It’s hard to seek mental health services in the Philippines. Not only is it expensive and scarce, but there’s also a social stigma associated with it.

Here’s a story about it from one of my longtime subscribers. We re-wrote the email for clarity and to protect the identity of the people involved.

An OFS who’s been working with us for years experienced a serious tragedy. So we offered to arrange for help with a therapist through an online counseling / mental health website. They accepted the offer, reported attending online therapy sessions, and eventually said they were feeling better. But they later admitted that they only attended a couple of sessions with the reason that they had a hard time making appointments.

Months later, I found out from another team member that the OFS never went to the therapy despite reporting that they wanted to and repeatedly telling me directly in zoom calls that it was helpful. When confronted, the team member told me they had never used it but was too ashamed to decline the offer. To save face, they lied about using it.

Here in the US, we don’t have that stigma about mental health. If you’re depressed or anxious or you have an addiction or relationship issues, you go to a therapist. It’s not a big deal, everybody’s doing it.

So I asked my OFS, Julia about this. Here’s her answer:

In the Philippines, shame and stigma are still associated with mental illness and asking for mental health support.

Some shame and stigma come from people who still associate asking for mental health treatment with being crazy or deranged. If you’re diagnosed with something, you need to be institutionalized.

Religion also plays a role in feeding into that stigma. Many Filipinos have grown up being told that if they’re feeling overwhelmed, helpless, or afraid, all they need to do is ask God for help and pray it away. If that doesn’t work, maybe we didn’t pray enough or we’re not devout enough. We didn’t do enough to “fix” ourselves, and God didn’t see us as good enough to be “fixed”.

Lastly, some are simply ignorant about the issue. Some don’t know that mental health issues are a real thing. Some believe mental illness is a curse brought about by monsters that faith healers and witch doctors can cure.

The Philippine government is doing something about it. It’s still expensive, but more people are speaking up about it. Even PhilHealth now provides a limited mental health package. It’s not much, nowhere near enough, but it’s something.

The OFS lied about going to therapy to save face. In the second part of the email, the employer talks about how saving face also affects their work.

That email made me realize that the Filipino culture of saving face also creates mindless work. So I will talk about that in the next email to update the series I wrote a few months ago: