Maribel Bronda, a 50-year-old environmental officer from Quezon City, in Metro Manila, thought about killing herself when she caught the coronavirus. While the Philippines struggles to deal with the coronavirus pandemic that has swept the nation since early this year, many Filipinos have battled mental health crises caused by the upheaval, chaos and continuing danger of viral infection. Bronda tested positive for the virus in early June and was admitted to a quarantine facility in the city. She says her loneliness and isolation were challenging because she had never been away from her family before. “I couldn’t sleep most nights, and I was really longing for companionship,” she says. “On top of that, I was also questioning why it had to be me.” While in quarantine, Bronda learned her husband and son had also caught the virus. The stress of the news paired with her loneliness led to thoughts of suicide, which she fought to ignore. These days, months after being released from quarantine, she continues to have bouts of anxiety. “Whenever I hear an ambulance’s siren, I get really nervous,” she says. “But I steel myself and tell myself that the Lord will keep me safe.” Although there are no official statistics, reports of Filipinos taking their own lives made the headlines as the Covid-19 death toll accelerated across the nation and unemployment rose to a record 45.5 per cent, or about 27.3 million people. As of October 23, there had been more than 366,000 cases of Covid-19 in the country and 6,915 deaths. In August, the surge in suicide cases prompted Philippine Justice Secretary Menardo Guevarra, a member of the Inter-Agency Task Force on Emerging Infectious Diseases, to call on Filipino spiritual leaders to provide guidance to the public during these difficult times. “It was the first thing we thought of, but we know that it is not the only solution,” he tells the South China Morning Post . “And the religious leaders were quick to answer.” Hong Kong model Mia Kang’s journey from self-loathing to self-love Mental health professionals around the world warned of a potential mental health crisis when the pandemic began to take lives and shut down businesses. Sharlene Ongoco, a doctor with the Philippine National Centre for Mental Health, says the centre’s crisis hotline has received an average of between 30 and 40 calls daily – nearly 900 a month – during the pandemic. By comparison, the hotline received less than half as many calls, an average of 400 a month, between May 2019 when it was first set up and February 2020. Psychiatrist Reggie Pamugas says that prayers might help people recover from mental health crises, but he emphasises the need for the church and science to work together. “We recognise that medicines are not always the first answer, which is why, in this regard, one’s belief can help a lot,” he says. “Our hope here is that our church leaders will learn to accept science and refer their followers to us should the need arise.” But religious Filipinos often have an archaic view of mental illness. Freelance content writer Lily Mendoza, 22, who prefers not to use her real name, used to be part of a local church group. She found comfort in the members and its services, especially during times when she would get into arguments with her father. But when the constant clashes with her father made her anxious and led to suicide attempts, she began to isolate herself from the group. She received little sympathy or guidance from the church, with fellow members even saying that her anxiety came from her lack of devotion. “I had to leave, because it felt like a dismissal of my mental struggle, but this is not just about faith,” Mendoza says. She has been living agnostically for more than a year now, and she says she feels more at ease with herself. Filipinos are God-fearing people. Having a higher spirituality gives us a better fighting chance against mental illnesses Philippine Justice Secretary Menardo Guevarra Even beyond the confines of organised religion, there are Filipinos who view mental illness as an absence of faith, which sociologist and pastor Jayeel Cornelio says is an effect of “religious inadequacy”. “People subscribe to this idea that having faith will solve all problems and therefore make us happy – because there are not enough religious conversations about grieving,” he says. “What they fail to realise is that Jesus wept. Does this mean that he did not have faith?” Secretary Guevarra’s call to church leaders launched a renewed discussion about mental health in the Philippines. He remains confident that the situation is not too bad, despite the spike in distress calls to the National Centre for Mental Health. “We do need to address these reports of Filipinos committing suicide,” he says. “Certain government agencies, like the department of health and the department of education, have already come up with measures to increase awareness of mental health. But Filipinos are God-fearing people. Having a higher spirituality gives us a better fighting chance against mental illnesses.” Churches have set up support groups for those in need of mental and spiritual counselling. Nevertheless, mental illness continues to be stigmatised in Philippine society, despite the introduction of a mental health law in 2018. Some of the discrimination stems from the intangible nature of these diseases, Pamugas says. “We can’t actually see emotions in an X-ray. And because of this, some people are led to believe that patients with mental illnesses aren’t really sick.” As a result, individuals dealing with anxiety, depression or any other form of mental disease find it hard to seek support and sometimes eventually lose the will to find the treatment they need. “Compared to tuberculosis or dengue , mental health statistics are not that big, because cases often go unreported,” Pamugas says. “Let me reiterate that these illnesses are real. Everyone can be susceptible to it, and these are but normal reactions to abnormal situations.” The Covid-19 pandemic has also highlighted the high cost of health care in the Philippines, which includes access to mental care. Bronda, a devout Catholic, admits she and her family only go to clinics because they cannot afford hospitals. But what she lacks in financial resources, she makes up for in her faith, she says. “I consider the Lord a doctor who keeps us safe and healthy.” For 29-year-old communications manager Nico Pablo, mental health services must reach across all levels of society. “I’d like to acknowledge that Filipinos often see it as a middle- or upper-class concern,” Pablo says. “I’ve heard this many times before – ‘only rich people can have depression’ – because there are a lot of expenses attached to it. We need to shift the conversation, because mental well-being cuts across every class.” Pablo was medically diagnosed with panic disorder in 2017, and had to take medication for it, which cost around 42 pesos (US$2) per tablet. Psychiatric consultations cost 3,000 pesos (US$140) per session. Pablo has now stopped both using medication and seeing a psychiatrist. The Philippines has moved to phase three of a Covid-19 plan, which means Filipinos can move about more freely, but Pamugas says individuals will continue to experience anxiety and other mental crises. He calls on the government to fast-track free mass testing instead of resorting to militaristic responses, such as the prolonged quarantine measures currently in place in certain parts of the country. He continues to push for a holistic approach to mental health, and a stronger, rights-based implementation of the mental health law. If executed properly, he says, the law will increase the public’s awareness of mental illness, integrate mental health services into basic health care, and promote mental health in workplaces and communities. ‘Alarming rise’ in young people suffering mental distress amid Covid-19 crisis Despite the challenges of mental health, there is hope yet for society, says Pablo, whose partner’s workplace already offers benefits such as free counselling for employees. “If mental health is institutionalised at this level, people have more opportunities to teach themselves about it,” Pablo says. “Everyone will benefit if we talk about and normalise it.” If you are having suicidal thoughts, or you know someone who is, help is available. For Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call The National Suicide Prevention Lifeline on +1 800 273 8255. For a list of other nations’ helplines, visit this page .