IT COST my parents roughly Php 15,000 in psychiatric visits and psychological assessments before I could be clinically diagnosed with Bipolar II and Major Depressive Disorder.
Every time I am reminded of the price tag on my condition, I feel a bottomless pit of guilt in my stomach. I’ve been trying to convince myself that the cost would have been justifiable to me if it were for something visible—a broken bone, a cataract. Is this not essentially the same paralyzing experience, made different only because these disorders are not something I can point a finger at?
The difference, I suppose, is how long you can live with it. During a session with my therapist, I divulged to him that I’ve felt unstable for so long that I couldn’t remember what life was like before the mental illness. In turn, he asked me: “What took you so long to get diagnosed?”
It was not an unkind question. I am sure that he came from a place of genuine concern. After all, I had just admitted to dealing with a decade’s worth of baggage. And yet I found myself unable to tell him the plain truth as to why I refused to seek someone out all those years.
I didn’t think I could afford to get help.
On average, therapy in the Philippines can run up to Php 1,000 to Php 4,500 per session. Known medication brands such as Xanax and Prozac could cost Php 130 per tablet, some going as high as Php 300. These expenses might not seem like much, yet when they all add up, it is one hell of a bill to pay.
Luckily, there are cheaper alternatives for medication with smaller doses averaging around Php 50 a piece. More organizations now offer free counseling and psychiatric consultation services. But back when I was 10 and feeling unlike myself for the first time, therapy was borderline unavailable. In my province, there were barely any options for psychological assistance; of the estimated 600 registered psychiatrists in the country, most are based in Manila. There was a moment of weakness when I even called the government-funded crisis hotline and was told that they couldn’t assist me because it was “beyond office hours.” For years, getting help seemed impossible.
Now, I am diagnosed and soon to schedule a session with my attending psychiatrist. I take two types of medications for my depression and another set for acute insomnia. It takes a conscious effort to not put a quotation on my healing—to not want to apologize to my parents for the value of my mental health.
Nonetheless, I still recognize the gaps in the system that make treatment inaccessible. An abysmal 3 to 5% of the country’s health budget is all that is set aside for mental health care, which is barely enough for the World Health Organization’s estimation of 3.6 million Filipinos suffering from mental, neurological, and substance use disorders. It is due time that both national and local governments invest more in mental health services.
Training and recruitment for health care workers should be at the forefront, given the uneven ratio of 0.41 psychiatrists per 100,000 people. The Mental Health Act should then be revisited to consider equitable distribution amid economic restrictions that prevent the general population from seeking treatment. Finally, wide-scale community organization can bridge the gap of lacking services in more far-flung areas, allowing non-government units and private civil society groups to contribute if needed.
It has been easy to turn a blind eye and weather these conditions because they are largely unseen. But if 3.6 million Filipinos broke a bone, then it would be a completely different story. It would be seen as an epidemic—which is exactly how the Philippines’ mental health crisis should be viewed.
No person should ever have to wonder if they can afford to get better. The price of treatment should never be so steep that it would make someone feel guilty over getting help. These are hard pills that I am still learning to swallow, and graces that many others are yet to be granted.
