The rise of suicidal behaviors and cases in the wake of the covid-19 pandemic is a cause for growing concern. The pandemic has caused ripple effects on the mental health of individuals across different sectors and demographics across the world, which are more and more apparent (Buenaventura, Ho, & Lapid, 2020; Craft, 2020; Mamun & Ullah, 2020; Sher, 2020; Tee et al., 2020). This means nations with more social and political risk factors such as poor health infrastructure, worse socioeconomic safety nets, political instability, conflict, and risk to climate change more vulnerable to worsening suicide risk (Gunnell et al., 2020; Milner, McClure, & De Leo, 2012; Mollica et al., 2004; Neumayer, 2003; Redaniel, Lebanan-Dalida, & Gunnell, 2011).  

Even before the pandemic, suicide has been a major problem. Globally, close to 800,000 people die by suicide and 79 percent of these are from developing countries  (World Health Organization, 2019). Countries like the Philippines often lack accessible mental healthcare, leaving many Filipinos deprived of possibly life-saving services. Over 20 percent of the Philippine population is poor, and because of the impact of the pandemic, economic hardships are felt more intensely, making spending for mental health a luxury more than ever (Philippine Statistics Authority, 2016). The country is in the middle of the world’s longest covid-related quarantine protocol with industries left closed and millions left jobless (Enriquez, 2020; Tee et al., 2020). Simultaneously, the climate emergency continues to affect the country with typhoons and natural disasters hitting millions of Filipinos each year (Nahar et al., 2014). 

There is a dearth of human resources to help address the growing and worsening mental health woes of the nation. There are just around 600 psychiatrists and 1500 licensed psychologists to provide primary mental healthcare for a population over 100 million (Philippine Statistics Authority, 2016). While the recent mental health policy galvanized locally trained guidance counselors and social workers, they are often unprepared to deliver primary mental health interventions (Lally et al., 2019). An entire population is therefore constrained to fend for themselves and cope using whatever resources are available to them — often prayers and good wishes. 

Risk factors such as preexisting conditions, social isolation, economic hardship, and the uncertainty over the pandemic and pandemic response worsen the risk of suicide with disadvantaged populations facing the heaviest burden (Buenaventura et al., 2020; Gunnell et al., 2020; Kawohl & Nordt, 2020; Sher, 2020; Tee et al., 2020). Data from previous pandemics and economic recessions have shown an increase in suicidal behavior even before the rise in unemployment (Gunnell et al., 2020; Kamekis, Rachiotis, Markaki, Samara, & Symvoulakis, 2020; Kawohl & Nordt, 2020; Sher, 2020; Wahlbeck, Anderson, Basu, McDaid, & Stuckler, 2011). Apart from this, the psychological impact of quarantines such as social isolation, loss of routine, and rises in cases of domestic violence or abuse are well-known risk factors for suicide (King & Merchant, 2008; McCloskey, Boonzaier, Steinbrenner, & Hunter, 2016; Sher, 2020).  

In light of the gaps in mental healthcare services in developing nations like the Philippines, establishing stronger policies to strengthen alternative mental health support systems like digital mental health services and community-based mental health intervention is urgent. 

Mental health practitioners have transitioned to digital platforms due to the pandemic (Torous, Myrick, Rauseo-Ricupero, & Firth, 2020). Digital mental healthcare improves accessibility especially to those living in areas where there are no mental health professionals that can provide this specific service (Chen & Chan, 2020). Digital mental health services can also be more cost effective and cheaper for healthcare centers, reducing overhead costs such as for rent and maintenance of clinics. It also extends healthcare beyond the clinic. Further, it makes mental healthcare research easier, integrating data collection into the service-delivery platform. But it doesn’t address all the issues of existing mental health systems just yet. 

Digital mental health services in the Philippines are still uncharted territory. Funding for  research and human resources in mental healthcare is still scarce in developing nations (Zhou, Yu, Yang, Chen, & Xiao, 2018). Although effective in addressing depression and mitigating suicide risks, types of treatments and interventions available through a digital platform remain limited (Chen & Chan, 2020). Another clear limitation is unavailability to those who cannot access the internet.

Community-based interventions aside from the online mode are worth looking into. Most transitioned to the internet due to local quarantine restrictions and concerns over personal safety. They should find a way of resuming offline operations.

Prioritizing mental health remains an uphill battle. The growing awareness of the population regarding mental health has not translated to improvements in access to it even with its affordability. But there are signs of hope, and hope is always something to hold on to. 

 

References:

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