The sad state of mental health

I was asked to do a report in our ethics class regarding the topic on Mental Health and I think what I have find out is worth sharing in this blog. So let me just place here some parts of my presentation and let everyone reflect on the sad situation of mentally ill patients for no one will surely talk about their rights except us who are still capable of thinking.

Mental health – has been defined variously by scholars from different cultures.
Concepts of Mental health include the following:Subjective well-being, Perceived self-efficacy, Autonomy, Competence, Self-actualization of one’s intellectual and emotional potential.From cross-cultural perspective, it is nearly impossible to define mental health comprehensively.The World Health Organization defines mental health as a state of well-being that allows a person to realize his or her own abilities to cope with the normal stresses of life.

Mental health has been recognize by WHO since its origin and is reflected by the definition of health in the WHO constitution as “not merely the absence of disease or infirmity” but rather “ a state of complete physical, mental and social well-being”Mental Health Situationer

Global perspective:

Based from WHO Report 2001, Mental and behavioral disorders are estimated to account for 12% of the global burdens of disease while mental health budgets of the majority of countries constitute less than 1% of their total health expenditures.

More than 40% of countries have no mental health policy and over 30% have no mental health programme.Over 90% of countries have no mental health policy that includes children and adolescents. Mental health plan frequently do not cover mental and behavioral disorders at the same time level as other illnesses.

In the Philippines, up to one in five adult Filipinos have “psychiatric disorders" and more people are developing mental disorders due to “extreme life experiences". According to Dr Lourdes Ladrido-Ignacio, a former president of the Philippine Psychiatric Association, said between 17 to 20 percent of the country’s adult population have psychiatric disorders.About 10 to 15 percent of children aged 5 to 15 are believed to have mental problems.Ladrido-Ignacio also noted that in remote barrios without doctors, 50 percent of adults who consult at rural health centers were diagnosed to have some form of psychological illness.

The National Statistics Office’s 2000 disability ranked mental illness as the third most common form of morbidity, or type of disease, after visual and hearing impairments among Filipinos.The same survey showed that 88 Filipinos out of every 100,000 population with mental problems.The region with the highest prevalence rate of mental illness is Southern Tagalog at 132.9 cases per 100,000 population,
NCR at 130.8 per 100,000 population and Central Luzon at 88.2 per 100,000 population.

In 2004, a DOH-commissioned Social Weather Stations survey found that 0.7 percent of total Filipino households have a family member who has a psychological disorder such as depression, schizophrenia, epilepsy, and substance abuse.Oliveros said addressing mental illness as a public health concern remains as a challenge since there are only 400 licensed psychiatrists practicing in the country.

This detrimental scenario in mental health both global and local shows us why there are still so many mentally ill patients who were walking in the streets and remains unattended and neglected. However, because of their mental conditions they cannot demand for services for even some of their relatives already considered them outcast. Based on the study of WHO, one problem that needs to be address with regards to mental health is the concept of stigma which can be defined as a mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against and excluded from participating in a number of different areas of society. The WHO identified that stigma, discrimination and neglect have prevented care and management from reaching persons with mental disorders. Actually, stigma is more on personal level since many of us who lack knowledge about mental health will eventually just think that those who are suffering from this kind of illness should be isolated without even knowing that there are many people with mental disorder who are still functional but because of their high status in society they remained to be highly respected.

According to WHO there are so much things that needs to be done in order to address mental health concerns which includes the following recommendation:

1. Formulating policies designed to improve the mental health of populations

2. Assuring universal access to appropriate and cost-effective services, including mental health promotion and prevention services

3. Ensuring adequate care and protection of human rights for institutionalized patients with most severe mental disorders.

4. Assessment and monitoring of the mental health of communities, including vulnerable populations such as children, women and the elderly

5. Promoting healthy lifestyles and reducing risk factors for mental and behavioral disorders such as unstable family environments, abuse and civil unrest

6. Supporting stable family life, social cohesion and human development

7. Enhancing research into the causes of mental and behavioral disorders, the development of effective treatments, and the monitoring and evaluation of mental health system

Our very own DOH also come up with the following strategic thrust for 2005-2010

1. Strengthen advocacy and public information campaign on mental health

2. Establish database and information system preventive, family-focused and community oriented

3. Integration of mental health into the provision of other public health services nationwide

4. Develop model programs for prevention of substance abuse and risk reduction for mental illness

5. Develop a financial package

6. Advocate for positive health-seeking behavior

Actually, there are so many policies identified but what is crucial is the implementation. Since, the main subject of the discussion are mentally ill patients then they are not mentally capable of asking for what is right and due to them. I hope normal people like us especially those policy makers will do something. For me, those who are in mental institution were more helpless and disadvantaged but worse than the deaf and mute they cannot speak up for themselves.

I remember our tour last 2002 to Elsie Gaches village, Hospicio de San Jose and Malaya Center. My students and me witnessed how many clients were put into cage because of their worsen mental health condition because if they are allowed to get out, they will cause harm to others. If we feel pity to an animal who were in the cage, how much more for humans like them? Some clients also do not have families in Malaya center so it is assume that some of them will live and stay there forever. According to the social worker their families do not visit them.

I know that there are so many human rights issues that needs our focused but isn't it mental health is a human rights concern? I hope we will ponder on this.

References:

A Public Mental Approach to Mental Health – The WHO Report 2001 Mental Health: New Understanding, New Hope
World Mental Health, 1995 – Rober Desjalais et. Al.
Ethics in Psychology and the Mental Health Professions Gerald P. Koocher access at http://books.google.com/
4.http://www2.doh.gov.ph/noh2007/NOHWeb32/NOHperSubj/Chap4/MentalHMD.pdf

Unconventional Love

When I was teaching social work before, I have lesbian student who often seated at the back and even if you will ask her to come and occupy the seat in front she will refused because she said "she's not comfortable". She's very shy and seldom participated in the class discussion and most of the time enjoys being alone. Being her teacher, I asked her one time why is it she keeps on isolating herself? I told her that if you are planning to become a social worker then you much practice mingling with others so that you will learned to socialize. Then, she replied "actually Mam, I just took up this course because I don't know what course to take and I also want to understand myself but I don't have intention to graduate". Listening to her reasons, made me asked her then, "will you just let it be that way?" and then she gave me a response "Just give me time Mam, because, you know as of now I have lots of problems, I feel so unloved and I think no one really understand me".

So the days goes on,and since our subject is Introduction to Social Work we need to discuss Basic Ethical Principles of a Social Worker. The primary principle is "acceptance". This means that you need to accept your client as a person with inherent rights and dignity. Then, my students were discussing about "What if you have sexual hang-up? take for instance, you are homosexual or you are lesbian then, how will you learn to accept others when in fact, you have problems within yourself. The discussion continous like acceptance should start within you. Then, are you sure that other people will also accept you? Most of the students commented that in our society we have different treatment towards homosexual relationship then how will you deal with this?. There's so many questions which had been discussed but eventually since the principle is "acceptance" so it simply mean that if you are a person who cannot accept others for who and what they are therefore Social Work course was not meant for you.

It's a coincidence that it's valentines day also on that day, it's February 14, 2007

After the class my lesbian student approached me and asked if I can meet her somewhere to have a date on valentines. Actually, to be really honest, I was thinking she's asking me for a date on that day but since we had just discussed the principle of acceptance, I don't feel turning her invitation down or it will just lead her to think that I don't mean what I preached. So, I accepted her request to meet her in one of the fastfood at 2:00 pm in NCCC Davao.

So, when I arrived in the place, I saw her smiling and she told me "Mam, I'm glad you really came, I have surprised for you". Then, she asked me to sit down and wait for her to come. So, I just seated silently waiting for her surprised then she came back with a beautiful smile on her face with a sexy girl and then, they seated in front of me. She introduced the girl to me like "Mam, this is my girlfriend. I love her so much, but I can't bring her home although, I really want to marry her but since you told me about acceptance, I want her to meet you." It quite struck me, but I hold my emotions and breath and so, I shake hands with her girlfriend and after that she kiss the girl and hugged her as if she was so happy on what she had accomplished on that day. Then, we eat together and after that I left them and told then that they can continue with their date.

This is an experienced that struck me when I was teaching. I can't believe that beyond classroom we have so much influenced to our students even in their very personal life and they believed in us and they think that even if their parents will not accept them for sure we can understand them.

But beyond, what I saw on that day, I realized that love is itself was not purely exclusive for men and women but it can also be for other gender who longs respect and acceptance for their preferences.

I am still asking how many unconventional love was celebrated every valentines day. Then, how many are happy and satisfied with this arrangement?

So now, when I saw roses on the street I think about how many lesbian gave roses to their partners? and also how many gays received roses?

Well, I am so glad to have that kind of experienced in my life at least it teach me real things in this world. We are different but we have one desire. That is to love and be loved. No matter what they tell us?

My volunteer prayer

I AM THANKFUL
Kokshetau, Kazakhstan Tuesday, February 03, 2009

I wanted to write about all the good things that I received from this 26th year of existence and I wanted to thank my God for all of these things for I believed that it was not only me who did it by myself but something extraordinary hands leads me and guide me in this short life that I have:

I am thankful to extraordinary God for all the blessings that I have in this life. I know it was not only me who work hard every day in this life but there was someone who guide me and gives me so much strength.

I am thankful for my parents who showed me their failures and because of that I have learned hard lessons in life and promise to myself not to commit the same mistakes again. I am thankful for the courage, determination and kindness that I inherit from them. I am thankful for having them for despite of all their shortcomings they have shown me unconditional love.

I am thankful for my brother and sister for their love and care. I am thankful that even if they do not always send me message or call me, I know in my heart, that they love me.

I am thankful that I’ve met a lot of people in my life that helps me without thinking of something in return. I am thankful to those people who were there in the most difficult times in my life. I am thankful because they showed me that in this life relationship with people was more important than material gain.

I am thankful that I have many friends from different races and background for they showed me that despite differences in the human face we still shared some similarities and common dreams. Making this world a little bit better for all of us.

I am thankful because despite the fact that I was born with nothing, I do not feel much insecurity. Most of the time I feel blessed and that I have more to give than to receive.

I am thankful for the chance that God was given me to see the different sides of the world for he let me see the wonder and greatness of his creation.

I am thankful that even if I do not see God but he continuously and forever exist in my unconscious mind and my faith in him was much stronger than my earthly desire.

I am thankful because he showed me several times that in prayer there is hope and in despair there is strength. I am thankful for feeling at peace that I’ve got that he gives me in prayer.

I am thankful for all the people who hate me for they showed me the ugliness of hatred.

I am thankful for all people who loved me because they showed me that love is greater feeling than hate.

There are times that I feel disappointed, depressed, and lonely, uncared, unloved and feel like I have so many responsibilities that supposed not meant for me.

But I always remember my teacher who told me that if you have many blessing in life you have many responsibilities and I think with so many things in life in which I am thankful there is no reason that I should not accept my responsibilities.

So now, I am thankful.

(I wrote this article as a prayer when I was working as volunteer in Kazakhstan. I clearly recall that I wrote this during the cold winter in Kazakhstan when I have nothing to do but look outside my window filled with snow or as they said some people experienced this time winter depression),

"On Stage" - Reflections of PASINAYA festival and tribute to Lantaw Ondee Theater Group

PASINAYA FESTIVAL 2009

I have a very beautiful sunday since we went to Cultural Center of the Philippines and watched the opening of PASINAYA Open House Festival a show case of various theatrical, music, literature, film and visual art presentation of this year CCP 40th year anniversary.

My hunger for arts was really satisfied. First, we listened to the Chiang Kia Shek Choral group, most of the singers were chinese young girls and boys and hearing their angelic voices brings my soul to heaven with their great rendition of "Aleluya" it was more than attending a one-month mass because the singers were really had this powerful voices. But what is most memorable for me was when they sung the song "A girl from the North country" because we used to sing that song in Kazakhstan and I really love that part of the lyrics "She was once, a true love of mine". So beautiful!.

Then, we also watched in Star theater the Ballet Manila presentation about High school Musical. Wow! the dancers were really great! most especially the gay dancers were really amazing. There were two gay dancers and despite wearing high heels she/he can tip toe. So great!

Another funny presentation was the musical version of ZA sha Saturna with Eula Valdez as the lead character. It's also awesome!

The St. Benilde Romancion Dancers also caught my attention because their presentation struck me because I can't imagine how they dance like a birds using tip toe in a fast music and movements. Looking at them dancing gives me so much energy and inspiration. So energizing!.

After the festival I feel so alive again and highly energize well, what makes PASINAYA great was there are fifty shows and you will just choose which shows your going to watch for 30 minutes and so you have a tour to CCP complex in one day. Actually I feel on that day that day that my world is a grand theater. All my stress about thesis and other work really gone out of my consciousness. That is why I agree what is written at the back of Pasinaya brochure "Iba talaga pag may art sa buhay mo".

Tribute to Lantaw Ondee

"on stage", "lights on!", "occupy the space" and "the show must go on". These are theater jargon that I always heard everyday. Thinking about highschool days remind me always of Lantaw Ondee because half of my life was spent there and not in school work. At exactly six o-clock we must be in Balay Pasilungan for our daily rehearsal.

"Lantaw Ondee" is a children's theater created by Davao City Government through the Send a Street Child to School program. The name of the group was taken from two words "Lantaw" from bisayan dialect meaning "Vision" and "Ondee" from Badjao dialect "Ondee-ondee" which means "bata". This makes Lantaw Ondee a group for child's vision.

Not all street child can be qualified to become a member of the group, only those kids who passed the two months intensive theater training and those kids who were good in their academic performance. This means you need to balance your time between school and theater. But there are so many privileges given to Lantaw Ondee member first is the opportunity to visit various places in the city like best hotels like Marco Polo, Mandaya, Grand Menseng and resorts for free during presentation.

Lantaw Ondee also performed during opening ceremony of Araw ng Davao and Kadayawan Festival and also street dances. During the first Kadayawan festival it's Lantaw Ondee theater group which garnered the first prize and later won prizes during float parade.

I remember when I was still in the group we were having shows in the mall as well as in public schools. I think for every member what is unforgettable was when we stage play "oh! what a teardrop" in San Pedro Auditorium, Brokenshire College and Magsaysay Park together with Councilor Leo Avila acting as God. That is the reason we don't call him councilor but kuya leo instead because he was a part of Lantaw Ondee. His our God.

The group also showcase it's talent in local television and other advocacy related to children's rights and environment because the Philippine Foundation for Environment supported the group to advocate environmental issues. So, most of the dances of Lantaw Ondee are songs from Joey Ayala like Agila (The Eagle) and Bathala (God).

Being a member of this group for four years was one of the most happiest and funniest moment in my life and through that I forgot that I don't have a father because I've met there my surrogate parents like Papa P and other kuyas like Kuya R, Kuya I and kuya J and ate rose. I also feel that I have many brothers and sisters in the group because once we performed we take care of each other's needs like make-up and custome and watch out each other's movement.The group is a good instrument for socialization because we just think that everyday we are going to play.

Lantaw taught me many things like I have learned that when the "lights on" you need to focus on your role and forget about the rest including your emotional baggages.It's simply saying "focus".

The "element of space" is also crucial in theater because you have to conquer the space especially when you do solo performance. If you are a solo performer it means that you have all the power to make use of it but in theater normally the space includes other which you need to work with others in harmony.

"Curtain call" reminds me always of time and there is time for everything which means given that limited time you have to deliver your line.

Finally, the "show must go on" is a learning point that whatever happens you have to perform as plan which is clearly based on your script or if you forget your lines you have to "ad lib". In this situation, you will learn spontaneity, fast thinking and reading between the lines.

I left Lantaw Ondee after highschool because I am not a child anymore and then we trained second liners through holding of Art Camp and then DIECT (Drama and Education and Children's Theater) Workshop but when the program was turned over to CSSDO (City Social Services and Development Office) Lantaw Ondee eventually dies.

Now, most of the members were professionals and the rest pursue their artistic work like JM and went to other country to perform. I think theater was very helpful tool for street children transformatin because in stage play and workshops they can freely expressed their buried emotions which social workers cannot easily get in their counseling session.

What is good about theater? is the fact that it's a total performing arts and it's encompassing music, dance, visual art, puppet, acting and the child needs not to master one material but just taste everything which makes a person multi-talented that wherever you put him or her for sure he/she can survived with so many talents that person has but now programs focused only in one thing like making crafts.

When, I started being academician that part of me subsides because an artist is free but in the academe everything was structured and they are not complimentary. But sometimes, I integrate it in the classroom like art review competition for my gender subjects but actually in the academic field only few appreciate an art because maybe they have never gone through such experienced. It's because most academic person thinks that art is a waste of time. Actually, for a non-artistic person art is quite useless because only an artist can make sense of an artistic environment. The waste of the human world can be an art for a person with talent in arts.

When I watched stage presentation like PASINAYA or in Kazakhstan it reminds me of Lantaw Ondee days especially my funny friend "Juan" although he died now. How I wish we can replay things again but for sure only in our memory but that night we played on stage was a wonderful memory that makes me laugh unknowingly sometimes.

That's why despite of hardships I just think that my life is like a theater.