MENTAL HEALTH is a basic human right and a state of well-being that allows people to cope with stress, perform to their full potential, and contribute to the community.

In 2018, the Philippine Mental Health Act (RA 11036) was established to integrate mental healthcare services at the community, regional, provincial, and tertiary hospital levels. The act aims to promote a rights-based approach in mental health care by providing government funding and assistance in the operations of mental healthcare facilities. 

However, recent research estimates that mental disorders continue to affect around 12.5 million Filipinos. Progress in mental healthcare also remains limited due to systemic issues such as stigma, underfunding, and understaffing.

When care hits traffic

Despite the implementation of the Mental Health Act, Ateneo Bulatao Center Executive Director Arsenio Sze Alianan Jr., RPsy reveals that mental healthcare is inaccessible in the country due to a lack of resources and licensed psychologists. He further highlights that there are fewer than 3,000 licensed psychologists for over 100 million Filipinos.

Monique Bolisay (3 BS PSY) is among those who struggle with mental healthcare access. She shares that due to the high volume of patients, her psychiatrist rarely ever gets back to her.

Similarly, Juliana,* a sophomore from the University of the Philippines – Manila,  experiences long patient queues for free psychotherapy consultations offered by the Philippine General Hospital. While she considers herself fortunate to have waited only four months for an initial consultation, her follow-up schedules are sporadic, making it difficult to consistently schedule them.

Apart from long waiting times, cost remains another barrier to mental healthcare. For Juliana, who relies on financial assistance from her family for her medication, this burden persists, as one prescribed tablet costs Php 50 per day.

Bolisay echoes concerns over the cost of mental healthcare, sharing that she spent Php 15,000 on five consultations with her psychiatrist, excluding prescribed medicine. On average, private consultations in the Philippines range from Php 1,000 to Php 4,500.

On the side of the healthcare workers, Alianan explains that mental healthcare pricing is a systemic challenge that requires striking a balance between the needs of the patients and the workers. He also notes that even with the limited number of psychological professionals in the country, local opportunities remain scarce for them. 

“For us to stay [in the Philippines], we need to have a decent living. We would charge a lot, and then we would be told: ‘Mental health services are expensive,’” he says. This reality highlights the competing pressure embedded in the cost of mental healthcare.

Barricades of stigma

Aside from the struggle for access, both Bolisay and Juliana feel burdened by the stigmatization of mental health in their homes.

In her family, Juliana shares that not everyone is open to discussing mental health, stating that they obliviously use derogatory terms that make her feel less comfortable asking for help.

Meanwhile, Bolisay stresses that the topic of mental health care is sustained as a taboo in her household. “There was [some] sort of disgust towards [people with mental health issues]—as if they were a burden to society—that was ingrained in me growing up,” she recalls.

Bolisay adds that Filipinos often underestimate mental health problems to avoid seeking help. This tendency reflects Filipinos’ culture of resilience and self-reliance, as those with mental health conditions endure the struggle in the name of upholding socially accepted beliefs.

In addition, Alianan highlights that stigmatization is a result of misunderstandings surrounding the definition of mental health and its effect on a person’s daily functioning.

Due to this sustained stigma, mental health becomes an afterthought in the presence of more urgent needs such as food and money. Alianan points out that this stems from poverty and a lack of education in the Philippines. He says that when people are struggling to bring food to the table, they are less likely to think about emotions.

Consequently, Alianan expresses that mental health issues are not prioritized enough because such conditions are perceived as not fatal enough to warrant concern.

Quezon City (QC) Health Department Medical Officer III Rica Fatima Charlene Arias, MD, a licensed physical therapist, nonetheless affirms that mental health is equally significant as physical health, as it manifests in real hardships that hinder people from achieving their goals.

The road ahead

With economic barriers and stigma surrounding mental health, achieving the goals of the Philippine Mental Health Act remains difficult. The understaffed mental health sector, therefore, requires effort from different levels. To support the cause, initiatives from the public and private sectors have been implemented.

In 2015, a group of researchers from the Ateneo Bulatao Center for Psychological Services developed Katatagan, a group-based resilience plan for post-disaster survivors of Typhoon Yolanda.

This trained non-professionals to mitigate mental health risks, and gave birth to the Katatagan Plus, an evidence- and community-based early intervention program for those at risk for mental health issues. Alianan highlights that their work is all open-sourced and hopes that local entities do the same.

Similarly, Arias states that the QC Government decentralizes mental healthcare by offering services through six mental health access hubs. They also address mental health concerns through Helpline 122 and free psychiatric medications.

Arias also emphasizes the importance of tackling mental health holistically by addressing its root causes. She notes that socioeconomic factors affect mental health, prompting them to refer patients to employment offices and business cooperatives.

As the urgency for access to mental health care becomes more recognized, both Alianan and Arias stress the role of the community in preventing and addressing mental health issues. “[Community effort is about] getting people who are aware of such concerns elected. It’s about advocating, talking about it. Making [mental health] legitimate because it is,” Alianan asserts.

Despite the shortcomings in the implementation of the Mental Health Act, Alianan recognizes that the Act was a good beginning, as it paves the way for more attention and better budget allocation towards the sector.

However, Arias argues that mental health is not just a concern of the health system. It also exists in workplaces, schools, and cultural systems—in places where people interact and thrive. “Kahit maging mabait ka lang sa kapwa mo […] naka[ka]tulong ka na sa mental health ng kasama mo. (By simply being kind to others, you can already help in improving the mental health of those around you),” Arias adds.

The Mental Health Act was established to address systemic issues through institutional responsibility. However, even when private and public agencies work towards such a goal, the lived experiences of both patients and mental healthcare workers reveal a persisting gap in making mental health a fundamental right rather than a privilege.