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Mental Health – a Societal Concern Essential to Women’s Well-being

October has been declared as World Mental Health Awareness Month by the World Health Organization (WHO). Awareness is really a key element in addressing this societal concern most especially that Mental Health is rarely discussed and studied and there is still considerable stigma and taboos on matters surrounding mental illnesses.

Reports indicate that 17 to 20 percent of Filipino adults experience mental health disorders, while 10 to 15 percent of Filipino children, within the age group of 5 to 15 suffer the same. NSO accounts mental health illnesses as the third most common forms of morbidity for Filipinos.

According Philippine Health Information System on Mental Health (PHIS-MH), schizophrenia is the top mental health problem in the Philippines, affecting 42 percent (mostly males) of the group studied. Also included in their list of disorders common to Filipinos are depression, anxiety disorder, schizoaffective disorder, acute and transient disorder, and stimulant-related issues.

In the Philippines, various stakeholders have already started to aggressively raise awareness of the public regarding the issue which is a most welcome development. However for most of these interest groups, mental health awareness usually merely focus on identification of certain MH disorders, on signs and symptoms on what to watch out for and the management or treatment of such illnesses. What are left out are similarly important issues that impact on the mental state of individuals but are relegated to the side lights or oftentimes even completely disregarded. These are the social determinants to mental health.

A sound socio-economic milieu is vital to maintaining a sound mental health. In a society where social inequity is widespread, we also find particular sectors at high risk of suffering from physical and mental health challenges.

The WHO captures the crux on the social determinants of the mental health. It aptly stated that “Certain population subgroups are at higher risk of mental disorders because of greater exposure and vulnerability to unfavourable social, economic, and environmental circumstances, interrelated with gender”.

There is recognition that gender is also of vital concern in mental health because of women’s marginalized status in society. But considering that majority of women belong to the lower class levels in the social ladder make them even more vulnerable in acquiring MH disorders.

In our society where almost 18 million Filipino families are already destitute, surviving on incomes below the family living wage of Php30,000 per month (IBON Research group) , where unemployment and underemployment rates are high (there is a considerable 11.5 million who are without work or still looking for more work because of the poor quality of jobs) where inflation rate has been fast increasing, and now at its highest at 6.7 while majority of workers live on pitiful wages, we can surely find majority of Filipinos trying to maintain their mental well-being a major challenge having to face issues of their family’s survival.

We have heard about the case of Kristel Tejada who took her life by consuming a silver-cleaning fluid in March 2013 . She was unable to pay her tuition at UP Manila of Php10,000 because of the “no late payment” policy of the state university. The family had faced financial difficulties after her father was laid off from work at a factory that closed down early on. A few years prior to the Tejada case, Mariannet Amper, a 12 year old girl from Davao also committed suicide out of despair for her family’s impoverished life. In the Philippines, WHO estimated the number of suicides in 2012 at 2,558 mostly among the youth (550 female, 2009 male).

We can also surely find other distressed sectors among the urban and rural poor, where they constantly face the threats of demolition or of being driven out of their lands because corporations are converting them into subdivisions or commercial estates. Or of indigenous peoples, whose territories are being militarized because mining companies’ interest are being protected by investment security forces designated by the government wanting to exploit the rich mineral resources of their communities. In militarized communities, children expressed not being able to sleep well and of experiencing nightmares and bed-wetting, which are apparent signs of trauma.

Then there are those being pursued by the state and it’s security forces because of their political beliefs and for asserting their rights. For those suffering from political persecution and vilification, and where threats to one’s life are constant realities, stress and trauma are too common. Such are the cases of the 5 women human rights defenders belonging to cause-oriented NGO’s from the Cordillera facing trumped up charges or those in the terrorist proscription list. One of them, Rachel Mariano is now languishing in jail for a crime she was falsely accused of. This matter triggered her Hyperthyroidism aggravating the trauma she suffers on the ordeal she had to face together with her family. Depression, sleep problems, fast heartbeat, heat intolerance, weight loss and crying spells are just some of the symptoms she endures.

Additionally, poor women’s burdens are made worse because of their subordinate status in society. Societal norms and standards make them vulnerable to abuse. Women have to contend with society’s expectations on how women should behave and act in ways that are “proper”. Otherwise, society dictates that they deserve the violence inflicted on them. Violence against women is common in our society where sexualisation and commodification of women’s bodies are widely accepted but ironically puts women in a much disadvantaged position. There are also certain mental health disorders that are more common to women such as anorexia nervosa or bulimia. Women’s distorted ideas about their bodies are due to social beliefs on images and roles demanded of women in society. Women’s standards of beauty are that of models and beauty queens who must be fair, tall, thin and who must have bodies with “perfect” vital statistics. It is then no wonder why many women are conflicted contributing to their low self-image and worth.

All of the above social determinants of mental health are factors that make one more at risk to mental health disorders. The higher the social inequities, the higher vulnerability particular groups in society face.

Addressing our mental health concerns therefore entails not only tackling the issues of individuals facing mental health issues. It must in fact address the root causes of social inequalities that make marginalized segments in our society more vulnerable in suffering mental health disorders. A comprehensive program in tackling the issue is therefore of paramount importance. It cannot be denied that the prevalence of mental Illness in our country is a mere reflection of the social ills plaguing our society.

A community’s grief and anxiety through children’s eyes

The usual road to Loacan from Ucab, Itogon, Benguet is now missing in maps and photos, defaced from the wrath of the September 15 heavy downpour that saturated the soil and followed the law of gravity. The new route is via Sabkil, offering us distant views of Ucab and Loacan whose mountains bear scars from the recent onslaught, and unseen reminders of a century of mining.

After a 45-minute ride through Ambuklao Road, past landslides that were being cleared, we held our collective breath and kept our wits in place, fear disguised in nervous laughter as the hired jeepney descended down the steep, winding (i.e., hairpin curves), narrow road at Amteg.

The proof of the driving acumen among Cordillera drivers is the ability to negotiate a one-lane road while doing that nerve-wracking reverse shift to give way to an upcoming vehicle, of steering the wheel to the edge of the road resulting in a passenger’s cardiac somersault and sudden religiousity.

With relief goods that weighed half of all our weights combined, the thought of the vehicle veering down the ravine if and when the brake malfunctions, was paralyzing. We gratefully arrived at the mining community of Purok 1, Loacan Proper where the elementary school is located. No one would think a catastrophe hit this place, with the usual activities of people by the road. The heat was quite oppressive and gradually, one sensed THE gloom.

They seemed like other ordinary children with their playful, even impish behaviour, spontaneous smiles, restlessness and banter. They knew we were coming and were expecting an activity. While the rest of the public focused on news and regular updates on the extent of damages and casualties, rare, if not absent, was focus on the situation of the children in the affected communities.

Except for Grade I students who were unable to join us since their teachers were away on a seminar, students from Grade II to Grade VI were to undergo a psychosocial processing through visual arts and creative writing.

These are avenues for creative expression of the children recovering from distress and anxiety, or exhibiting abnormal behaviour as a result of trauma. Two weeks after Typhoon Ompong’s rampage caused massive landslides that buried more than a hundred residents who were mostly families of small scale miners, both teachers and students, at close range are still in shock and mourning. To go about the daily routine is almost a burden as uncertainty pervades the air with kin and friends missing beneath the killer mudslide.

The children were asked to describe what they saw and heard, what they felt, how they are presently coping, and what they are looking forward to. The illustrations are telling of the myriad of emotions of the children who witnessed and actually heard nature gone berserk. The common theme and images were of the physical deluge, of relentless rain battering their puny shelter, of earth slithering down to conquer humans, of deforested mountains and rainwater coming together, rushing down to obliterate hapless victims and burying them in mounds of mud, of rescuers shovelling, of relief workers coming to their aid.

The fear, helplessness and grief showed in the lines and colors executed by the students. Always, always, the reminder and question gaping through the images, “What have you done to our home?”

The literary outputs were explicit with raw emotions and had the common tone of sadness and defeat, of being powerless against the rage of nature. In detailing the chronology of events, they wrote of the impending storm, of the actual lashes that battered their walls and roofs, and of the sound of rushing water and grumbling earth. The children recaptured their moment of agony upon hearing their parents talk and weep about those who died in their attempt to help their relatives and neighbors. Many wrote about mourning for the dead, sympathy for the bereaved, and grasping at threads of hope for bodies still unretrieved. ”Sana mahanap pa nila sina Uncle…” was a repetitive plaint of tragic innocence.

Having been traumatized by Ompong, they expressed fear of the reported approaching typhoon Paeng. Aware that they cannot redirect its course, they wrote a plea for it not to take lives again or destroy their houses. There were those who were ambivalent about the role of mining in the disaster. “Dahil sa pagmimina kaya naglandslide. Kung mawawala na ang pagmimina, paano na ang trabaho ng magulang namin?” When asked to verbally share their insights about the tragedy, a cheerful boy volunteered, “Kung mawawala na ang pagmimina, pwede na tayong magtanim, para meron tayong makakain.”

Children being children, they have dreams for Loacan and the days ahead. They wrote of wisdom that we can learn from.

“Ang gusto kong mangyari dito sa Loacan ay sana maayos na yong mga bahay na nasira,maging alerto kapag may susunod na bagyo, maging maayos ang kapaligiran, magtipid na dahil wala na ang pagtratrabahohan dahil inestop mona ang pagmimina pansamantala at sa kapayapaan, sana mahanapan nila yong pinsan ng aking nanay. Sana mawalan na ng takot o lungkot ang aking mga magulang.” (Klouie, 10 yrs. old)

Time and attention must be given the children. Though distraught, they are coping with the huge changes in their homes. Their parents, teachers and community officials must heed signs of post-traumatic stress disorder (PTSD) that may manifest in various ways. There are continuing nightmares they have to grapple with caused by external causes they were not responsible nor accountable for. Their teachers who are in daily engagement with them have to be equipped with basic psychosocial skills to deal with these manifestations. Most importantly, this is the time to listen to the children’s plea: to get the community on its feet again, for the Loacan residents to be more nurturing of their environment, and to be prepared and alert for any impending disaster.

The usual road to Loakan may take long to recover or may even be totally diverted or rerouted, the children know this. But what they look forward to is a way out of the devastation, a restoration of normalcy and a sense of security.#

(In coordination with the Serve the People Brigade, the facilitators of the psychosocial workshop and art therapy conducted in Loacan Elementary School last Sept. 27, 2018, were staff of the Cordillera Women’s Education, Action and Research Center (CWEARC), the St. Louis University School of Nursing, and members of Tuklas Innovation Project and Sulong Likha of the Dap-ayan ti Kultura iti Kordilyera (DKK).