healthy lifestyles. These policies must cut through all sectors, across all income brackets and age groups, from early childhood interventions, social support to the elderly, to mental health initiatives in school and at work.
In order to address the needs of those afflicted by mental health disorders, awareness is the first key step: knowledge on detecting signs and symptoms of these disorders are important to take action and prevent more complex problems like suicide and substance abuse.
Globally, about 14% of the world’s population are affected by mental, neurological, and substance use disorders with a higher prevalence of 11 to 44% for developing countries such as the Philippines. The stigma is prevalent among people with mental health disorders, who are further driven into poverty either by high costs and inaccessibility of treatment, or by being marginalized and denied opportunities at work or school.
In the Philippines, 20% of adult Filipinos suffer from mental or psychiatric disorders, with an average of 88 reported cases for every 100,000 citizens, according to the Philippine Statistics Authority. In the 2000 National Census, 200,000 Filipinos had a mental disability among 1.4 million Filipinos with disabilities. Currently, only about 500 psychiatrists are licensed in the country, with less than 6,000 hospital beds allocated for people suffering from mental health disorders. In UP, most mental health issues revolve on relationships, family, and financial concerns.
The Department of Health has a proposed National Mental Health Policy as its flagship mental health program headed by a DOH Undersecretary and the Director of the National Center for Disease Prevention and Control. It aims to work with other agencies such as the Philippine Psychiatric Association, the National Center for Mental Health, the Philippine Mental Health Association, and civil society organizations to provide mental health services and to engage in policy and legislation, research and capacity-building, and establish an information system and database.The National Mental Health Program Strategic Plan for 2017-2022 focuses on “Wellness of Daily Living, Extreme Life Experiences, Substance Abuse and Other Forms of Addiction, Neuroloic Disorders and Mental Health Disorders.”
The role of the University
As the national university, UP’s mandate includes the promotion of mental health and wellness, which is spearheaded by the Office of Counseling and Guidance (OCG) in the University of the Philippines Diliman.
Dr. Violeta Bautista serves as Director of the OCG and also teaches with and heads the Clinical Psychology Program of the UP Department of Psychology in the College of Social Sciences and Philosophy. She explains that mental health is the healthy functioning of the different dimensions of one’s psychosocial being by themselves and together.
She laments how mental health problems in the Philippines tend to be associated with issues related to psychiatric problems such as depression and anxiety. As a result, most initiatives such as seminars and workshops are geared towards addressing these narrower issues. In fact, mental health programs must also tackle issues related to wellness in daily living such as enhancing happiness and satisfaction in life, understanding the self and others, marriage enhancement, experiencing wholeness in the workplace, and finding meaning and purpose in one’s studies and work to name but a few of such concerns. These are all mental health problems, according to Dr. Bautista.
“We certainly would like to nurture intellectual giants, but we would also like to nurture the total person among our students,” adds Dr. Bautista. The OCG’s vision is to have self-aware, psychologically healthy students who are clear about their life goals, who can manage the range and depth of their emotions, and are compassionate and caring towards other people. It pleases her that UP is oriented to a more holistic total-person orientation in education, a trend that is being observed worldwide.
Existing mechanisms within the University
Because mental health must not only be concerned with treating those who are already sick, the OCG offers both mainstream and innovative services. Aside from counseling to address personal and school related concerns, it also offers assessments to support career exploration and personality development. Freshmen are encouraged to drop by the OCG for an intake interview, to get to know the OCG’s services and people and to see how they can be helped. Interestingly, finding the intake interview to be most helpful to their students, several colleges are now institutionalizing the practice among their freshies. With the reported increase of psychiatric and serious psychological problems both here and abroad, the OCG is recruiting psychosocial support specialists, such as graduate students at the tailend of their program, who can provide psychotherapy under the supervision of licensed psychologists.
The OCG is also developing innovative initiatives emphasizing strength and thriving. Modules on stress management, understanding and knowing oneself, nurturing healthy relationships in the campus, and leveling up study habits are offered to address the need for students to thrive and grow. These workshops fall under the Campus Caravan program in which various colleges host roving talks and seminars.
Annual events such as the University Job Fair are also organized by the OCG in partnership with the University Student Council, AdCore, and JPIA to provide students with current and life-giving perspectives on career exploration and job search and to create opportunities for meet-ups between prospective employers and graduating students, which highlights the students’ values and aspirations which are integral psychosocial factors.
The annual Celebrate Life event coincides with Suicide Awareness Week. It is a half day of fun and meaningful activities that invite students to discover opportunities for thriving in the Diliman campus. Perspectives and tips on dealing with stress, anxiety, depression and even suicidal thoughts are shared.
To provide psychosocial support to students, the OCG is putting in place a buddy system, a program that aims to link up naturally friendly students with freshies and other students who need company and guidance. Another key program of the OCG is the “Learning to be a Lifeline” workshop. This is a one-day competency-building workshop for gatekeepers (teachers, admin staff, dormitory and security staff) designed to equip them to spot vulnerable students and to refer them to competent professionals.
In consultation with other units, the office has also crafted Policies and Guidelines on Mental Health and Psychosocial Support which will guide the provision of such services to the students, with special focus on suicide prevention and post-vention.
The University Health Service (UHS) has also integrated a questionnaire that lists down items as a means to identify incoming freshies who may be at risk of psychological or psychiatric problems. An appointment with a mental health professional is necessary to get a student’s clearance to enroll.
Psychological first aid
Cassie Deluria, an incoming member of the UP Diliman USC and one of the student leaders who convened the Youth for Mental Health Coalition, started being a mental health advocate when she realized that within just one week, there was an upsurge in her daily conversations with friends involving depression, failing marks, and an overall fatigue towards student life. The trend worried her and she started doing research on whether this was a normal occurrence. This was when she encountered “psychological first aid” which consists of simple questions like asking if someone already had a full meal or a full night’s rest.
Psychological first aid is outlined in the WHO’s Mental Health Gap Action Programme (MHGAP), a handbook of sorts to guide non-specialists in providing support and implementing an intervention guide. The MHGAP lists general principles of care, a master chart of priority conditions, and easy-to-understand flowcharts on assessment and management of various scenarios.
A first in the country, the Youth for Mental Health Coalition is an alliance of student councils, organizations, and individuals who are interested in raising awareness, connecting people to places to get professional support, and push for legislative gains in Congress. The coalition goes from school to school to stage events, with the first one held at the University of Santo Tomas. The coalition seeks to institutionalize psychological first aid in schools and universities. Other members of the coalition from UP are from the College of Social Sciences and Philosophy, the School of Statistics and the College of Engineering.
What’s next for mental health in UP?
The OCG is developing a Total Inclusive University Environment Project that aims to develop programs that will help students with mental and psychosocial disabilities to do well as students and experience total person growth in the university.
Recruitment of licensed mental health professionals such as guidance counselors and psychologists is also a priority, alongside the call for more psychosocial volunteers.
The OCG is building into its programs an evaluation component to gauge the impact and effectiveness of existing services, and to build on the current gains to design new ones. Admittedly, resources are also needed to improve existing physical structures to create a nurturing ambience and character in line with the message of the office. On top of everything, a communication strategy is being crafted to make the services of the office more known to the students and the wider Diliman campus community.
For the Youth for Mental Health Coalition, the passage of Senate Bill 1190 is a huge step forward for the cause. Senate Bill 1190, or the Mental Health Act of 2016 sponsored by Senator Risa Hontiveros, aims to uphold the basic right to mental health services and facilities by Filipinos. Its primary objective is for the national government to develop a mental healthcare system responsive to the psychiatric, neurologic, and psychosocial needs of the Filipino people. A parallel initiative is now being started at the House of Representatives with mental health champions Rep. Tom Villarin and Rep. Kaka Bag-ao.
What can a normal person do to help?
Since lack of awareness is the primary hurdle that mental health advocates seek to overcome, what can an ordinary member of the UP community do to help?
Cassie believes the first step is to remove the cloak of special treatment around mental health problems in relation to other ones. She illustrates this by pointing out the stark difference between reactions on mental health (“I have depression”) which garners glorifying and flattering reactions and physical health (“I broke my arm”) which gets the usual reactions. The fact that a certain amount of bravery is needed to come out and discuss mental health issues may be a barrier to people who need professional help. She envisions a future in which people can speak about psychological pain as openly as they speak about physical pain.
Dr. Bautista, on the other hand, suggests a very basic approach: if you happen to have any psychological or psychiatric problem, there’s no reason to be ashamed of it. She says that it’s not a sign of being any less a person when confronted with these challenges. She adds, “Be confident that there are people and places on campus where you can ask for support in managing these problems. UP is committed to encourage not only to your surviving but also to your thriving and healing.” She ends with an open call for volunteers who wish to contribute directly by helping the OCG in the performance of its work.
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