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The Pandemic and its Toll on Mental Health

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The Pandemic and its Toll on Mental Health
UNICEF Philippines

On average, individuals expressing strong public trust and confidence in the national healthcare system are less likely to suffer from depression and anxiety.

By Nina Dela Cruz and Raymond Gaspar

The coronavirus disease (COVID-19) pandemic has taken a toll on the psychological and social well-being of many Filipinos. Stay-at-home orders have left many in isolation and experiencing feelings of fear and anxiety, largely over economic hardship and uncertainty. The Philippines’ National Center for Mental Health has been receiving an average of as much as 400 calls per month related to depression and mental health during the pandemic—a steep increase from an average of 80 hotline calls per month observed before the imposition of community quarantines and social distancing guidelines (WHO Philippines 2020).

When all classes went online, the prevailing digital divide put poor students, especially those in more remote areas, at a disadvantage. Amid workplace closures, a large group of workers, particularly part-time employees and those whose work cannot be feasibly done at home, have either been furloughed or have faced reduced working hours with negative consequences on their income and finances. Women, especially mothers, have been taking on a greater domestic burden of housework and childcare during the pandemic, while the elderly have long been restricted from going outside due to their vulnerability to the virus.

Using a weekly online survey collected from the Philippines by the Imperial College London-YouGov Covid 19 Behaviour Tracker Data Hub between 31 March and 30 September 2020, we examined the state of mental health among Filipinos during the pandemic and how it is influenced by sentiments toward the government’s handling of the pandemic and confidence in the national healthcare system.

Our measures of mental health are consistent with the standard depression and anxiety screening tools, i.e., Patient Health Questionnaires (PHQ-2) and Generalized Anxiety Disorder (GAD-2). We empirically linked these measures with individuals’ perceptions on how well the government is handling the pandemic and their confidence in the public healthcare system.

We found robust evidence of women having higher odds of experiencing considerable mental health concerns. Women, especially mothers, face a greater challenge of juggling paid work and domestic responsibilities. In a rapid gender assessment conducted in the National Capital Region from 15 April to 27 May 2020, Dizon and Medina (2020) found that Filipino women, on average, were spending 7 hours on housework from only 4 hours before the pandemic.

Our findings also revealed that young adults aged 18–25 are relatively more at risk of episodes of psychological distress. Shaikh et al. (2021) also found a high incidence of stress, anxiety, and depression among Filipino young adults aged 18–30. Fernandez (2021) showed that accumulating worries associated with missing traditional milestones and losing economic opportunities and vital relationships are leading young adults into mental distress amid the ongoing crisis.

Another group of individuals who are disproportionately feeling the brunt of the pandemic are part-time employees and the unemployed. Due to workplace closures, reduced working hours, and irregular wages and salaries, these individuals face much higher economic uncertainty, which could lead to a deterioration in their mental state.

Further, our analysis strongly links individuals’ states of mental health and their perceived trust and confidence in the government and public healthcare system. On average, individuals expressing strong public trust and confidence in the national healthcare system are less likely to suffer from depression and anxiety. Citizens who are confident in the capability, reliability, and efficiency of institutions to resolve issues related to the pandemic can have peace of mind and a feeling of assurance. The success of healthcare authorities in mobilizing scientific expertise to tackle rising forms of misinformation about the virus and measures, such as vaccination programs, also play a crucial role.

Our empirical analyses lend support to formulating targeted policy initiatives for young adults, women, part-time employees, the unemployed, and those suffering from pre-existing health conditions, which relate to adopting strategic solutions and guidelines for handling the pandemic. While vaccination programs are ramped up, the Philippines’ COVID-19 Inter-Agency Task Force for the Management of Emerging Infectious Diseases should facilitate the safe reopening of schools and face-to-face classes and forge strategic partnerships with the business sector to ensure the welfare of workers. If feasible, labor market interventions, such as career guidance and skills training should enable individuals to navigate into a more digitized economic environment.

Evidently, with the ongoing pandemic, building public trust makes policy sense and should always be considered when formulating public initiatives for addressing mental health issues. A trusted government and public authorities could effectively demand a cooperative and considerate attitude and compliant behavior from the public, which we have observed in many safety instructions and practices, such as hand washing and sanitizing practices, stay-at-home orders, and social distancing. The relevant public authorities should, therefore, show strong and capable governance in setting clear directions and guidelines. Government actions should be transparent, collaborative, consistent, and credible. In partnership with the scientific community and relevant private sectors, public health authorities should dismantle any form of misinformation and conspiracy regarding COVID-19 and vaccines.

Indeed, as Mazzucato and Kattel (2020) argued, governments have a very important role to play in this pandemic era, which involves strengthening their capacity to adapt and learn, align public services and citizen needs, and govern data and digital platforms. In the medium-to-long run, the country needs to effectively overcome the existing challenges of the insufficient availability of medical treatments, appropriate facilities, and mental health professionals.

About the Authors

Nina Ashley O. Dela Cruz is a consultant involved in the formulation of evidence and gap maps at the Campbell Collaboration in New Delhi.

Raymond E. Gaspar is a policy research specialist at the United Nations Development Programme Bangkok Regional Hub.

Originally published in Asia Pathways, the official blog of the Asian Development Bank (ADB)

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