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MANILA, Philippines – The National Center for Mental Health, they call it “sa loob.” If you live in Mandaluyong, people think it’s funny to ask if you’re a resident of the outside or the inside. If you ask a tricycle driver in the area to bring you to the NCMH, they will joke with their fellow tricycle drivers: “Ano pre, sama na kita?”
The NCMH is a punchline, and it’s also a myth. People don’t go there, they are brought there, or wind up there, or are kept there – that is to say, the prevailing idea seems to be that no one goes to the NCMH because they want to. Why would they? The inside, by all accounts from people who dont know any better, is a scary place.
Depending on what one find’s scary, this may or may not be true. What’s more certain is that the inside is actually quiet. And not quiet like it is in the horror movies when you’re waiting for the ghost to creep out form a corner. It’s a peaceful, inviting kind of quiet, especially walking in from busy Nueve de Pebrero street, where the NCMH’s main entrance is. When you go in, make sure you to leave cigarettes and any sharp objects behind.
Near the entrance, there’s a statue of Sisa – Noli Me Tangere’s tragic figure, the mother who went insane looking for her two sons.
What you need to know
In a country where mental health services are hardly affordable even for people who earn above minimum wage, the NCMH is one of the few places one can go to if they need help, but don’t have a lot of money.
A one hour session with a psychiatrist or psychologist can cost a minimum of P2000 at a private hospital or mental health clinic. But a consultation with a psychiatrist at the NCMH’s outpatient department (OPD) will set you back by only P400 – with an additional P20 if it’s your first time to go, when they give you your Patient’s Identification Card that you need to have with you each time you come back.
If it’s your first time, or even if you’re a returning patient, one of the key things to remember is that even if you’re at your wit’s end or on the verge of tears, you will have to go line up, wait at several windows, and fill out several forms before you can even sit at the waiting room and wait to be called.
As of September 2019, the NCMH’s OPD is a makeshift set of rooms set up in the middle of the complex’s old sports pavilion. The original one, the guards say, is being renovated.
The temporary OPD is further inside the NCMH complex, but it’s a short and pleasant walk to get there, with trees shading the sidewalk, and staff pointing you in the right direction if you get lost.
The old sports pavilion is a green building surrounded by more trees. Though there are more people waiting there, it is just as quiet as it is on the sidewalks, or just past the NCMH entrance.
Makeshift rooms are positioned in the middle of the old sports pavilion. Their doors are all shut. A small waiting area is set up on one side. The pale yellow walls are clouded with a faint layer of grey dirt. The screenless windows frame the leaves from the trees outside. You can hear birds from outside too. You can hear the buzz of the TV – the latest news on whats happening on the outside.
Over that, you can hear the soft, steady hiss of electric fans, they provide no coolness as they swing over the handful of people in the waiting area – pay patients who forked over the P400 fee, and not the charity cases who could only afford P100. Some people have companions, but some people are alone – yes, it’s possible to consult at the NCMH without anyone accompanying you – but it might make the experience infinitely more bearable if you did have a person you trust waiting along with you.
Everyone holds a piece of paper with a number. You just have to assume that the number will be called at some point. When? Called by who? You won’t know until it happens, even when you ask.
The consultation itself, once you finally get called in for it, happens in a cramped room where other people are consulting with other doctors. There are no walls – at least none that can dependably keep your secrets secret. Try not to let it bother you, and be as honest with your doctor as you can be.
When you are called in, sometimes the staff will ask you what your complaint or problem is – they’ll do so while you’re in a queue with other people next to you, and you may have to stammer and try to give the cleanest, simplest version of the issues you’re dealing with. For instance, a panic attack is not a panic attack, but stress.
“Stress lang pala!” – goes the staff – then they send you to a doctor they think will suit you. Other times, they don’t ask, and you wind up with whoever is available.
Some doctors will let you cry for as long as you need to, and then proceed to ask you questions in an effort to understand what you are going through. Other doctors will ask maybe 4, 5 questions, slap you with a diagnosis and a prescription, and send you on your way. If you have doubts, Google them, he’ll say.
Beside the pavilion, there’s a pharmacy that can provide the medicines your doctor prescribed for slightly cheaper prices than drugstores on the outside.
This is what it’s like on the inside – your consultation becomes a game of roulette – sometimes you get lucky, and go back outside with the help you needed. Other times, you carry your doubts back out with you, except at least now you have a prescription for strong sedatives – never mind that no mentally fragile person should have access to that.
It’s not as scary sa loob as people may think. And it’s not a funny punchline either. What it is is a place you can go to if you need help but don’t have a lot of money.
It’s a place where there are forms to fill out, lines to queue up in, a place with no walls to keep your secrets in (at least for now), a place where there are good doctors, and doctors that should have asked more questions. It’s a place with trees, with a quiet that offsets the cacophony outside, a place that hopefully keeps you wanting to live to fight another day, at the very least. – Rappler.com