Looking through the Current Lenses
The Future of School-Based Mental Health in 2040
Introduction
In every academic and non-academic activity in schools, enthusiasm, cheers, and laughs are seen in students as they enjoy their time at their second home. However, behind the joyful faces that they present, are they fine at all? In the school year 2021–2022, the number of students who took their lives in the Philippines was 404 and 2,147 respectively (Ramos, 2023). These numbers do not give the actual mental health situation of these individuals, as there are underreporting instances. In addition, minor and significant manifestations that trigger these attempts and acts must be addressed to decrease the number of these cases and ensure that these students have satisfactory mental conditions.
But really, who is responsible for the mental well-being of the students? The answer is everyone. Mental health problems come from different aspects of life. Thus, providing interventions to address this issue also needs to be efficient. To answer this, efforts to promote mental health are already being made in the various sectors of society. However, these initiatives still seem lacking as the numeral data of the mentally struggling students is increasing. Therefore, making schools available for students to receive quality and accessible mental health care is needed.
Health is an essential part of every person’s life. One of the main discussions in the health field revolves around the importance of mental health. In its primary context, mental health precedes an individual’s mental well-being. It allows them to recognize how they cope with diverse life situations, manage daily stresses, acknowledge personal strengths and weaknesses, learn through interpersonal communication, and actively participate in society. Additionally, mental health encompasses the shared proficiencies of every individual in decision-making, fostering connections, and influencing the world — underscoring its indispensable role in overall health and well-being (World Health Organization, 2022).
In regards to providing mental health services for students, it is important to choose a suitable setting to put it to ensure that it is easily reachable to its target demographic. A study suggests that the optimal setting for delivering mental health services for young people and children should be within the educational institution. The observation came from if there are counseling services that are readily available in school, a significant number of students take advantage of it; it underscores the importance of integrating mental health services in the system of education for equity in accessing the services and destigmatizing mental health issues in students (National Association of School Psychologists, 2021).
Students should be the utmost priority in mental health services. There is a message from a student who has been diagnosed with a mental health illness and suffered prolonged struggles due to their hesitancy in seeking help as a student. The message emphasized that students need diverse mental health resources to be available in schools, just as diverse as their backgrounds; as mental health concerns cannot be addressed individually and left at that; it should be comprehensive because it is a multifaceted issue (Mesfin, 2022).
What is the current status of Mental Health in the Philippines?
The sad reality is that in the Philippines, mental health is still considered taboo. Various studies have shown that the prevailing taboo around mental health is primarily because of the stigma around the topic. This stigma takes the form of a public perception, stemming from the persistent tendency of the general population to stereotype and discriminate against those dealing with mental illness. This ingrained bias leads individuals to internalize negative beliefs toward mental health, even before personally experiencing it. As a result, the impact of public stigma is far-reaching, causing individuals to distance themselves socially and resist seeking medical treatment or engaging in activities related to mental health support (McLean Hospital, 2023).
The issue of mental health remains a taboo subject, primarily because many individuals view it as a sign of weakness and vulnerability. This perception often leads to the topic being avoided, particularly among men. Societal expectations place immense pressure on men to embody strong masculinity, causing them to conceal their mental health struggles, as these struggles are unfortunately seen as indications of frailty (Williams, 2020). Nevertheless, individuals of all genders commonly encounter discrimination when it comes to mental health. The notable difference lies in the difficulty men often face when attempting to seek help (McLean Hospital, 2023).
Mental Health Provision Lacks in Many Aspects
Human Resource
It is concluded in a study that investing in mental health professionals, especially in schools, is vital in promoting the mental health of adolescents, which includes the target individuals of this paper (McIntosh & Romer, 2005). As of now, human resources in the mental health field are still undervalued and underinvested. Out of 60,157 schools in the country, only 16,557 have guidance offices (Torregoza, 2023). Compared to the ideal 1:250 ratio of guidance counselors to students, the ratio mentioned previously shows the need to hire more counselors and mental health professionals in schools to accommodate all students needing mental health services (American School Counselor Association, 2021). It is acknowledged in the country that the shortage of counselors comes from the workers’ high educational requirements and low salaries (Chi, 2023).
Finance
Recent studies proved mental health services are not the Philippine government’s top budget priority. Despite the presence of the Mental Health Act and Universal Health Care laws in the Philippines, the government’s allocation for mental health remains disproportionately low, accounting for just 5% of its healthcare outlay. Although a national mental health policy has been set in motion since 2001, it continues to suffer from inadequate resources, as noted by Lally et al. in their article (Dela Peña, 2023). Currently, the country continues to experience the treatment gap. As highlighted by research conducted at Harvard University’s humanitarian research center, findings indicate that Filipinos encounter ongoing barriers to accessing mental health care. These barriers include the elevated cost of treatment and services, as well as the pervasive stigma surrounding mental health (Cabico, 2023).
Competency of Administrators
In the Investment Case Report on Mental Health in the Philippines, Sumlao, the DepEd Chief of the School Health Division, stated that population-based interventions are essential in addressing the mental health situation in the country (WHO, 2021). Administrators and policymakers in the government must first acknowledge the importance of mental health interventions. Then, having relevant educational background and experiences supports the competency of government officials to craft and implement such policies and programs. More than knowledge about public service is required — being knowledgeable about mental health and advocating for health are also pivotal.
Scarce Literature
According to insights provided by Mark Rasenick, Ph., in an article published in Care for Your Mind (2017), the existence of deficiency in scientific advancements within the field of psychiatry came from the continuous stigma associated with mental health and the insufficient allocation of funding. The emergence of the COVID-19 pandemic yielded new perspectives in mental health research, prompting heightened academic focus. Articles have delved into mental health interventions aimed at adolescents and university students, the welfare of specific population groups, and the progression of telemedicine in the field of mental health treatment. Nonetheless, the swift publication of research during the pandemic constitutes a promising starting point rather than an exhaustive foundation. It’s important to acknowledge that the complexities of mental health effects are challenging to comprehensively observe and study (Liang et al., 2022).
Beyond research studies, Professor John Paolo Sarce from Ateneo De Manila emphasized in his paper that the discourse within Philippine Literature rarely addresses such illnesses, resulting in a lack of literature about health and illness — a crucial element for fostering empathy among readers. Notably absent from this discourse is mental health. Integrating discussions about mental health into the country’s literary works is strongly advised. This effort holds the potential to enrich the literary landscape, enabling future generations to gain deeper insights into mental health by engaging with and learning from these literary expressions (MentalHealthPH, 2022).
Futures and Foresight Tools
Scanning. With the conducted interviews and research from secondary sources, the researchers used environmental and horizon scanning to determine the trends and weak signals concerning the focal issue. The STEEP framework was used to explore the social, technological, economic, environmental, and political dimensions of school-based mental health.
Environmental Scanning. To gather the trends regarding the focal issue, the researchers used this tool, a systematic procedure of identifying forces of change that are widely known outside of different echo chambers. This method allows researchers to interpret and analyze why certain phenomena are happening at present and how this can be impactful in the future’s decision-making process (SHRM, 2021).
Horizon Scanning. The researchers used horizon scanning to identify weak signals regarding the focal topic. This is a systematic procedure that allows researchers to search and analyze emerging issues regarding the focal issue that has weak signals in the current time with only a few works of literature and experts that talk about it, which can develop as a threat or opportunity in the future.
Trends and Weak Signals
From the Future thinking tools, the researchers have noted key trends and weak signals regarding the focal issue. Trends are the factors that are currently happening in school-based mental health while weak signals are regarded as the factors that policymakers must keep in mind for better mental health care for students in the Philippines.
The Trends
- Shortage of Mental Health Professionals
The role of human resources in the mental health sector is pivotal for the viability and success of mental health initiatives, extending beyond school contexts. They are the providers of medical and counseling expertise for those who require mental health response. If these experts are undervalued, undertrained, and underinvested, addressing mental health issues would be difficult. Multiple articles and studies substantiate the scarcity of mental health experts nationally, encompassing educational institutions. Interviewed experts within the field have themselves attested to this data, with a subset noting that the scarcity of adequately trained mental health professionals compounds the issue.
2. Low Salary Grades of Mental Health Professionals
Mental health professionals are essential in providing quality mental health care services. Unfortunately, many choose to leave the country or change their career paths due to limited job promotions and low compensation. The lack of incentives and training opportunities locally forces them to seek options abroad where they can enjoy better working conditions and higher salaries (Maravilla and Tan, 2021).
3. Lack of Economic Studies Supporting Target Budget Allocation for Mental Health Expenditures
The mental health budget mustn’t be solely confined to treatment. Allocating funds for commissioned economic studies is equally important. These studies would establish the necessary budget to effectively reach the desired beneficiaries in response to demand. The lack of such economic studies results in an inefficient budget allocation for mental healthcare. With these studies, there’s a clear target, leading to certainty in acquiring the needed funds. Moreover, economic studies shape school-based mental health by guiding decisions for better long-term outcomes.
4. Weak Referral System
In the context of the Philippines, experts in the field stated that schools still need to ask for doctors outside of the school for them to check on diagnoses and communicate with students which can still be a burden in everyone’s time as there is still an uncertainty if the doctor is available and they can’t automatically facilitate actions especially if the situation is severe and needs immediate actions. Because of these hindrances, this may lead to serious consequences for the students involved and frustration for both patients and professionals. This trend is a concerning aspect of school-based mental healthcare as more students can be left untreated with their mental health problems. Policymakers must keep in mind that an effective referral system ensures that everyone is treated in the best way possible and provided with the easiest access
5. Deficiency in Critical Thinking Ability Towards Online Information
Media literacy has been an important discourse since the start of the pandemic as everyone is exposed to social media and different algorithms that can be unreliable. Online misinformation can cause high levels of anxiety in students, affecting their mental health as a whole. Disinformation and lack of critical thinking have a big impact on society including students as people can no longer have the drive to research and validate their claims but only rely on what they have accessed.
6. Shortage of Mental Health Equipment and Facilities
Based on a conducted study, mental health facilities in the country are overcrowded, have inadequate operating units, regular staff shortages, and budget constraints are concerns being encountered, especially in peripheral facilities (Dela Peña, 2023). Even if the stakeholders bring the student to the nearest mental health center or hospital for therapy or treatment, if it is overcrowded and leaves them unaccommodated, the therapy or medication they need will remain unaddressed, which may worsen the condition and affect the student’s studies. They may receive medication or therapy as early as possible, only if there are enough facilities to accommodate those who are in need.
The Weak Signals
1. AI-driven Mental Health Diagnoses, Treatments, and ServicesThe integration of AI and technology has brought significant transformations to school-based mental health, providing valuable support to professionals. Moreover, AI yields insights into patient-therapist dynamics, enhancing comprehension of emotional well-being, and easing the burden on professionals. This allows more time for patient care and minimizes delays in delivering service to students. However, the expert warns of AI’s potential to overshadow therapy’s core goal if overly relied upon, emphasizing a balanced approach.
2. Mandatory Mental Health Testing For Administrators
Integrating psychological tests for a position plays a significant impact in assessing the mental capabilities and behavior of an individual for handling a specific job. Psychological testing gives a person’s background to assess their overall skills, knowledge of particular societal issues, strengths and weaknesses, advocacies, and other motivators that allow them to achieve overall development for the common good. It has a significant impact on the focal topic because it will help the people to see if they are capable of creating policies and initiatives about awareness and response, capable of assessing the total needs and concerns of the people, especially for learners in conditions involving school-based mental health.
3. Changes in Curriculum and Format of Learning
The future of education is likely to see significant changes in curriculum and learning formats as a result of the COVID-19 pandemic (Yongzhao and Watterston, 2021). According to the experts, the change from face-to-face setup to online has taken a huge toll on both teachers and students as they are not used to being on their screens all day for academic-related work. The experts have also stated that more mental health problems were recorded during the online session. The new learning set-up might be an unnoticeable factor for mental health but this can lead to a big impact in the future as schools might not be ready to cater to the new world of learning because of insufficient funds, socio-economic factors, and other inconsistencies that may happen. To support this, related literature has stated that the sudden shift of students from face-to-face learning to online modalities has tremendously affected their mental health resulting in them being diagnosed with anxiety or depression. Not only that, students who are not part of the upper class of society are the most affected by this situation as they do not have the means to buy new technologies (ie. cell phones, laptops, or tablets) due to insufficient funds. (Psychiatr, 2021)
Conclusion
So close, yet so far–the current picture of school-based mental health in the city remains a blur in the current lenses. There are interventions done by stakeholders but these only partially address prevailing problems surrounding the focal issue. In the community, slow progress can be seen in how the members are getting conscious little by little of their role in protecting the well-being of the students. These efforts still lack and cannot completely encompass all the needs of the learners. There are persisting socioeconomic factors that not only impede how these individuals receive mental healthcare but also worsen their mental conditions.
Mental health is a multifaceted issue, versatile solutions are needed. This is precisely where the significance of school-based mental health initiatives becomes apparent. Educational institutions, akin to a second home for students, are responsible for addressing existing mental health issues and proactively averting their occurrence by prioritizing the students’ overall quality of life.
However, not solely the government and schools bear responsibility for these students. To establish a positive school climate for the well-being of the students, various segments of society, ranging from the four corners of homes to the offices of those with power and authority, must put forth significant endeavors to advocate for students’ mental health. Cultivating a mental health support system within and beyond educational institutions secures a future-ready approach to nurturing the mental health of young individuals, which is what these students genuinely deserve.
We should remember that the future is full of endless possibilities and opportunities. It’s important not to get caught up in the present and forget there’s so much more ahead for mental health, encourage each other to keep pushing forward positively, and the world will open up in ways we never expected. Mental health has the potential to improve. We need not be complacent and pessimistic about its future but have the goal for changes and improvements for the sake of the students and all.
References
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Dela Peña, Maniego, Panghulan, and Ruiz are a group of 2nd and 3rd year students studying at the University of the Philippines Diliman taking up B Public Administration under the National College of Public Administration and Governance.
