A Silent Killer: The Filipinos Fighting for Better Mental Health
‘Kung ‘di lang kasalanan magkapamatay, ginawa ko na (If only it wasn’t a sin to commit suicide, I would’ve done it already).’
In 2016, a report revealed that 46% of all deaths from suicide recorded in the Philippines were of people between the ages of 10 and 35. Not only that, but the rate of suicide among Filipinos had been steadily on the rise since 1984; and worse still, nobody was talking about it.
Dennis Relojo-Howell, a blogger and PhD student at the University of Edinburgh – driven by his passion as a mental health blogger and lived experience as an adolescent who attempted suicide multiple times – has made it his mission to reverse this trend.
A silent killer
‘J’ was one of the survivors of the 2006 Guinsaugon landslide in Southern Leyte. Both her parents were missing after the tragedy, leaving the teenager in the hands of her older siblings. But luck was never quite on her side; ‘J’ and her siblings had to live in separate towns to survive. This left ‘J’ alone, scared and vulnerable, having to process the pain of losing her parents without the support she so desperately needed. – Excerpted from Rappler
The landslide had left thousands of people dead, and swathes of children orphaned. They were the lucky survivors, they were told. The true impact of this devastating tragedy, however, was only just beginning. The toll of the loss experienced was to be felt across the nation and shatter the mental health of millions.
The truth is that the vast majority of suicide research has only ever focused on developed nations and, as a consequence, there is a chronic lack of knowledge and understanding around the factors that affect the risk for suicidal behaviour in many low and middle-income countries. It is this knowledge gap that has contributed to the steady rise in young people dying in places like the Philippines.
Rising from the ashes
‘J’ struggled with her mental health for over a year before, writing her final cry for help across her bedroom wall: ‘Kung ‘di lang kasalanan magkapamatay, ginawa ko na (If only it wasn’t a sin to commit suicide, I would’ve done it already).’
On the kitchen wall, she wrote: ‘Walang nagmamahal sa akin (Nobody loves me).’
Thankfully for ‘J’, her struggle was seen, and through the help of mental health advocates, she was given the diagnosis of clinical depression and received psychosocial support. Soon enough, she scrubbed her walls clean.
This is sadly not the case for many more like ‘J’, who go on to lose their battle with depression. For ‘J’ it was clear – people like her in developing countries need tailored suicide interventions, and the heavily biased research focussed on richer countries didn’t speak to the experiences of her community. Something needed to be done.
Developing a plan
Even when compared to similar countries, suicide rates in the Philippines are unusually high. This is deeply concerning. According to 2017 figures from the World Health Organization, the overall rates of 3.7 per 100,000 (across gender) is higher than those found in Syria, Algeria, Indonesia, Guatemala, or Pakistan – where rates are 3.2; 3.1; 3.0; 2.7; and 2.5 per 100,000, respectively.
But despite the global discrepancy in rates of suicide among adolescents in the Philippines, there is a dearth of research in this area, along with a constellation of significant barriers (such as stigma and discrimination, financial barriers, and mental health system barriers) to mental health treatment for the adolescents who need help.
Dennis Relojo-Howell was another young Filipino who battled with mental health issues, similar to those experienced by ‘J’. He has now dedicated his life to understanding how to better support the mental health of those growing up in poorer communities, using his own experiences to connect with others and drive forward his research.
‘When we talk about suicidal behaviour – and mental health in general – one human characteristic consistently emerges as a key protective factor: resilience.
‘Resilience has been known to be predictive of anxiety and depressive symptoms. That is, those who have low levels of resilience are likely to develop anxiety and depressive symptoms,’ Dennis shares.
He recognises that depression requires a suite of supportive interventions, and the comorbidity of depression and anxiety is what so often leads to suicidal behaviour. When a young person experiences periods of both, it is only resilience that could see them through.
These psychological elements formed the basis of his research project for his PhD.
Dennis is grateful for the people who helped him: ‘I was lucky. People and circumstances rescued me; I will be eternally grateful. Now, it’s time for me to give something back. This is the very reason why I summoned the courage and determination to do a PhD.’
Dennis is harnessing the power of blogging to help him in his work.
‘It might sound surprising to most people but there is a psychology behind blogging. An emerging subfield in psychology that focuses on the application of psychological principles and research in order to optimise the benefits that readers can derive from consuming blogs is known as blog psychology.
Making some noise
Dennis’s research aims to design a psychological intervention that will be trialled on different cohorts of university students. It will explore how effective it is in promoting resilience to address anxiety and depressive symptoms among Filipino adolescents.
With suicidal behaviour being a global public health dilemma, the implications of his research project are threefold: First, this will be the first empirical study which will investigate the efficacy of a blog-based digital mental health intervention for suicide prevention among adolescents. Second, it will build upon previous works on ways to promote resilience among adolescents, and finally, it will form a comparative framework for future research on blog-based intervention.
Conversations about mental health, psychology, and well-being play a crucial role in helping people feel better about themselves. Blogging gives people a chance to create these conversations.
Dennis hopes that helping young Filipinos to find their voice will transform their experience of anxiety and depression. By giving them a way to connect and communicate, these young people will be able to access a reserve of resilience that will help them navigate the challenges they face. Then, as a community recognise that there is a way forward; they no longer need to remain silent.