mental health

[OPINION] ‘Kaginhawaan’ and the systemic barriers to mental health

JR Ilagan

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[OPINION] ‘Kaginhawaan’ and the systemic barriers to mental health
'True mental health awareness should be coupled with the acknowledgment of and fight against social structures that may be disadvantaging certain subsets of the population'

On August 25, 1994, President Fidel Ramos declared the second week of October as National Mental Health Week (prior to this it had been on the third week of January). Since then, October has now become our country’s mental health awareness month, and I believe it is safe to say that there has been a lot of progress in this regard since the ’90s. 

We have seen the professionalization of careers, such as guidance counselors, psychologists, and psychometricians through the Philippine Regulatory Commission, and an increase in the number of said professionals. With an increase in professionals also comes more access to said services. In addition to this, talk about mental health has become a part of the discourse in the public sphere: we hear our politicians talk about this topic; celebrities have come out into the open about their personal experiences with psycho-emotional turmoil; and there has even been legislation for mental health services to be provided by companies for their employees. However, despite all of this, it wouldn’t be fair to say that we, as a country and as a culture, have reached the pinnacle of mental health awareness. 

Dr. Tuliao found that the manner in which Filipinos conceptualized mental health created barriers to actually seeking professional help. In our culture, mental illness was often seen as one of two things: 1) a spiritual failure or 2) a personal shortcoming. Given the prevalence of religion and folk spirituality’s influence on the Filipino psyche, manifestations of mental illness, such as disturbed behavior, negative thinking, and emotional turmoil, are often attributed to not doing enough spiritually or personally. At the end of the day, mental health issues are often construed as something an individual person could deal with on their own through prayer and spiritual rituals or through personal development and resilience. I am guessing that many of you might have heard the phrases “magdasal ka nalang” or “inarte lang yan” in the midst of a legitimate mental health issue, which can be very invalidating, and honestly, painful to hear. These common representations of mental health often lead to a sense of shame and embarrassment, which makes it difficult for an individual to actually seek help. To complicate things even further, even if there has been a steady increase of mental health professionals, a lot of the services they provide are inaccessible to many of the Filipino population due to cost and location on top of the already existing stigma that comes with mental health. 

Furthermore, it is important to note that mental health awareness has also been advocated for through a clinical lens. When we talk about mental health in public discourse, it is often done so by trying to “cure” and address psychological issues. In doing this, awareness is reactive; it is as if mental health becomes important once it becomes a problem. Instead, I feel that it is just as import to consider how we can foster an environment conducive to positive mental health, which we can refer to as wellness or kaginhawaan

Dr. Samaco-Zamora and Dr. Fernandez conducted a study in an attempt to discover what aspects of life contributed to the experience of kaginhawaan in Filipinos. According to their research, they found that family was the core category of wellness – which comes as no surprise given the centrality of family in Filipinos’ lives and identities. Spirituality and psycho-emotional well-being also emerged as categories of wellness. In the aforementioned categories, we see that relationships (with the self, others, and “something bigger than us”) all serve as foundations of wellness. Interestingly, occupation and economic conditions were the last two categories that made up the concept of kaginhawaan, both of which are factors that are often outside an individual’s control. We can’t choose what kind of economic conditions we were born into and these conditions gravely affect the kind of occupation we may be able to achieve later on. And yet these things outside our personal control seem to contribute hugely to general wellness. Given this, if we want to look at mental health through the lens of actual kaginhawaan, it is just as important to acknowledge the systemic factors in place that block many Filipinos from actually experiencing a sense of well-being.

For example, in August 2022 the Philippines Statistics Office released a report stating that the ability to spend P18.62 per meal placed you above the poverty threshold. Despite this disgustingly low estimate, poverty incidence still rose in 2021 from 2020. Many Filipinos have shared that even if they found themselves above this threshold, they still did not have enough money for basic needs and services. In addition to this, if you were 10% above this threshold (let’s say you have the ability to spend just above over P20 per meal), you would now become ineligible for the 4P’s program of welfare. When the government is so out of touch from the reality of these individuals, it makes it easier to come up with an illusion that being able to spend P18.62 per meal places these people above the poverty threshold. 

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Philippines’ poverty incidence rises to 18.1% in 2021

Philippines’ poverty incidence rises to 18.1% in 2021

In September 2022, Vice President Duterte also shared that she had no plans of increasing the salary of public school teachers because it would lead to the closure of private schools. Yet again, we see the government not taking care of its people – its literal employees who work for the government, those who educate majority of the Filipino youth. 

With the recent hikes in inflation, how do you think these people’s kaginhawaan is being affected? These people are just a subset of the whole Filipino population and yet, in these two very recent examples, we can imagine a huge number of people whose wellness may be at stake because of systemic factors. With all of this, it is of my opinion that true mental health awareness should be coupled with the acknowledgment of and fight against social structures that may be disadvantaging certain subsets of the population. –

JR Ilagan is a licensed psychologist that does both psychotherapy and psychological assessment in GrayMatters Psychological & Consultancy, Inc. At the moment, he is finishing up his dissertation for his PhD in Ateneo de Manila, which focuses on disrupting the narrative consent of Duterte’s war on drugs through art. He is currently a part-time faculty in the same institution as well. Most of his recent research focuses on the public discourse of government, citizens, and collectives in line with societal, cultural, and mental health issues.

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