Psychopathic

In the Tondo neighborhood where I grew up, one of our neighbors was a young woman who often took off all her clothes in their yard. I knew when she did this because a crowd of men and young boys would gather by her house, laughing and clapping and taunting her until a dismayed member of the household would pull her away from public view.

I remember some neighbors saying the woman lost her mind after she was raped, but I never found out the truth. I also don’t know if her family ever sought professional help for her, but throughout our years as neighbors I don’t recall her being committed to a mental health institution. She was always there, baring her breasts to the boys, pulling down her underwear for all to see, or going fully naked.

Her family was middle-class and might have been providing her with psychiatric help at home but didn’t want her committed to an institution. In those days, we heard only horror stories about such mental health facilities. The impression was that after prolonged drug treatment or a lobotomy, patients slipped into catatonia or else turned into Jekyll-and-Hyde monsters. Movies such as the popular “One Flew Over the Cuckoo’s Nest” in 1975, with Jack Nicholson’s brilliant performance, didn’t help.

The state-run National Center for Mental Health in Mandaluyong was called the Insular Psychopathic Hospital, also the Mental Hospital, when it was established in December 1928. The Psychopathic Hospital was set up to accommodate the spillover of patients from the “Insane Department” of Manila’s San Lazaro Hospital and the City Sanitarium in the Philippines.

In my childhood, “psychopathic” was the word used by Pinoys to refer to both the hospital and all types of mental disorders. Back in the day, families found it shameful to have any member confined in “Saykopatik” or “Mental.” Mandaluyong, at the time a town, was the butt of many jokes for being the site of Saykopatik.

When we moved out of Tondo I lost track of our neighbor. These days I wonder how much her life might have changed for the better if she had access to professional help and a changing public attitude toward mental health problems.

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Millennials are among the biggest drivers of this sea change in Filipinos’ outlook toward mental health. Perhaps because they grew up in the age of social media, there is greater awareness that depression and other forms of mental disorders are quite common particularly in their age group.

There is instant comfort in realizing that one is not alone in a predicament. When you realize that you’re not a freak and you’re not bearing the weight of the entire planet solely on your shoulders, there is more openness to possible solutions, assistance or healing.

Today we even have a Youth for Mental Health Coalition, set up in October 2016 and with a volunteer “director for education,” Jarvin Tan. The articulate 23-year-old pharmacy graduate of the University of the Philippines told us on “The Chiefs” last Friday on Cignal TV’s One News channel that interest in mental health issues among the Filipino youth has grown exponentially in recent years.

Tan, who joined the coalition in April last year, heads the mental health advocacy team of the Philippine Pharmacists Association. Among the advocacies of the coalition, which is registered with the Securities and Exchange Commission, is suicide prevention. On World Suicide Day in September last year (yes, there is such a day), the coalition helped organize a “SuPre (Suicide Prevention) Run.”

The coalition was also among the groups that lobbied for the passage of the National Mental Health Act, Republic Act 11036, which seeks to erase the stigma of mental disorders and give even the poor access to mental health care.

Neophyte Rep. Chiqui Roa-Puno of Antipolo’s first district, sponsor of the measure at the House of Representatives who also appeared on our TV show, is pleasantly surprised at the speed by which the law was enacted. While the country’s drug problem helped give the law the necessary push from Malacañang and quick approval by Congress, its passage is undoubtedly a victory for all mental health advocates.

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Mental disorders of course afflict not only the youth. The coalition’s national adviser, psychiatrist Gia Sison, told us on “The Chiefs” that consultations on mental health problems have also been on a steady rise among older generations.

The readiness to seek professional help is in itself a significant change. Because of my interest in psychology and other mental health issues, psychiatry was one of the careers I had considered pursuing. But relatives warned me that I would end up a pauper because no one consulted shrinks in this country.

Today, Dr. Sison’s profession must be thriving. And she and her colleagues could be swamped when RA 11036 goes into full force once the implementing rules and regulations are out. The country, Sison says, has only about 700 psychiatrists, most of them concentrated in Metro Manila and other large cities. Even if PhilHealth is mandated to cover mental health care under the new law, there aren’t enough qualified professionals to provide the services. Dealing with drug abusers alone could prove overwhelming.

The problem is worst in places that are underserved even when it comes to basic health care. These are the places where epilepsy is still considered a case of demon possession, which is treated through beatings and exorcism. It may take some time before residents in these communities stop insulting people who are considered mentally unwell and calling them may sayad or saykatok.

It’s also doubtful that certain individuals who clearly need psychiatric care – the psychos who find pleasure in torture and murder – will ever admit suffering from mental disorder and seek professional help.

Having a law in place, however, is a transforming step. The mantra of health advocates is a quote from the first director general of the World Health Organization. It’s significant that the WHO’s Dr. Brock Chisholm was a psychiatrist. His memorable quote: “Without mental health, there can be no true physical health.”

There are still a lot of hurdles in the implementation of RA 11036, and in preventing discrimination against those who are ready to admit mental health problems and seek help. But the first big step has been made in assisting those suffering from mental disorders and preventing suicides. Among those who might be saved could be your loved one.