Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

Abstract

Purpose This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking. Methods Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis. Results Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help. Conclusion We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

Philippine Mental Health Act: Just an Act? A Call to Look Into the Bi-directionality of Mental Health and Economy

“…Consequently, mental illness has become the third most common disability in the Philippines, wherein six million Filipinos live with depression and anxiety. Because of this, the country has the third highest rate of mental disorders in the Western Pacific (Martinez et al, 2020 ). Also, the Philippine World Health Organization (WHO) Special Initiative for Mental Health conducted in 2020 showed that ≥3.6 million Filipinos suffer from at least one kind of mental, neurological, or substance use disorder (Department of Health, 2020 ).…”

“…Suicide rates are reported to be at 3.2 per 100,000 population with higher rates among males (4.3/100,000) than females (2.0/100,000). However, these numbers may be underreported because suicide cases may sometimes be misclassified as “undetermined deaths” (Lally et al, 2019 ; Martinez et al, 2020 ). The WHO estimated that 154 million Filipinos suffer from depression, 1 million from schizophrenia, and 15.3 million from substance use disorders, while 877,000 die due to suicide every year (Department of Health, 2018 ).…”

“…The state of mental health in the Philippines in summarized in Figure 1 (World Health Organization—Assessment Instrument for Mental Health Systems, 2007 ; Department of Health, 2018 ; Tanaka et al, 2018 ; Martinez et al, 2020 ).…”

“…However, increasing the wages of low-wage earners would not entirely enhance their mental health (Kronenberg et al, 2017 ). According to Martinez et al ( 2020 ), although Filipinos enjoy more opportunities and higher wages abroad, mental health issues still exist among Overseas Filipino Workers due to language barriers, immigration status, lack of insurance, and discrimination. This may be explained by the happiness-income paradox presented by Easterlin et al ( 2010 ).…”

Philippine Mental Health Act: just an act? A call to look into the bi-directionality of mental health and economy

“…Consequently, mental illness has become the third most common disability in the Philippines, wherein six million Filipinos live with depression and anxiety. Because of this, the country has the third highest rate of mental disorders in the Western Pacific (Martinez et al, 2020). Also, the Philippine WHO Special Initiative for Mental Health conducted in 2020 showed that ⩾ 3.6 million Filipinos suffer from at least one kind of mental, neurological, or substance use disorder.…”