Mental health, community, traditions, and a global pandemic

Content warning: this article discusses mental health and contains mentions of suicide and self-harm. 

The COVID-19 pandemic threw everyone’s mental health through trials and tribulations. In the wake of the initial outbreak, people have had to adjust to rapid changes and adapt to a new ‘normal’. These changes are not without consequence. As a mentor once reminded me, every change brings a sense of loss, and with every loss comes grief. This pandemic has hoisted grief onto all our plates, but not everyone carries the same grief; people’s circumstances are different and individuals are affected in different ways. As a result, not everyone faces the same challenges to their mental health. People who are in disadvantaged communities or who live with vulnerabilities confront worse difficulties. At the start of this year we spoke with Alice*, a young Filipina teacher living in one of the most culturally and ethnically diverse areas of the Southern Philippines. She shared her experiences of navigating her mental health during the pandemic and how her faith and her indigenous community intersected with her mental health struggles.

The Philippines is a bustling archipelago in Southeast Asia, known for its beaches, mangoes, and lechon (roasted pig). During the pandemic, the country has gained recognition for having one of the longest lockdowns in the world. Unfortunately, it has also recently received some of the lowest placements in Bloomberg’s COVID-19 resilience ranking. The health system struggled heavily during the surge of the Delta variant, especially in areas outside the metros. Industries closed due to lockdowns, and with the staggering levels of unemployment many were struggling to put food on the table. The Philippines is a large archipelago, and some of these inequalities worsen the further south you go from the capital. Alice lives and teaches in such an area.

Alice was formally diagnosed with depression in late 2019, just prior to the COVID-19 pandemic. She decided to seek professional help after she saw her friend self-harm and attempt suicide. The experience was a wake up call. Alice told us she did not want to put anyone else in the position she found herself in, of feeling terrified and unsure of how to help. Seeing her friend’s struggles with their mental health made her realise she needed to get help herself. She was able to find a psychiatrist who prescribed her medication. This was not easy, however. Mental healthcare in the Philippines is normally paid out of pocket, for both the consultation and the medication. As a young professional, this takes a chunk out of her salary.

Affording mental healthcare wasn’t the end of Alice’s struggle. Seeking support for mental health in her community isn’t easy. While mental health is generally stigmatised in the Philippines, the stigma runs particularly deep in certain communities. Alice belongs to an indigenous community, one with strong traditions and beliefs that are often at odds with mainstream approaches to mental health. “I had to suffer in silence,” she says. Mental health was not something well understood or accepted in her family or her community. Whenever she found herself opening up about her struggles, the responses she received were often disappointing. People told her that she just needed to pray more, or that her mental health struggles were ways the devil was trying to get to her. Attempts to support her were through offers to shower her with prayers, or advice that she adhere to specific traditions and beliefs—things she understood personally would not help her mental health. Alice sometimes went to the church of a different religion in search of peace, to find a space away from the familiar faces who seemed to be judging her for her struggles. “Sometimes I feel I’m having an identity crisis,” she says. Alice describes feeling actively ‘othered’ by her community and religion, feeling the need to retreat to her own world as she was continuously dismissed and alienated. She further laments the pervasiveness of misconception and stigma. For example, her co-workers perceive suicide as a weakness and see mental health as an excuse to be lazy. Alice even felt the need to hide her mental health condition when seeking a new position, fearing it would be seen as a reason to reject her application. 

The pandemic also took its toll on Alice. She talks about losing friends and mentors while managing her own personal grief. The one word she used to describe her experience was “difficult”. Her friends were busy or were also grieving, and she recalls how difficult it was to hold space for herself and others during this time. It was hard for her to say no to friends who were looking for her to be their support system. For her, supporting her friends and fulfilling her responsibilities were ways to keep herself together through the challenges. 

Reflections

Alice talked about the process of reflection that has come about through her struggles with mental health. She pondered on the disconnect between the traditions and spiritual beliefs that she inherited from her community and her own experience of mental health. She also spoke of the meaning-making work she has done and how it has made her a better teacher.

“Part of the reason I’m depressed is because I don’t have the basic necessities. I need to do more to survive.” Alice recognises that the spiritual aspect of her health isn’t something she can reflect on as much as her community and beliefs implore her to. This is due in part to the circumstances of her material condition; it is particularly salient that as a full-time professional she can barely afford her own mental healthcare.

Despite her hardship, Alice felt a level of meaningfulness behind her experiences and grief. She talks about how she was able to embrace her own mental health as a part of herself, a part that does not diminish her. She also feels that her situation allows her to connect with people in deeper ways. Alice says that, as a teacher, she is now better able to empathise with her students and engage them in conversations about mental health. Her students are from one of the poorer areas of her province and most of them live in difficult conditions. They often lack vital resources such as an internet connection—a necessity for online schooling. While other teachers don’t often have these conversations about mental health, Alice is now better able to connect to the students in her care.

At the end of our conversation, Alice told us that while she feels much better than she did months before, she is aware that the struggle still continues. Her mental health still weighs on her heavily from time to time but there is also a sense of achievement, as “ninety-percent [of the time] it's helping [her] be more humane.”

* Name changed to maintain confidentiality

End note: This article discusses sensitive themes and topics including suicide and self-harm. If you are struggling with thoughts of suicide or are worried someone you know is, there are resources available:

In the UK and Ireland, Samaritans can be contacted on 116 123 or you can email jo@samaritans.org or jo@samaritans.ie.

In the US, the National Suicide Prevention Lifeline is 1-800-273-8255.

In Australia, the crisis support service Lifeline is 13 11 14.

Other international helplines can be found at https://www.opencounseling.com/suicide-hotlines