research about mental health of filipino teachers

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Filipino Teachers' Mental Health Amidst the Covid-19 Pandemic

International Journal of Multidisciplinary: Applied Business and Education Research

The study investigated the problems that adversely affect the mental health of Filipino teachers during the time of Covid-19 pandemic. The results of the study revealed various ways teachers cope with their problems on mental health. Family and other forms of social support, recreational, and spiritual activities have always been beneficial in these challenging times and a lot of studies has proved its effectiveness on dealing with mental health. However, aside from these coping strategies, teachers have proven themselves to be flexible enough to find ways for them to feel much better. The study also proves that teachers are resilient in dealing with their problems. They acknowledged their difficulties, yet they also manage and divert their focus into something more positive and productive. It is also noteworthy that teachers are less likely to experience pandemic fatigue since they always try to be obedient with the safety precautions mandated by the government considering that ...

Related Papers

Asian Journal of Education and Social Studies

Novie John Palarisan

Aims: The present investigation aims to determine the mental health status of public school teachers post-pandemic. This study seeks to provide descriptive results on the depression, anxiety, and stress scale of the respondents. Study Design: The study employed a quantitative survey design. Methodology: A total of 175 public school teachers responded to the survey. This utilized the DASS-21. Data were analyzed using frequency and percentage, mean and standard deviation, ANOVA, and T-test. Results: The findings revealed that 58.29% of respondents are female, 34.86% are between 31 to 35 years old, and 41.71% have been in service for 6 to 10 years. At the time of this study, 45.71% of the respondents are currently enrolled in graduate studies. The status of their mental health was as follows: Stress scale (20), depression scale (13), and anxiety (9) interpreted as moderate, mild, and mild, respectively. Also, there is a significant difference in the statuses of respondents' mental ...

JPAIR Multidisciplinary Research

Godfrey Velayo

The well-being of teachers influences the well-being of the students in ways that influence the mental health trajectory of future generations. However, when the pandemic started, lockdowns and the closure of schools caused teachers to suffer stress because they needed to adapt policies to provide learning. Thus, the changes in work methods have caused mental health issues among teachers. The study aimed to describe the anxiety, stress, and depression among secondary school teachers in Batanes. By considering the level of these mental health issues teachers are experiencing, institutions might be in a better position to put in place the relevant support structures that may be needed. This study utilized a quantitative research approach and was conducted in all secondary schools in the province. The study was conducted among 73 secondary school teachers, 17 males and 56 females aged 23 to 59. A three-part survey questionnaire was used to gather data in the study – Consent Form, Dem...

Psychology and Education: A Multidisciplinary Journal

Psychology and Education

This study determined the coping strategies of secondary teachers in Malasiqui District II, Pangasinan I divsion amid Covid-19 pandemic. It also determined the stress level of teachers amid Covid-19 pandemic, significant relationships and significant differences between and among variables. It used the descriptive-correlational research design and utilized the google forms in the distribution and collection of data from the secondary teachers.This study found out that in the profile variables of the respondent-teachers, majority are married, 26-35 years old, Master's degree holders with 5 years and below teaching service. Majority of the respondents too, are Teacher I who have 3 and below number of seminars or trainings attended. The teachers' coping strategies amid the covid-19 pandemic along physical aspect, mental aspect, social aspect, emotional aspect, and spiritual aspect are highly effective. Significant relationship exists between the coping strategies of teachers amid the Covid-19 pandemic and the teachers' profile variables; age, civil status, position, and number of years teaching. Likewise, significant difference exists on the coping strategies of the teachers amid the Covid-19 pandemic and the teachers' profile variables; age, civil status, position, and number of years teaching.It is strongly recommended that teachers should continue their studies and should attend more seminars or trainings to improve their knowledge and skills specifically in handling unexpected situations such as the Covid-19 pandemic. It is also recommended that programs and projects in the schools must be developed to help teachers sustained their abilities in facing situations similar to this pandemic if ever another one will happen anytime in the future. Further, school professional and developmental program must be institutionalized and implemented specifically including variables that are consistent as source of stress among teachers. Lastly, there should be another study on the coping strategies of teachers with Covid-19 pandemic to further verify, complement or contrast the result of the present study.

AJHSSR Journal

The COVID-19 Pandemic changes many"s lives thus, knowing and understanding the things to consider in hurdling challenges relating to mental health are essential for everybody. Nowadays, students and teachers are also confronted with challenges due to the implemented new normal environment in teaching and learning in the different state colleges in the Philippines. Knowing the stressors faced by the students and teachers is significant in structuring activities to lessen stress and anxiety, which believably are the reasons for their hesitation to work and to involve themselves in related-academic activities. Knowing the level of stressors and its effect to students and teachers is essential to assess the efficiency of the existing practices in every institution. This paved way also in launching programs to develop instructional activities for the HEIs in the country. Gathering of data was done online using a standard questionnaire deployed through google forms. The result revealed that the school and work-related matters contributed the most to the stress experienced by the students and teachers of Occidental Mindoro State College, Philippines. Findings revealed that students often experienced stressful activities relating to mental health matters compared to teachers.

THE JOURNAL OF ORIENTAL RESEARCH MADRAS

KALYAN CHOWDHURY

COVID-19 pandemic and different phases of lockdown has brought about a keen sense of anxiety, fear, solicitude and agitation around the globe. The normal day to day life events has been totally elided even all the educational establishments have been ceased with Govt. order unprecedentedly leading to a psychosocial and mental health implications for the learners as well as for the teachers. The purpose of this study is to measure the impact of COVID-19 pandemic on the mental health of secondary school teachers who were moved off abruptly from their intrinsic regular teaching-learning environment. To measure the impact a scale has been developed by the researchers using google form and sent via WhatsApp and Gmail to secondary school teachers of Purulia district, West Bengal with a request to fill the five-point Likert-type questionnaire and to submit it through online as physical administration of the scale is not possible to maintain the lockdown protocol. One-way ANOVA and 't' test have been applied to interpret of the findings. The results revealed that 16.85%, 67.0% and 16.10%

Psychology and Education , Henmar Cardino , Jeemon Rey A. Bacaoco

The COVID-19 pandemic affected everyone and almost all industries across the world including the educational system. The impact of the pandemic on students was given attention in several research. However, its negative effects on the teacher's and school administrators' well-being are not yet fully analyzed and understood. Thus, in this research, the Pagdadala model was used to understand the impact of the pandemic on teachers' and administrators' well-being. The data gathered from 244 participants were analyzed using thematic analysis by Braun and Clarke (2006). Following their recommended six phases of data analysis from familiarizing with data, generating initial code, looking for, reviewing and naming the themes, and coming up with the final results, it showed that the Dinadala (Burdens) of the burden bearers were grouped into health, work, financial, self, and family themes. The manner in which the burden bearers handle the identified burdens or the Pagdadala (Burden Bearing) was themed into personality development, selfcare, spiritual, community protocols, and other possible resources. Last, the source of strength of the burden bearers or the Patutunguhan (Destination) were grouped into family, spirituality, society, self, and work themes. The results of this research can be utilized as a guide in identifying appropriate interventions to improve the well-being of teachers and administrators and address the concerns that emerged because of the pandemic.

The Impact of the Covid-19 Pandemic on Teachers' Mental Health: A Systematic Literature Review (Atena Editora)

Atena Editora

A pandemia de COVID-19 teve impactos significativos na educação, aumentando os desafios enfrentados pelos professores, categoria que já lidava antes com problemas relacionados aos grandes níveis de estresse. O presente artigo objetivou analisar a saúde mental dos professores durante a pandemia de COVID-19, através de revisão sistemática de trabalhos científicos publicados durante o período, que avaliavam domínios como qualidade de vida, ansiedade, depressão, estresse, burnout e exaustão nestes profissionais. Foram obtidos 1003 artigos a partir da busca por palavras-chave, sendo que destes, nove artigos abordavam o tema proposto, sendo eles objeto de análise da revisão. Os artigos estavam distribuídos em sete países, todos por questionário, sendo dois estudos longitudinais e sete transversais. Apenas um artigo avaliou professores escolares, os demais artigos selecionados avaliaram professores universitários. Foram selecionadas as categorias de análise isolamento e suporte, crianças e família, gênero, idade, finanças e estabilidade, saúde física e sono, comparação entre grupos, questões pedagógicas. Grande parte dos participantes das pesquisas analisadas apresentaram níveis altos de depressão, ansiedade e estresse, e relataram aumento da sua carga de trabalho durante a pandemia. As populações mais sujeitas à incidência de depressão, ansiedade e estresse foram mulheres, profissionais mais jovens e indivíduos com crianças em casa. Além disso, foi encontrado que o suporte familiar e no ambiente de trabalho são fatores de proteção contra a incidência dos transtornos supracitados.

Bisma The Journal of Counseling

Mardhiah Rosli

This study was conducted to determine the level of mental health and psychological well-being of school teachers during the Movement Control Order (MCO) enforced throughout COVID-19 pandemic in Malaysia. The study sample consisted of 274 male and female school teachers in Selangor state, Malaysia. This quantitative data was obtained using an online questionnaire developed via 'Google form' application, and was analyzed using SPSS software version 28.0. Perceived Stress Scale (COVID-19 PSS-10) English Version shows Alpha Cronbach's value of α = 0.719. The validity test of the instrument Ryff's Psychological Well-Being Scale (PWB) English Version shows the alpha Cronbach's α = 0.86. The set of questionnaires was analyzed descriptively, independent sample t - test was also conducted. The study found that respondents have a moderate level of psychological well-being. There were no significant differences between the genders of teachers. The findings of the study are ...

IJMRAP Editor

The primary emphasis of this study was on the stress and coping mechanisms of elementary teachers and school administrators in Zamboanga del Sur Division during the school year 2021-2022. Ten (10) school administrators and ninety-one (91) elementary teachers from the chosen primary schools in the lowland and upland zones are taking part in this study. Both descriptive and inferential statistics were used for the precise analysis and interpretation. In determining the stress level, extent of barriers experienced by the teachers, and coping mechanism applied, Weighted Average Mean was used. To determine whether there is significant difference between the school administrators and teachers' level of stress, barriers experienced by the teachers, and their coping mechanism, Analysis of Variance of F-test was used. Further investigation was done to ascertain whether there is significant relationship between the teachers' stress level and barriers experienced by the teachers; stress level and coping mechanism; and barriers experienced and coping mechanism, Pearson Correlation Coefficient was used. Using SPSS, all inference tests were examined. The results demonstrated that the stress levels of school administrators and teachers during the pandemic were moderately high, as was clearly demonstrated by the overall means of 2.95 and 3.33, respectively. The grand averages of 3.60 and 3.43, in particular, provide strong evidence that the personal, technical, logistical, and financial barriers experienced by the teachers during the modular distance learning were to a large degree preset impediments. The findings also show that there is no noticeable difference in the stress levels of teachers and school administrators. Additionally, the stress level was linked to the challenges the teachers faced. The degree of stress and coping strategies used by teachers and school officials were significantly correlated.

Utamax : Journal of Ultimate Research and Trends in Education

Helma Malini

The COVID -19 pandemic, which has been ongoing for over a year, has become a burden to the world, causing anxiety and depression. The purpose of this study is to investigate the depression and stress levels of senior high school teachers in Indonesia during the COVID-19 outbreak since they have experienced substantial teaching situations change as a result of it. In particular, the changes in their professional, as well as personal lives, pose challenges during the pandemic. This quantitative study distributing questionnaires to 50 high school teachers in Indonesia. The findings indicate that social support is the most significant factor (0,46%) needed to prevent depression and stress among the teachers. Meanwhile, workload and role conflict cover 0,74% and 0,84% respectively of variables that teachers can change with the assumption that both variables exist even before a pandemic arises. This study also reveals that teachers continue to receive less attention and support, especiall...

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Stress and Depression in the Workplace of Educators in the Philippines

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ORCID record for Caren Casama Orlanda-Ventayen
ORCID record for Randy Joy Magno Ventayen
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Workplace Stress and depression should be treated properly in order to maintain productive teaching as the noblest profession. Unmanaged stress and depression could lead to a serious outcome that affects the happy environment in the classroom. Thus, managing stress and avoiding depression in the workplace is one of the important situations that a teacher should aim in order to succeed. This study aims to determine the level of workplace stress and depression of the educators in the Philippines by gathering their profile, workplace stress, and the state of depression. A correlation was investigated if there is a significant difference in the profile to the workplace stress and state of depression. Based on the result of the study, teachers sometimes experience stress in the workplace, while some experience depression at some point in time. It is recommended that teachers should understand how to practice stress management and avoiding depression.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Funded by Pangasinan State University

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

A request and approval to conduct of the study was addressed to DR. JESUS L. R MATEO Undersecretary of the Department of Education in the Philippines was secured. To observe the highest ethical standards in research involving the teachers, the office has recommendations which was complied by the researchers. The suggestion of the department such as inclusion of the statement "participation is voluntary and respondents can discontinue/opt-out in the survey anytime", revision of questionnaire based on the requirement of the department was complied.

All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Biodata : Caren Casama Orlanda-Ventayen is a core faculty Bachelor of Elementary Education (BEEd) and General Education Department of Pangasinan State University, Alaminos City Campus. A graduate of Master of Arts in Education major in Educational Management. She finished her Bachelor’s degree in Elementary Education at the Adelphi College in Lingayen, Pangasinan, and Bachelor of Secondary Education major in Technology and Livelihood Education at PSU Lingayen Campus.

Email: cventayen{at}psu.edu.ph

Randy Joy Magno Ventayen is the current Director for Public Relations, Publiction and Information of Pangasinan State University. He is also a faculty of PSU Open University Systems, PSU Lingayen Campus and a mobile faculty of PSU Binmaley Campus. He Graduated his Doctoral Degree in Business Administration in 2010 and Doctor in Information Technology at the University of the Cordilleras in consortium with Ateneo de Manila University in 2019. He served as the University Web Administrator of Pangasinan State University in 2016 to 2018, and the former Dean of the College of Business and Public Administration of PSU Lingayen Campus.

Email: dayjx{at}yahoo.com

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Filipino Teachers' Mental Health Amidst the Covid-19 Pandemic

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Article Details

United Nations

Unodc regional office for southeast asia and the pacific, philippine educators explore mental health concerns in unodc webinar series.

Manila (Philippines), 25 January 2022 – Over 7,000 teachers nationwide tuned in for the launch of the United Nations Office on Drugs and Crime’s (UNODC) Psychosocial and Mental Health Webinars for Teachers via Zoom and Youtube Live. The webinar series supported by the Bureau of the International Narcotics and Law Enforcement Affairs (INL) of the US Department of State provides an avenue for teachers to understand how prolonged stress, impediments imposed as a result of COVID-19 pandemic and related fears can affect mental health and well-being. Moreover, work-life balance as well as stress-release techniques were discussed to equip participants with essential skills to properly respond to early signs of stress and deterioration of mental health. Department of Education (DepEd) Chief of Health Division Dr. Ma. Corazon Dumlao, who represented Undersecretary Revsee A. Escobedo, relayed a message of solidarity as she underlined the importance of protecting the emotional, psychological, and social well-being of the community as she quipped, “We should not be afraid to ask for help.” For its first offering, Dr. Homer Yabut of the De La Salle University-Psychology Department and chairperson of the Psychological Association of the Philippines-Central Luzon Chapter expounded on the common mental health issues in the workplace such as stress, anxiety, depression, and burnout. Dr. Yabut discussed the implications of the COVID-19 situation on individuals including teachers such as experiencing fear, worry, and loneliness and feeling isolated due to the accentuated distance from support systems. Virtual participants were able to share how they feel and how they perceive their current state of mental health through online interactive platform Mentimeter. Majority of the teachers expressed that they experienced burnouts, had difficulty in concentrating, and found it hard to engage in leisurely and pleasurable activities.

Dr. Yabut mentioned how prolonged anxiety and distress may push individuals to use illegal substance and emphasized the importance of understanding the harmful use of psychoactive substances and underlying conditions as overlapping and interplaying areas. Further, he appealed to educators and officials to collectively work towards creating a healthy workplace through developing the positive aspects of work and the strengths of employees, and through enforcing health and safety policies and practices including identifying potential sources of distress. INL Director Kelia Cummins also graced the activity and expressed support of the US Embassy in continuously providing assistance to counter crime and fight illegal drugs and instability abroad. She related the INL’s mandate in curbing the healthcare-related impacts of the pandemic including the mitigation of negative impact of COVID-19 in at-risk communities and schools. “Together, we can continue to seek inspiration from each other in overcoming these challenges, not only through this training but through collaboration and communication,” Director Cummins said. As the pilot run of the series ended, participants were reminded to practice mindfulness, recognize fleeting emotions in self and others, and regulate these emotions effectively. Running until March 2022, the webinar series will next tackle peer support systems and mental health first aid. The episodes on mental health first aid were aired on February 15, 16, and 17, 2022 from 1PM-5PM.

Fraud Alert

Mental health of Filipino seafarers and its implications for seafarers' education

Affiliations.

1 University of the Philippines Visayas, Iloilo City, Iloilo, Philippines. [email protected].
2 Seafarers International Research Centre, Cardiff University, Cardiff, United Kingdom.
PMID: 34604987
DOI: 10.5603/IMH.2021.0035

This narrative review examines current academic literature on the mental health of Filipino seafarers working internationally, including the mental health effects of coronavirus disease 2019 (COVID-19). Framed within a rights-based approach, it aims to identify and analyse emerging themes on Filipino seafarers' mental health literature to understand what these studies potentially mean for the improvement of seafarers' education on mental health. Based on a broad selection criteria, 28 eligible papers demonstrate collectively three key findings: firstly, there is paucity in published research on seafarers' mental health; secondly, the majority of published studies are associated with a recent piracy crisis, where a significant number of mariners were attacked, taken as hostages, or killed; thirdly, three key areas emerged under which research on Filipino seafarers' mental health can be organized: the medical repatriation of seafarers, system of care for the mental health of seafarers including the diagnostic standards used, and seafarers' experiences and conceptions of mental health including the mental health effects of COVID-19. Though the bulk of the current understanding of the mental health problems is associated with piracy, several risk factors for which the quality of quantitative and qualitative evidence are patchy. The few sources of primary data to date lack focus on mental health needs which makes it difficult to grasp the extent of the problem. Developing policies and programmes for the promotion of mental health through mental health education among seafarers is important for a couple of reasons. Seafaring remains a dangerous and socially isolating occupation where work-related accidents are likely and will be potentially traumatic to mariners. Research on occupational stressors is increasingly providing evidence of their contributions to poor mental health outcomes among seafarers. Thus, mental health education of seafarers in the context of their work is important for proactive training and development.

Keywords: COVID-19 and mental health of seafarers; mental health education of seafarers; mental health of Filipino seafarers.

Publication types

COVID-19 / psychology*
Crime / psychology
Mental Disorders / diagnosis
Mental Disorders / epidemiology
Mental Health / education*
Naval Medicine / methods*
Occupational Health
Occupational Stress
Philippines / ethnology

Open access
Published: 27 May 2024

Youth not engaged in education, employment, or training: a discrete choice experiment of service preferences in Canada

Meaghen Quinlan-Davidson 1 , 2 ,
Mahalia Dixon 1 ,
Gina Chinnery 3 ,
Lisa D. Hawke 1 , 4 ,
Srividya Iyer 5 , 6 ,
Katherine Moxness 7 ,
Matthew Prebeg 1 , 8 ,
Lehana Thabane 9 , 10 , 11 &
J. L. Henderson 1 , 4

BMC Public Health volume 24 , Article number: 1402 ( 2024 ) Cite this article

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Prior research has showed the importance of providing integrated support services to prevent and reduce youth not in education, employment, or training (NEET) related challenges. There is limited evidence on NEET youth’s perspectives and preferences for employment, education, and training services. The objective of this study was to identify employment, education and training service preferences of NEET youth. We acknowledge the deficit-based lens associated with the term NEET and use ‘upcoming youth’ to refer to this population group.

Canadian youth (14–29 years) who reported Upcoming status or at-risk of Upcoming status were recruited to the study. We used a discrete choice experiment (DCE) survey, which included ten attributes with three levels each indicating service characteristics. Sawtooth software was used to design and administer the DCE. Participants also provided demographic information and completed the Global Appraisal of Individual Needs–Short Screener. We analyzed the data using hierarchical Bayesian methods to determine service attribute importance and latent class analyses to identify groups of participants with similar service preferences.

A total of n =503 youth participated in the study. 51% of participants were 24–29 years of age; 18.7% identified as having Upcoming status; 41.1% were from rural areas; and 36.0% of youth stated that they met basic needs with a little left. Participants strongly preferred services that promoted life skills, mentorship, basic income, and securing a work or educational placement. Three latent classes were identified and included: (i) job and educational services (38.9%), or services that include career counseling and securing a work or educational placement; (ii) mental health and wellness services (34.9%), or services that offer support for mental health and wellness in the workplace and free mental health and substance use services; and (iii) holistic skills building services (26.1%), or services that endorsed skills for school and job success, and life skills.

Conclusions

This study identified employment, education, and training service preferences among Upcoming youth. The findings indicate a need to create a service model that supports holistic skills building, mental health and wellness, and long-term school and job opportunities.

Peer Review reports

Youth not in education, employment, or training (NEET) struggle to navigate school to work transitions and experience difficulties accessing jobs [ 1 ]. These youth are disconnected from school, have limited work experience [ 2 ], and experience a loss of economic, social, and human capital [ 3 ]. NEET status is associated with lower education, parental unemployment, low socioeconomic status, low self-confidence, more precarious housing, and young parenthood [ 4 , 5 , 6 , 7 , 8 ]. In Canada, the percentage of NEET youth (15–29 years) was estimated at 11% in 2022 [ 9 ]. Importantly, NEET status is not homogenous across the country, ranging from 36% in Nunavut, 20% in Northwest Territories, and 17% in Newfoundland and Labrador to 10% in Quebec, Prince Edward Island and British Columbia) [ 10 ]. Supporting and protecting these marginalized youth remains a challenge, particularly in light of the Coronavirus disease 2019 (COVID-19) pandemic, which adversely impacted the school to workforce transition for youth across the country [ 11 ]. Although the term NEET has been used to describe this population, it is considered stigmatizing and associated with a deficit-based lens[ 12 ]. As such, and in consultation with one of our youth team members, we refer to this population as ‘Upcoming youth’[ 13 ].

Upcoming status has gained attention across Canada in recent decades [ 14 ]. As an illustration of this focus, federal, provincial/territorial, and local programs exist to support Upcoming youth across the country [ 15 ]. Despite these efforts, evidence indicates program fragmentation, limited coordination across sectors and regions, and a lack of evaluation of these programs [ 16 ]. Further, these programs may be available to youth on a short-term basis and specific to youth who meet education, income, and age criteria [ 17 ]. There is a lack of knowledge of how to (re)engage Upcoming youth in general education and employment support services. Often the same limited outcomes are measured and reported (e.g., job attainment) with services focusing on these outcomes. At the same time, youth have not been asked what outcomes they prefer and accordingly what services they would like. Indeed, selective outcome reporting and lack of engagement of youth impairs the quality of evidence and contributes to research waste [ 18 ]. Given the heterogeneity of Upcoming status, this lack of evidence is particularly important for subgroups of youth (e.g., geographic location; socioeconomic status; mental health status) who face challenges in the school-to-work transition.

Prior global research has emphasized the importance of integrated, coordinated interventions that offer a range of support services (e.g., on-the-job, classroom-based, and social skills training) to prevent and reduce Upcoming status [ 19 , 20 , 21 , 22 , 23 ] [ 24 ]. Integrated youth service (IYS) models, which integrate education, employment, mental and physical health, substance use, peer support, and navigation in one, youth-friendly location have been established in Canada [ 25 ]. IYS deliver services that meet the needs, goals, and preferences of youth, and hold promise in serving vulnerable Upcoming youth through the provision of holistic services in a youth-friendly environment. Indeed, IYS models are investigating how to optimize employment, education, and training services as a critical component of supporting youth wellbeing and their successful transition to adulthood. This point is particularly important as Upcoming youth experience greater mental health and substance use (MHSU) concerns compared to youth who do not identify as Upcoming [ 26 , 27 ].

An essential component to designing and enhancing health and social services for Upcoming youth is understanding their perspectives [ 28 ]. Yet, there is a lack of evidence on Upcoming youth’s perspectives and preferences for employment, education, and training services within the Canadian context. For interventions to be relevant to the needs and experiences of youth—which will increase their chances of using the services and benefiting from them—it is important to understand what youth aim to achieve when participating in an intervention. Engaging youth in identifying service components and interventions will ensure that programs and services are relevant, feasible, and appropriate to this population group [ 29 ].

An approach that can be used to identify the demands and preferences of youth is the discrete choice experiment (DCE) [ 30 , 31 ]. The DCE is a quantitative method that requires participants to state their choice over sets of alternatives described in terms of several characteristics called attributes and the value placed on each attribute [ 30 , 31 ]. In this way, the DCE is able to identify the importance of attributes along which a variety of service options vary, as well as service preferences among subgroups. DCEs are one of the most popular methods for eliciting stated- preferences in health care [ 32 , 33 ]. They force participants to make trade-offs, identifying the importance of different service attributes [ 32 , 33 ]. Previous findings generated from DCE studies have been useful in informing service design and delivery, resource allocation, and policies, including the preferred design of IYS services [ 34 , 35 , 36 , 37 ].

Understanding service preferences from the perspective of Upcoming youth is critical for the development of interventions and policies that will help youth navigate the school-to-work transition. As such, the objective of the current study was to identify employment, education and training service preferences of Upcoming youth. As our approach to COVID-19-related impacts shifts, the need for this research is more urgent than ever, as a way to support vulnerable youth, reduce Upcoming status, prevent further exclusion, and help them on their path towards adulthood.

Discrete Choice Experiment (DCE)

A discrete choice experiment (DCE) methodology was used in this study, as described in the study protocol [ 13 ]. We followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines on good research practices for conjoint analysis [ 38 ]. Attributes and levels were developed using the following methods. First, we reviewed the literature on relevant and preferred services for youth with Upcoming and at-risk Upcoming status [ 26 ]. An initial set of six attributes with three to four levels was developed from the literature review, highlighting components such as mental health, goals, and skills training. Second, focus groups were conducted among youth (16–29 years) with Upcoming and at-risk Upcoming status across Canada to obtain youth feedback on proposed service outcomes [ 39 ]. Thematic analysis [ 40 ] of the focus group data identified prominent attributes and levels, including skills training, mentorship, and networking. The project team included youth team members with lived/living experience of MHSU concerns and researchers; meetings were held with the team to refine the attributes and levels.

The list of attributes and levels were piloted among n = 9 youth (16–29 years) across Canada. Pilot participants completed the DCE with a member of the project team. The aim of the pilot was to obtain youth feedback on the proposed list of attributes and levels, as well as the design and functionality of the DCE. Based on pilot feedback, a final list of attributes and levels was developed. The final DCE list included ten attributes, each with three levels. The attributes included mentorship; skills for school and job success; technical skills; life skills; basic income; networking opportunities; securing a work or educational placement; career counselling; access to free mental health and substance use services; and support for mental health and wellness in the workplace. Using a 3 × 3 partial-profile design, we used Sawtooth software (version 9.14.2) [ 41 ] to administer the 14 randomized choice tasks. This design was chosen to optimize orthogonality, minimize participant burden, and ensure data robustness [ 42 ]. Table 1 shows a sample choice task; Additional File 1 contains the full list of attributes and levels in the study.

Participants and procedure

The study was approved by the Centre for Addiction and Mental Health’s (CAMH) Research Ethics Board in Toronto, Canada. This study consisted of n = 503 youth (14–29 years), recruited over a three-month period in late 2022 and early 2023. The sample size was based on a priori power calculations and exceeds the sample size of most DCE studies [ 13 ]. Study flyers with survey links were distributed through internal CAMH and external professional networks, as well as through social media (Facebook and Instagram).

Participants were eligible to complete the DCE if they were between the ages of 14 and 29 years; lived in Canada at the time of survey completion; and identified as Upcoming status or having ever been concerned of being at-risk of Upcoming status (self-identified). They were screened through an online survey sent via email, hosted on REDCap electronic software [ 43 ]. Participants gave informed consent and filled out anti-spam and eligibility questions. Those who were eligible were sent a link to complete the DCE through Sawtooth Software [ 41 ]. The survey was in English only. They also filled out self-report questionnaires on demographics, and mental health and substance use. Reminder emails to complete the survey were sent to participants once per week, with a maximum of three reminders sent. A total of n = 515 participants initiated the survey and n = 503 completed the survey, yielding a response rate of 97.7%. The median time to complete the DCE was 20.63 min. Participants received a $30 gift card as honorarium for survey completion.

Mental health and substance use measures

Participants completed the Global Appraisal of Individual Needs–Short Screener (GAIN-SS) (version 3) [ 44 ]. Internalizing disorders (depression, anxiety, somatic complaints, trauma etc.); externalizing disorders (hyperactivity, conduct problems, attention deficits, impulsivity etc.); and substance use disorders are domain subscales that are screened in the GAIN-SS [ 44 ]. The GAIN-SS also includes a crime/violence domain, however, low level of endorsement in this study precluded the inclusion of this subscale. Participants rated each administered symptom “never” to “within the past month”, indicating how recently they experienced symptom difficulties. Within each domain subscale, endorsed past month symptoms were counted and summed. Scores could range between 0–6, 0–7, and 0–5 for the Internalizing, Externalizing, and Substance Use Problems domain, respectively. Following previous literature, three or more items endorsed within the past month indicate a high likelihood of needing services and/or meeting threshold criteria for psychiatric diagnoses [ 44 , 45 ].

Demographic characteristics were collected. We included age (categorical measure), gender identity (man/boy [cis, trans]; woman/girl [cis, trans]; Gender diverse); ethnicity (White; Indigenous, Black, Asian, Mixed); region in Canada (Prairies, Western/Northern, Atlantic, Central); self-rated physical and mental health (good/very good/excellent; fair/poor) [ 46 ]; socioeconomic status (live comfortably; income meets needs with a little left; just meet basic expenses; don’t meet basic expenses); living arrangement (alone; with partner; with family; other); and area of residence (large city and suburbs of large city; small city, town, village or rural area).

Youth engagement

Following the McCain Model of Youth Engagement [ 47 ], and working with the Youth Engagement Initiative at the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, we engaged youth throughout the study. To enhance study design, promote youth buy-in, and relevance of the study, youth were involved from project inception and implementation of study activities to interpretation of findings and manuscript development.

Statistical analysis

Statistical analyses were performed using Sawtooth Software version 9.14.2 [ 41 ] and Stata version 16.1 [ 48 ]. Descriptive statistics were calculated for all study variables overall and by latent-class grouping. Using hierarchical Bayesian methods within Sawtooth Software [ 41 ], utility estimates were calculated for each participant. Standardized zero-centered utilities were used and the average utility range of attribute levels was set to 100 (49) to calculate the estimates. Attributes with higher utility estimates indicated higher relative value compared with other attributes (Table 2 ).

To identify groups of participants with similar service preferences, we conducted latent class analyses [ 41 ]. To belong to a latent class, probabilities were assigned to each participant. Using different starting seeds, five replications for each latent class group was calculated, with log-likelihood decreases of 0.01 or less indicating convergence. Based on the analysis, we retained a three-class model. This model was determined by analyzing the Bayesian Information Criteria (BIC), Akaike Information Criteria (AIC), Consistent Akaike Information Criterion (CAIC), and Akaike’s Bayesian Information Criterion (ABIC); latent class sizes; and the interpretation of latent class groupings (Table 3. ). Team discussions with youth team members were held to review the importance scores and rankings and establish the names of the latent glass groupings (Table 4 ). Stata 16.1 [ 48 ] was used to compare latent classes on demographic characteristics and GAIN-SS scores using chi-square tests.

Table 5 presents participant demographic characteristics. The majority of participants were between 24 and 29 years of age; lived in urban areas; were engaged in employment and training only; and identified as White and girl/woman (Trans, cis). Almost two thirds of participants (65.79%) met threshold criteria for an internalizing disorder, followed by 36.62% with an externalizing disorder, and 8.65% with a substance use disorder.

Overall service preferences

The overall service preferences and importance scores of participants are presented in Table 2 . Participants positively endorsed services that promoted life skills, mentorship, basic income, and securing a work or educational placement. Participants were least likely to endorse technical skills. Within life skills services, youth positively endorsed services that included managing finances, taxes, and skills associated with self-care and cooking. The provision of a mentor who worked within the participant’s field of interest was preferred by all youth. Participants positively endorsed basic income until having secured employment that matched the basic income level. All youth preferred services that provided support to secure long-term job positions or school placements that aligned with their career interests or long-term goals.

Table 3. illustrates the fit indices of the latent class analysis. A three-class model was retained based on fit, size of latent class grouping, and interpretation of findings. Attribute importance scores and rankings are presented in Table 4 by latent class. There were some commonalities identified across the latent classes. All latent classes positively endorsed services that offered mentorship (mentors in their field of interest, with similar backgrounds, or peer mentors), basic income, and networking. Youth preferred the provision of a mentor with work experience in their field of interest. Participants also positively endorsed receiving basic income until 25 years of age (regardless of school or job status), or until they had found a job that matched the basic income level. In addition, all participants endorsed skills to network and opportunities to network in their area of interest.

Over 60% of participants from all of the latent classes reported fair/poor mental health. In addition, over 60% of participants in each latent class grouping met threshold criteria for an internalizing disorder, compared to the other GAIN-SS disorders. Furthermore, more participants identified as having lived in large cities/suburbs compared to small cities/towns in each latent class.

Latent Class 1: Job and educational services

The first latent class endorsed services that focused on education and long-term job services, focusing on a career trajectory ( n = 204, 38.9%). Attributes that drove these decisions included career counselling and securing a work or educational placement. Youth positively endorsed career counselling that helped to figure out career goals, create a resume, and complete job applications. Further, youth positively endorsed receiving long-term job positions or school placements that align with their career interests and long-term goals, as opposed to temporary or any job position. Participants from this latent class (Table 6 ) were more likely to be 24–29 years of age compared to other ages. Approximately 22.06% of youth in this latent class identified as Upcoming.

Latent Class 2: Mental health and wellness services

The second latent class endorsed mental health and wellness services ( n = 171, 34.9%). This latent class preferred that services offer support for mental health and wellness in the workplace and free mental health and substance use services. Specifically, participants positively endorsed the provision of on-site in-person, individual mental health and substance use services, as opposed to the provision of virtual or in-person group services. Further, youth positively endorsed ongoing access to a support worker to help in securing accommodations in the workplace, as opposed to learning how to advocate for oneself in workplace or support during job onboarding. Participants that endorsed this latent class (Table 5 ) tended to identify as Indigenous, Black, Asian, and Mixed; girl/woman (cis, trans); both student and employed; income met needs with a little left; and rated their physical health as good/excellent. Approximately 16.96% of youth in this latent class identified as Upcoming.

Latent Class 3: Holistic skills building services

Skills building was the focus of the third latent class ( n = 128, 26.1%). Participants positively endorsed skills for school and job success, as well as life skills. Specifically, youth were interested in learning about how to organize time; prioritize tasks; identify problems and solutions; as well as professionalism, communication and relationship building. Youth were also interested in life skills that focused on learning about how to manage finances and taxes, as well as self-care and cooking. Participants in this latent class (Table 5 ) tended to identify as White; employed only; living in an urban area; and income that just met basic expenses. Approximately 15.63% of youth in this latent class identified as Upcoming.

To our knowledge, this study was the first to identify employment, education, and training service preferences among Upcoming youth and those at-risk of Upcoming status using discrete choice experiment methods. The findings indicate that overall, youth value services that enhance their ability to deal effectively with life demands; receive advice and guidance by a mentor; and obtain financial support through basic income. In examining youth participants by latent class, the findings indicate a need to create a service model that supports long-term school and job opportunities, holistic skills building, and mental health and wellness. Job and educational services prioritized long-term job and school placements, with career counselling. Mental health and wellness services endorsed free, easily accessible and in-person support services. Meanwhile, holistic skills building focused on problem solving, communication, relationship building, and organization of time, as well as building skills to help youth manage daily life.

Participants highly endorsed services that promote life skills, mentorship, and basic income. For life skills, participants valued skills that included managing finances, taxes, and skills like self-care or cooking. Participants may have valued this service attribute because life skills empower youth. These skills are positive behaviours that give youth the knowledge, values, attitudes, and abilities necessary to effectively meet and deal with everyday challenges [ 50 , 51 ]. Prior research has shown how these skills strengthen psychosocial competencies, promote health and social relationships, and protect against risk-taking behaviours [ 51 ].

For mentorship, participants valued having a mentor who has work experience in the field they are interested in. Prior research has shown the negative associations between unemployment, exclusion, and economic hardship among Upcoming youth [ 52 , 53 ]. Participants may have chosen this service attribute as mentoring is a key component of career development. Career mentoring provides opportunities for career exploration and strengthening decision-making within this domain [ 54 , 55 , 56 , 57 ]. Research has shown the benefits of mentorship. Mentors are a positive resource, providing support and guiding youth as they navigate and succeed in their careers [ 54 , 58 , 59 ].

Youth also prioritized receiving basic income until they secured employment that matches the basic income level. Empirical evidence has shown associations between income and youth mental health outcomes [ 60 , 61 , 62 ]. Indeed, Johnson et al. [ 63 ] [ 63 ] posit that a universal basic income can positively affect health through behaviour, resources, and stress. Defined as income support to populations with minimal or no conditions [ 64 ], prior research has shown the benefits of a basic income plan in terms of poverty reduction, improvements in physical and mental health, economic growth, and human capital gains [ 65 , 66 , 67 , 68 , 69 ]. In a qualitative study in England [ 70 ], youth (14–24 years) reported that a universal basic income plan would improve their mental health through financial security, agency, greater equality, and improvements in relationships.

Differences in service preferences were observed among youth subgroups based on the identified latent classes. Youth who identify as Indigenous, Black, Asian, and Mixed prioritized mental health and wellness services compared to youth who identify as White. Previous literature has showed that Indigenous , Black, and racialized youth have experience longer wait times and poorer quality of mental health care compared to their White counterparts [ 71 , 72 , 73 ]. Prior literature has described how MHSU systems often do not consider or address the discrimination, systemic racism, economic marginalization, and intergenerational traumas that Indigenous, Black, and racialized populations experience within and outside of the service system [ 74 , 75 ]. These negative experiences adversely affect their access to and quality of MHSU care, leading to inequities in MHSU outcomes. To ensure that mental health and substance use services are culturally responsive, safe, effective, and available to Indigenous, Black, and racialized youth, services should incorporate their perspectives into service design and delivery. The finding that youth 24–29 years of age endorsed job and educational services focused on long term career planning could be attributed to being more advanced in thinking about their careers and a desire to find a career as opposed to a job [ 57 , 76 , 77 ]. It could also be due to older youth experiencing poorer labour market conditions [ 19 , 78 , 79 ]. To improve long-term job opportunities for youth, Canada’s labour standards need to be updated, ensuring protection and benefits to informal and non-standard youth workers (17).

A critical component for education, employment, and training services is raising awareness about these services and their benefits among youth. A 2019 survey among NEET youth (16–29 years) in Canada showed that 54% reported a hard time finding information on the labour market services, while 42% said the information available on these services was not easy to understand [ 80 ]. One way to address this issue is by delivering services to Upcoming youth at the local, community level. In fact, as IYS strengthen education, employment and training services, these community-based services can support youth by connecting them with local job opportunities. IYS can also work with other public, private and community organizations to change local, fragmented school and work policies [ 19 ]. Another way to address this issue would be to provide access to this information at an earlier age, as shown in a parliamentary enquiry in Victoria, Australia in which career management was recommended for incorporation into primary school curriculum[ 81 ].

All three latent classes preferred services that provided mentorship, basic income, and networking opportunities. Youth value mentorship opportunities from individuals with experience in their field of interest. Similarly, youth prioritized networking opportunities in their field of interest. Federal, provincial/territorial and local programs could harness this preference by creating mentorship and networking structures across public, private, and community organizations for youth [ 17 ]. Further, the provision of basic income would help support youth as they re-engage with school and the labour market [ 17 ]. Interestingly, technical skills were not endorsed by youth in this study. Although technical skills are endorsed as part of technical and vocational education and training programs [ 82 ], it may be that youth were not as concerned about enhancing technical skills as they were other services. Future research should investigate youth experiences of technical skill programs.

It is important to note that participants in all latent classes endorsed poor mental health, while a higher proportion of youth screened positive for internalizing disorders compared to other disorders. These findings are in line with prior literature, particularly in light of the COVID-19 pandemic [ 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ]. It could also reflect the positionality of the researchers. The survey was administered by CAMH, a mental health teaching hospital, and could have been seen more among youth connected with mental health services compared to those not connected to CAMH. Prior research has showed that life skills training can promote positive development, mental wellbeing, and prevent risky behaviours [ 92 , 93 ]. The prioritization of long-term school and job placements among youth with mental health concerns indicates a need to strengthen these services for this cohort.

In fact, in 2020 the Individual Placement and Support (IPS) model [ 94 , 95 ], which provides mental health service users with personalized vocational support alongside mental health support to obtain employment, education, and training opportunities was launched in Alberta, British Columbia, Nova Scotia, Ontario and Quebec to strengthen existing IYS, including ACCESS Open Minds, Foundry, and Youth Wellness Hubs Ontario [ 96 ]. The program was implemented in 12 hubs across the country and is currently being evaluated. Despite the challenges that have arisen over the course of the pandemic, COVID-19 has highlighted an opportunity to improve the education, employment and training support systems that serve these youth. Some of the core principles of implementation of the IPS model align with findings from the current study and include integration of mental health treatment teams, employment specialists to support young people as they navigate the labour market, rapid job search approaches, and tailored job supports, among other principles [ 94 ].

Indeed, in building on the services endorsed in this study, it would be important to incorporate an evaluation framework such as the Consolidated Framework for Implementation Research [ 97 ] to evaluate the effectiveness and impact of these services. Determining potential outcomes that could be measured would also be important. Following the IPS model, for job and educational placements, services could implement the Youth Employment and Education Survey [ 94 , 95 ]. Potential outcomes could include status of school or employment, job permanency, educational placement duration, and satisfaction with the program, among others. For mental health and wellness support services, outcomes could focus on the number of in-person visits, satisfaction with the services, and self-reported mental health, among others. For holistic services, potential outcomes could focus on reporting and monitoring self-reported goals for problem-solving and communication, among others. It would be important to continuously assess and match services to Upcoming youth preferences.

We would like to acknowledge some limitations. This study includes a non-randomized sample of youth across Canada. Our study included less than 20% of youth who identified as Upcoming, which limits our ability to generalize the findings to this population group. Further research is needed among youth who identify as Upcoming to determine if these education, employment, and training services represent their preferences. Further, youth without stable and consistent internet access would also have been missed. We were unable to recruit large populations of youth from specific Indigenous and racialized backgrounds, although these did account for nearly half the sample. These groups may have different needs and preferences. Future research should investigate their perspectives on employment, education, and training services. In addition to the structure of the DCE survey, along with following a rigorous process in the development of the attributes and levels, there could have been some youth service priorities not assessed. Furthermore, as some of the attributes and levels built on each other, these commonalities could have influenced preference elicitation for specific service attributes. We tried to ensure that the survey was youth-friendly for all youth, however due to the cognitive capacity required to complete the survey, some youth with greater mental health and learning challenges may have been missed.

This study identified employment, education, and training service preferences among Upcoming youth and those at-risk of Upcoming status in Canada. The findings indicate a need at the federal, provincial/territorial, and local level to create a service model that supports school and job opportunities long-term; mental health and wellness; and building holistic skills. The model also requires community-based and youth-centred approaches in the design and delivery of these services. Our findings further support the need for widespread policy support for broader-spectrum IYS for Upcoming youth and those at-risk of Upcoming status.

Availability of data and materials

No datasets were generated or analysed during the current study.

Abbreviations

Akaike’s Bayesian Information Criterion

Akaike Information Criterion

Bayesian Information Criteria

Consistent Akaike Information Criterion

Centre for Addiction and Mental Health

Coronavirus disease 2019

Discrete Choice Experiment

Global Appraisal of Individual Needs Short Screener

Importance Scores

Individual Placement and Support model

International Society for Pharmacoeconomics and Outcomes Research

Integrated Youth Services

Mental health and substance use

Not in education, employment, or training

Standard Errors

Youth Wellness Hubs Ontario

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Acknowledgements

We would like to thank the participants for their participation in this study. We would like to thank members of the Centre for Addiction and Mental Health’s Youth Engagement Initiative for their support of this study.

This research was funded by the Social Sciences and Humanities Research Council (SSHRC) (435–2019-0393).

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Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

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Published: 20 August 2020
Volume 55 , pages 1397–1413, ( 2020 )

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Andrea B. Martinez ORCID: orcid.org/0000-0002-4437-769X 1 , 2 ,
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This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking.

Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis.

Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help.

We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review

Predictors of Help-Seeking for Mental Health Treatment Among Latinos

Predictors of professional help-seeking for emotional problems in afghan and iraqi refugees in australia: findings from the building a new life in australia database.

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Introduction

Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [ 1 ]. Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or misclassification of suicide cases as ‘undetermined deaths’ [ 2 ]. Despite these figures, government spending on mental health is at 0.22% of total health expenditures with a lack of health professionals working in the mental health sector [ 1 , 3 ]. Elevated mental health problems also characterise ‘overseas Filipinos’, that is, Filipinos living abroad [ 4 ]. Indeed, 12% of Filipinos living in the US suffer from psychological distress [ 5 ], higher than the US prevalence rate of depression and anxiety [ 1 ]. Long periods of separation from their families and a different cultural background may make them more prone to acculturative stress, depression, anxiety, substance use and trauma especially those who are exposed to abuse, violence and discrimination whilst abroad [ 6 ].

One crucial barrier to achieving well-being and improved mental health among both ‘local’ and overseas Filipinos is their propensity to not seek psychological help [ 7 , 8 ]. Not only are help-seeking rates much lower than rates found in general US populations [ 9 ], they are also low compared to other minority Asian groups [ 10 ]. Yet, few studies have been published on Filipino psychological help-seeking either in the Philippines or among those overseas [ 11 ]. Most available studies have focused on such factors as stigma tolerance, loss of face and acculturation factors [ 12 , 13 ].

To date, no systematic review of studies on Filipino psychological help-seeking, both living in the Philippines and overseas, has been conducted. In 2014, Tuliao conducted a narrative review of the literature on Filipino mental health help-seeking in the US which provided a comprehensive treatise on cultural context of Filipino help-seeking behavior [ 11 ]. However, new studies have been published since which examine help-seeking in other country contexts, such as Norway, Iceland, Israel and Canada [ 6 , 14 , 15 , 16 ]. Alongside recent studies on local Filipinos, these new studies can provide basis for comparison of the local and overseas Filipinos [ 7 , 8 , 12 , 17 ].

This systematic review aims to critically appraise the evidence on behavioural and attitudinal patterns of psychological help-seeking among Filipinos in the Philippines and abroad and examine barriers and enablers of their help-seeking. While the majority of studies undertaken have been among Filipino migrants especially in the US where they needed to handle additional immigration challenges, studying help-seeking attitudes and behaviours of local Filipinos is important as this may inform those living abroad [ 10 , 13 , 18 ]. This review aims to: (1) examine the commonly reported help-seeking attitudes and behaviors among local and overseas Filipinos with mental health problems; and (2) expound on the most commonly reported barriers and facilitators that influence their help-seeking.

The review aims to synthesize available data on formal help-seeking behavior and attitudes of local and overseas Filipinos for their mental health problems, as well as commonly reported barriers and facilitators. Formal psychological help-seeking behavior is defined as seeking services and treatment, such as psychotherapy, counseling, information and advice, from trained and recognized mental health care providers [ 19 ]. Attitudes on psychological help-seeking refer to the evaluative beliefs in seeking help from these professional sources [ 20 ].

Eligibility criteria

Inclusion criteria for the studies were the following: (1) those that address either formal help-seeking behavior OR attitude related to a mental health AND those that discuss barriers OR facilitators of psychological help-seeking; (2) those that involve Filipino participants, or of Filipino descent; in studies that involve multi-cultural or multi-ethnic groups, they must have at least 20% Filipino participants with disaggregated data on Filipino psychological help-seeking; (3) those that employed any type of study designs, whether quantitative, qualitative or mixed-methods; (4) must be full-text peer-reviewed articles published in scholarly journals or book chapters, with no publication date restrictions; (5) written either in English or Filipino; and (6) available in printed or downloadable format. Multiple articles based on the same research are treated as one study/paper.

Exclusion criteria were: (1) studies in which the reported problems that prompted help-seeking are medical (e.g. cancer), career or vocational (e.g., career choice), academic (e.g., school difficulties) or developmental disorders (e.g., autism), unless specified that there is an associated mental health concern (e.g., anxiety, depression, trauma); (2) studies that discuss general health-seeking behaviors; (3) studies that are not from the perspective of mental health service users (e.g., counselor’s perspective); (4) systematic reviews, meta-analyses and other forms of literature review; and (5) unpublished studies including dissertations and theses, clinical reports, theory or methods papers, commentaries or editorials.

Search strategy and study selection

The search for relevant studies was conducted through electronic database searching, hand-searching and web-based searching. Ten bibliographic databases were searched in August to September 2018: PsychInfo, Global Health, MedLine, Embase, EBSCO , ProQuest , PubMed , Science Direct, Scopus and Emerald Insight. The following search terms were used: “help-seeking behavior” OR “utilization of mental health services” OR “access to mental health services” OR “psychological help-seeking” AND “barriers to help-seeking” OR “facilitators of help-seeking” AND “mental health” OR “mental health problem” OR “mental disorder” OR “mental illness” OR “psychological distress” OR “emotional problem” AND “Filipino” OR “Philippines”. Filters were used to select only publications from peer-reviewed journals. Internet searches through Google Scholar and websites of Philippine-based publications were also performed using the search term “Filipino mental health help-seeking” as well as hand-searching of reference lists of relevant studies. A total of 3038 records were obtained. Duplicates were removed and a total of 2659 records were screened for their relevance based on their titles and abstracts.

Preliminary screening of titles and abstracts of articles resulted in 162 potentially relevant studies, their full-text papers were obtained and were reviewed for eligibility by two reviewers (AM and MC). Divergent opinions on the results of eligibility screening were deliberated and any further disagreement was resolved by the third reviewer (JB). A total of 15 relevant studies (from 24 papers) published in English were included in the review and assessed for quality. There were seven studies with multiple publications (two of them have 3 papers) and a core paper was chosen on the basis of having more comprehensive key study data on formal help-seeking. Results of the literature search are reported in Fig. 1 using the PRISMA diagram [ 21 ]. A protocol for this review was registered at PROSPERO Registry of the Centre for Reviews and Dissemination of the University of York ( https://www.crd.york.ac.uk/PROSPERO ; ID: CRD42018102836).

PRISMA flow diagram

Data extraction and quality assessment

Data extracted by the main author were crosschecked by a second reviewer (JB). A data extraction table with thematic headings was prepared and pilot tested for two quantitative and two qualitative studies to check data comparability. Extraction was performed using the following descriptive data: (1) study information (e.g. name of authors, publication date, study location, setting, study design, measurement tools used); (2) socio-demographic characteristics of participants (e.g. sample size, age, gender); and (3) overarching themes on psychological help-seeking behavior and attitudes, as well as barriers and facilitators of help-seeking.

Two reviewers (AM and MC) did quality assessment of the studies separately, using the following criteria: (1) relevance to the research question; (2) transparency of the methods; (3) robustness of the evidence presented; and (4) soundness of the data interpretation and analysis. Design-specific quality assessment tools were used in the evaluation of risk of bias of the studies, namely: (1) Critical Appraisal Skills Programme Qualitative Checklist [ 22 ]; and (2) Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project [ 23 ]. The appraisals for mixed-methods studies were done separately for quantitative and qualitative components to ensure trustworthiness [ 24 ] of the quality of each assessment.

For studies reported in multiple publications, quality assessment was done only on the core papers [ 25 ]. All the papers ( n = 6) assessed for their qualitative study design (including the 4 mixed-methods studies) met the minimum quality assessment criteria of fair ( n = 1) and good ( n = 5) and were, thus, included in the review. Only 11 out of the 13 quantitative studies (including the 4 mixed-methods studies) satisfied the minimum ratings for the review, with five getting strong quality rating. The two mixed-methods studies that did not meet the minimum quality rating for quantitative designs were excluded as sources of quantitative data but were used in the qualitative data analysis because they satisfied the minimum quality rating for qualitative designs.

Strategy for data analysis

Due to the substantial heterogeneity of the studies in terms of participant characteristics, study design, measurement tools used and reporting methods of the key findings, narrative synthesis approach was used in data analysis to interpret and integrate the quantitative and qualitative evidence [ 26 , 27 ]. However, one crucial methodological limitation of studies in this review is the lack of agreement on what constitutes formal help-seeking. Some researchers include the utilization of traditional or indigenous healers as formal help-seeking, while others limit the concept to professional health care providers. As such, consistent with Rickwood and Thomas’ definition of formal help-seeking [ 19 ], data extraction and analysis were done only on those that reported utilization of professional health care providers.

Using a textual approach, text data were coded using both predetermined and emerging codes [ 28 ]. They were then tabulated, analyzed, categorized into themes and integrated into a narrative synthesis [ 29 ]. Exemplar quotations and author interpretations were also used to support the narrative synthesis. The following were the themes on barriers and facilitators of formal help-seeking: (1) psychosocial barriers/facilitators, which include social support from family and friends, perceived severity of mental illness, awareness of mental health issues, self-stigmatizing beliefs, treatment fears and other individual concerns; (2) socio-cultural barriers/facilitators, which include the perceived social norms and beliefs on mental health, social stigma, influence of religious beliefs, and language and acculturation factors; and (3) systemic/structural and economic barriers/facilitators, which include financial or employment status, the health care system and its accessibility, availability and affordability, and ethnicity, nativity or immigration status.

Study and participant characteristics

The 15 studies were published between 2002 and 2018. Five studies were conducted in the US, four in the Philippines and one study each was done in Australia, Canada, Iceland, Israel and Norway. One study included participants working in different countries, the majority were in the Middle East. Data extracted from the four studies done in the Philippines were used to report on the help-seeking behaviors and attitudes, and barriers/facilitators to help-seeking of local Filipinos, while the ten studies conducted in different countries were used to report on help-seeking of overseas Filipinos. Nine studies were quantitative and used a cross-sectional design except for one cohort study; the majority of them used research-validated questionnaires. Four studies used mixed methods with surveys and open-ended questionnaires, and another two were purely qualitative studies that used interviews and focus group discussions. Only three studies recruited participants through random sampling and the rest used purposive sampling methods. All quantitative studies used questionnaires in measures of formal help-seeking behaviors, and western-standardized measures to assess participants’ attitudes towards help-seeking. Qualitative studies utilized semi-structured interview guides that were developed to explore the psychological help-seeking of participants.

A total of 5096 Filipinos aged 17–70 years participated in the studies. Additionally, 13 studies reported on the mean age of participants, with the computed overall mean age at 39.52 (SD 11.34). The sample sizes in the quantitative studies ranged from 70 to 2285, while qualitative studies ranged from 10 to 25 participants. Of the participants, 59% ( n = 3012) were female which is probably explained by five studies focusing on Filipino women. Ten studies were conducted in community settings, five in health or social centre-based settings and 1 in a university (Table 1 ).

Formal help-seeking behaviors

12 studies examined the formal help-seeking behaviors of Filipinos (Table 2 ), eight of them were from community-based studies and four were from centre-based studies. Nine studies reported on formal help-seeking of overseas Filipinos and three reported on local Filipinos.

Community-based vs health/social centres Data from quantitative community studies show that the rates of formal help-seeking behaviors among the Filipino general population ranged from 2.2% [ 30 ] to 17.5% [ 6 ]. This was supported by reports from qualitative studies where participants did not seek help at all. The frequency of reports of formal help-seeking from studies conducted in crisis centres and online counseling tended to be higher. For instance, the rate of engagement in online counseling among overseas Filipinos was 10.68% [ 31 ], those receiving treatment in crisis centers was 39.32% [ 17 ] while 100% of participants who were victims of intimate partner violence were already receiving help from a women’s support agency [ 8 , 32 ].

Local vs overseas Filipinos’ formal help-seeking The rate of formal psychological help-seeking of local Filipinos was at 22.19% [ 12 ] while overseas rates were lower and ranged from 2.2% of Filipino Americans [ 30 ] to 17.5% of Filipinos in Israel [ 6 ]. Both local and overseas Filipinos indicated that professional help is sought only as a last resort because they were more inclined to get help from family and friends or lay network [ 7 , 16 ].

Attitudes towards formal help-seeking

13 studies reported on participants’ attitudes towards seeking formal help. Seven studies identified family and friends as preferred sources of help [ 7 , 14 , 16 ] rather than mental health specialists and other professionals even when they were already receiving help from them [ 17 , 32 ]. When Filipinos seek professional help, it is usually done in combination with other sources of care [ 13 ] or only used when the mental health problem is severe [ 14 , 16 , 33 ]. Other studies reported that in the absence of social networks, individuals prefer to rely on themselves [ 32 , 33 ].

Community-based vs health/social centres Community-based studies reported that Filipinos have negative attitudes marked by low stigma tolerance towards formal help-seeking [ 7 , 14 , 16 ]. However, different findings were reported by studies conducted in crisis centres. Hechanova et al. found a positive attitude towards help-seeking among users of online counseling [ 31 ], whereas Cabbigat and Kangas found that Filipinos in crisis centres still prefer receiving help from religious clergy or family members, with mental health units as the least preferred setting in receiving help [ 17 ]. This is supported by the findings of Shoultz and her colleagues who reported that Filipino women did not believe in disclosing their problems to others [ 32 ].

Local vs overseas Filipinos Filipinos, regardless of location, have negative attitudes towards help-seeking, except later-generation Filipino migrants who have been acculturated in their host countries and tended to have more positive attitudes towards mental health specialists [ 10 , 13 , 15 , 34 ]. However, this was only cited in quantitative studies. Qualitative studies reported the general reluctance of both overseas and local Filipinos to seek help.

Barriers in formal help-seeking

All 15 studies examined a range of barriers in psychological help-seeking (Table 3 ). The most commonly endorsed barriers were: (1) financial constraints due to high cost of service, lack of health insurance, or precarious employment condition; (2) self-stigma, with associated fear of negative judgment, sense of shame, embarrassment and being a disgrace, fear of being labeled as ‘crazy’, self-blame and concern for loss of face; and (3) social stigma that puts the family’s reputation at stake or places one’s cultural group in bad light.

Local vs overseas Filipinos In studies conducted among overseas Filipinos, strong adherence to Asian values of conformity to norms is an impediment to help-seeking but cited only in quantitative studies [ 10 , 13 , 15 , 34 ] while perceived resilience, coping ability or self-reliance was mentioned only in qualitative studies [ 14 , 16 , 33 ]. Other common barriers to help-seeking cited by overseas Filipinos were inaccessibility of mental health services, immigration status, sense of religiosity, language problem, experience of discrimination and lack of awareness of mental health needs [ 10 , 13 , 18 , 34 ]. Self-reliance and fear of being a burden to others as barriers were only found among overseas Filipinos [ 6 , 16 , 32 ]. On the other hand, local Filipinos have consistently cited the influence of social support as a hindrance to help-seeking [ 7 , 17 ].

Stigmatized attitude towards mental health and illness was reported as topmost barriers to help-seeking among overseas and local Filipinos. This included notions of mental illness as a sign of personal weakness or failure of character resulting to loss of face. There is a general consensus in these studies that the reluctance of Filipinos to seek professional help is mainly due to their fear of being labeled or judged negatively, or even their fear of fueling negative perceptions of the Filipino community. Other overseas Filipinos were afraid that having mental illness would affect their jobs and immigration status, especially for those who are in precarious employment conditions [ 6 , 16 ].

Facilitators of formal help-seeking

All 15 studies discussed facilitators of formal help-seeking, but the identified enablers were few (Table 4 ). Among the top and commonly cited factors that promote help-seeking are: (1) perceived severity of the mental health problem or awareness of mental health needs; (2) influence of social support, such as the presence/absence of family and friends, witnessing friends seeking help, having supportive friends and family who encourage help-seeking, or having others taking the initiative to help; and (3) financial capacity.

Local vs overseas Filipinos Studies on overseas Filipinos frequently cited financial capacity, immigration status, language proficiency, lower adherence to Asian values and stigma tolerance as enablers of help-seeking [ 15 , 30 , 32 , 34 ], while studies done on local Filipinos reported that awareness of mental health issues and previous positive experience of seeking help serve as facilitator [ 7 , 12 ].

Community-based vs health/social centres Those who were receiving help from crisis centres mentioned that previous positive experience with mental health professionals encouraged their formal help-seeking [ 8 , 17 , 31 ]. On the other hand, community-based studies cited the positive influence of encouraging family and friends as well as higher awareness of mental health problems as enablers of help-seeking [ 12 , 14 , 16 ].

To the best of our knowledge, this is the first systematic review conducted on psychological help-seeking among Filipinos, including its barriers and facilitators. The heterogeneity of participants (e.g., age, gender, socio-economic status, geographic location or residence, range of mental health problems) was large.

Filipino mental health help-seeking behavior and attitudes The rate of mental health problems appears to be high among Filipinos both local and overseas, but the rate of help-seeking is low. This is consistent with findings of a study among Chinese immigrants in Australia which reported higher psychological distress but with low utilization of mental health services [ 35 ]. The actual help-seeking behavior of both local and overseas Filipinos recorded at 10.72% ( n = 461) is lower than the 19% of the general population in the US [ 36 ] and 16% in the United Kingdom (UK) [ 37 ], and even far below the global prevalence rate of 30% of people with mental illness receiving treatment [ 38 ]. This finding is also comparable with the low prevalence rate of mental health service use among the Chinese population in Hong Kong [ 39 ] and in Australia [ 35 ], Vietnamese immigrants in Canada [ 30 ], East Asian migrants in North America [ 41 ] and other ethnic minorities [ 42 ] but is in sharp contrast with the increased use of professional help among West African migrants in The Netherlands [ 43 ].

Most of the studies identified informal help through family and friends as the most widely utilized source of support, while professional service providers were only used as a last resort. Filipinos who are already accessing specialist services in crisis centres also used informal help to supplement professional help. This is consistent with reports on the frequent use of informal help in conjunction with formal help-seeking among the adult population in UK [ 44 ]. However, this pattern contrasts with informal help-seeking among African Americans who are less likely to seek help from social networks of family and friends [ 45 ]. Filipinos also tend to use their social networks of friends and family members as ‘go-between’ [ 46 ] for formal help, serving to intercede between mental health specialists and the individual. This was reiterated in a study by Shoultz et al. (2009) in which women who were victims of violence are reluctant to report the abuse to authorities but felt relieved if neighbours and friends would interfere for professional help in their behalf [ 32 ].

Different patterns of help-seeking among local and overseas Filipinos were evident and may be attributed to the differences in the health care system of the Philippines and their host countries. For instance, the greater use of general medical services by overseas Filipinos is due to the gatekeeper role of general practitioners (GP) in their host countries [ 47 ] where patients have to go through their GPs before they get access to mental health specialists. In contrast, local Filipinos have direct access to psychiatrists or psychologists without a GP referral. Additionally, those studies conducted in the Philippines were done in urban centers where participants have greater access to mental health specialists. While Filipinos generally are reluctant to seek help, later-generation overseas Filipinos have more positive attitudes towards psychological help-seeking. Their exposure and acculturation to cultures that are more tolerant of mental health stigma probably influenced their more favorable attitude [ 41 , 48 ].

Prominent barrier themes in help-seeking Findings of studies on frequently endorsed barriers in psychological help-seeking are consistent with commonly reported impediments to health care utilization among Filipino migrants in Australia [ 49 ] and Asian migrants in the US [ 47 , 50 ]. The same barriers in this review, such as preference for self-reliance as alternative coping strategy, poor mental health awareness, perceived stigma, are also identified in mental health help-seeking among adolescents and young adults [ 51 ] and among those suffering from depression [ 52 ].

Social and self-stigmatizing attitudes to mental illness are prominent barriers to help-seeking among Filipinos. Social stigma is evident in their fears of negative perception of the Filipino community, ruining the family reputation, or fear of social exclusion, discrimination and disapproval. Self-stigma manifests in their concern for loss of face, sense of shame or embarrassment, self-blame, sense of being a disgrace or being judged negatively and the notion that mental illness is a sign of personal weakness or failure of character [ 16 ]. The deterrent role of mental health stigma is consistent with the findings of other studies [ 51 , 52 ]. Overseas Filipinos who are not fully acculturated to the more stigma-tolerant culture of their host countries still hold these stigmatizing beliefs. There is also a general apprehension of becoming a burden to others.

Practical barriers to the use of mental health services like accessibility and financial constraints are also consistently rated as important barriers by Filipinos, similar to Chinese Americans [ 53 ]. In the Philippines where mental health services are costly and inaccessible [ 54 ], financial constraints serve as a hindrance to formal help-seeking, as mentioned by a participant in the study of Straiton and his colleagues, “In the Philippines… it takes really long time to decide for us that this condition is serious. We don’t want to use our money right away” [ 14 , p.6]. Local Filipinos are confronted with problems of lack of mental health facilities, services and professionals due to meager government spending on health. Despite the recent ratification of the Philippines’ Mental Health Act of 2018 and the Universal Health Care Act of 2019, the current coverage for mental health services provided by the Philippine Health Insurance Corporation only amounts to US$154 per hospitalization and only for acute episodes of mental disorders [ 55 ]. Specialist services for mental health in the Philippines are restricted in tertiary hospitals located in urban areas, with only one major mental hospital and 84 psychiatric units in general hospitals [ 1 ].

Overseas Filipinos cited the lack of health insurance and immigration status without health care privileges as financial barrier. In countries where people have access to universal health care, being employed is a barrier to psychological help-seeking because individuals prefer to work instead of attending medical check-ups or consultations [ 13 ]. Higher income is also associated with better mental health [ 56 ] and hence, the need for mental health services is low, whereas poor socio-economic status is related to greater risk of developing mental health problems [ 57 , 58 ]. Lack of familiarity with healthcare system in host countries among new Filipino migrants also discourages them from seeking help.

Studies have shown that reliance on, and accessibility of sympathetic, reliable and trusted family and friends are detrimental to formal help-seeking since professional help is sought only in the absence of this social support [ 6 , 8 ]. This is consistent with the predominating cultural values that govern Filipino interpersonal relationships called kapwa (or shared identity) in which trusted family and friends are considered as “hindi-ibang-tao” (one-of-us/insider), while doctors or professionals are seen as “ibang-tao” (outsider) [ 59 ]. Filipinos are apt to disclose and be more open and honest about their mental illness to those whom they considered as “hindi-ibang-tao” (insider) as against those who are “ibang-tao” (outsider), hence their preference for family members and close friends as source of informal help [ 59 ]. For Filipinos, it is difficult to trust a mental health specialist who is not part of the family [ 60 ].

Qualitative studies in this review frequently mentioned resilience and self-reliance among overseas Filipinos as barriers to help-seeking. As an adaptive coping strategy for adversity [ 61 ], overseas Filipinos believe that they were better equipped in overcoming emotional challenges of immigration [ 16 ] without professional assistance [ 14 ]. It supports the findings of studies on overseas Filipino domestic workers who attributed their sense of well-being despite stress to their sense of resilience which prevents them from developing mental health problems [ 62 ] and among Filipino disaster survivors who used their capacity to adapt as protective mechanism from experience of trauma [ 63 ]. However, self-reliant individuals also tend to hold stigmatizing beliefs on mental health and as such resort to handling problems on their own instead of seeking help [ 51 , 64 ].

Prominent facilitator themes in help-seeking In terms of enablers of psychological help-seeking, only a few facilitators were mentioned in the studies, which supported findings in other studies asserting that factors that promote help-seeking are less often emphasized [ 42 , 51 ].

Consistent with other studies [ 44 , 49 ], problem severity is predictive of intention to seek help from mental health providers [ 18 , 30 ] because Filipinos perceive that professional services are only warranted when symptoms have disabling effects [ 5 , 53 ]. As such, those who are experiencing heightened emotional distress were found to be receptive to intervention [ 17 ]. In most cases, symptom severity is determined only when somatic or behavioral symptoms manifest [ 13 ] or occupational dysfunction occurs late in the course of the mental illness [ 65 ]. This is most likely due to the initial denial of the problem [ 66 ] or attempts at maintaining normalcy of the situation as an important coping mechanism [ 67 ]. Furthermore, this poses as a hindrance to any attempts at early intervention because Filipinos are likely to seek professional help only when the problem is severe or has somatic manifestations. It also indicates the lack of preventive measure to avert any deterioration in mental health and well-being.

More positive attitudes towards help-seeking and higher rates of mental health care utilization have been found among later-generation Filipino immigrants or those who have acquired residency status in their host country [ 10 , 15 ]. Immigration status and length of stay in the host country are also associated with language proficiency, higher acculturation and familiarity with the host culture that are more open to discussing mental health issues [ 13 ], which present fewer barriers in help-seeking. This is consistent with facilitators of formal help-seeking among other ethnic minorities, such as acculturation, social integration and positive attitude towards mental health [ 43 ].

Cultural context of Filipinos’ reluctance to seek help Several explanations have been proposed to account for the general reluctance of Filipinos to seek psychological help. In Filipino culture, mental illness is attributed to superstitious or supernatural causes, such as God’s will, witchcraft, and sorcery [ 68 , 69 ], which contradict the biopsychosocial model used by mental health care professionals. Within this cultural context, Filipinos prefer to seek help from traditional folk healers who are using religious rituals in their healing process instead of availing the services of professionals [ 70 , 71 ]. This was reaffirmed by participants in the study of Thompson and her colleagues who said that “psychiatrists are not a way to deal with emotional problems” [ 74 , p.685]. The common misconception on the cause and nature of mental illness, seeing it as temporary due to cold weather [ 14 ] or as a failure in character and as an individual responsibility to overcome [ 16 , 72 ] also discourages Filipinos from seeking help.

Synthesis of the studies included in the review also found conflicting findings on various cultural and psychosocial influences that served both as enablers and deterrents to Filipino help-seeking, namely: (1) level of spirituality; (2) concern on loss of face or sense of shame; and (3) presence of social support.

Level of spirituality Higher spirituality or greater religious beliefs have disparate roles in Filipino psychological help-seeking. Some studies [ 8 , 14 , 16 ] consider it a hindrance to formal help-seeking, whereas others [ 10 , 15 ] asserted that it can facilitate the utilization of mental health services [ 15 , 73 ]. Being predominantly Catholics, Filipinos had drawn strength from their religious faith to endure difficult situations and challenges, accordingly ‘leaving everything to God’ [ 74 ] which explains their preference for clergy as sources of help instead of professional mental health providers. This is connected with the Filipino attribution of mental illness to spiritual or religious causes [ 62 ] mentioned earlier. On the contrary, Hermansdottir and Aegisdottir argued that there is a positive link between spirituality and help-seeking, and cited connectedness with host culture as mediating factor [ 15 ]. Alternately, because higher spirituality and religiosity are predictors of greater sense of well-being [ 75 ], there is, thus, a decreased need for mental health services.

Concern on loss of face or sense of shame The enabler/deterrent role of higher concern on loss of face and sense of shame on psychological help-seeking was also identified. The majority of studies in this review asserted the deterrent role of loss of face and stigma consistent with the findings of other studies [ 51 ], although Clement et al. stated that stigma is the fourth barrier in deterring help-seeking [ 76 ]. Mental illness is highly stigmatized in the Philippines and to avoid the derogatory label of ‘crazy’, Filipinos tend to conceal their mental illness and consequently avoid seeking professional help. This is aligned with the Filipino value of hiya (sense of propriety) which considers any deviation from socially acceptable behavior as a source of shame [ 11 ]. The stigmatized belief is reinforced by the notion that formal help-seeking is not the way to deal with emotional problems, as reflected in the response of a Filipino participant in the study by Straiton et. al., “It has not occurred to me to see a doctor for that kind of feeling” [ 14 , p.6]. However, other studies in this review [ 12 , 13 ] posited contrary views that lower stigma tolerance and higher concern for loss of face could also motivate psychological help-seeking for individuals who want to avoid embarrassing their family. As such, stigma tolerance and loss of face may have a more nuanced influence on help-seeking depending on whether the individual avoids the stigma by not seeking help or prevent the stigma by actively seeking help.

Presence of social support The contradictory role of social networks either as helpful or unhelpful in formal help-seeking was also noted in this review. The presence of friends and family can discourage Filipinos from seeking professional help because their social support serves as protective factor that buffer one’s experience of distress [ 77 , 78 ]. Consequently, individuals are less likely to use professional services [ 42 , 79 ]. On the contrary, other studies have found that the presence of friends and family who have positive attitudes towards formal help-seeking can promote the utilization of mental health services [ 8 , 80 ]. Friends who sought formal help and, thus, serve as role models [ 14 ], and those who take the initiative in seeking help for the distressed individual [ 32 ] also encourage such behavior. Thus, the positive influence of friends and family on mental health and formal help-seeking of Filipinos is not merely to serve only as emotional buffer for stress, but to also favourably influence the decision of the individual to seek formal help.

Research implications of findings

This review highlights particular evidence gaps that need further research: (1) operationalization of help-seeking behavior as a construct separating intention and attitude; (2) studies on actual help-seeking behavior among local and overseas Filipinos with identified mental health problems; (3) longitudinal study on intervention effectiveness and best practices; (4) studies that triangulate findings of qualitative studies with quantitative studies on the role of resilience and self-reliance in help-seeking; and (5) factors that promote help-seeking.

Some studies in this review reported help-seeking intention or attitude as actual behaviors even though they are separate constructs, hence leading to reporting biases and misinterpretations. For instance, the conflicting findings of Tuliao et al. [ 12 ] on the negative association of loss of face with help-seeking attitude and the positive association between loss of face and intention to seek help demonstrate that attitudes and intentions are separate constructs and, thus, need further operationalization. Future research should strive to operationalize concretely these terms through the use of robust measurement tools and systematic reporting of results. There is also a lack of data on the actual help-seeking behaviors among Filipinos with mental illness as most of the reports were from the general population and on their help-seeking attitudes and intentions. Thus, research should focus on those with mental health problems and their actual utilization of healthcare services to gain a better understanding of how specific factors prevent or promote formal help-seeking behaviors.

Moreover, the majority of the studies in this review were descriptive cross-sectional studies, with only one cohort analytic study. Future research should consider a longitudinal study design to ensure a more rigorous and conclusive findings especially on testing the effectiveness of interventions and documenting best practices. Because of the lack of quantitative research that could triangulate the findings of several qualitative studies on the detrimental role of resilience and self-reliance, quantitative studies using pathway analysis may help identify how these barriers affect help-seeking. A preponderance of studies also focused on discussing the roles of barriers in help-seeking, but less is known about the facilitators of help-seeking. For this reason, factors that promote help-seeking should be systematically investigated.

Practice, service delivery and policy implications

Findings of this review also indicate several implications for practice, service delivery, intervention and policy. Cultural nuances that underlie help-seeking behavior of Filipinos, such as the relational orientation of their interactions [ 81 ], should inform the design of culturally appropriate interventions for mental health and well-being and improving access and utilization of health services. Interventions aimed at improving psychological help-seeking should also target friends and family as potential and significant influencers in changing help-seeking attitude and behavior. They may be encouraged to help the individual to seek help from the mental health professional. Other approaches include psychoeducation that promotes mental health literacy and reduces stigma which could be undertaken both as preventive and treatment strategies because of their positive influence on help-seeking. Strategies to reduce self-reliance may also be helpful in encouraging help-seeking.

This review also has implications for structural changes to overcome economic and other practical barriers in Filipino seeking help for mental health problems. Newly enacted laws on mental health and universal healthcare in the Philippines may jumpstart significant policy changes, including increased expenditure for mental health treatment.

Since lack of awareness of available services was also identified as significant barrier, overseas Filipinos could be given competency training in utilizing the health care system of host countries, possibly together with other migrants and ethnic minorities. Philippine consular agencies in foreign countries should not merely only resort to repatriation acts, but could also take an active role in service delivery especially for overseas Filipinos who experience trauma and/or may have immigration-related constraints that hamper their access to specialist care.

Limitations of findings

A crucial limitation of studies in this review is the use of different standardized measures of help-seeking that render incomparable results. These measures were western-based inventories, and only three studies mentioned using cultural validation, such as forward-and-back-translations, to adapt them to cross-cultural research on Filipino participants. This may pose as a limitation on the cultural appropriateness and applicability of foreign-made tests [ 73 ] in capturing the true essence of Filipino experience and perspectives [ 74 ]. Additionally, the majority of the studies used non-probability sampling that limits the generalizability of results. They also failed to measure the type of assistance or actual support sought by Filipinos, such as psychoeducation, referral services, supportive counseling or psychotherapy, and whether or not they are effective in addressing mental health concerns of Filipinos. Another inherent limitation of this review is the lack of access to grey literature, such as thesis and dissertations published in other countries, or those published in the Philippines and are not available online. A number of studies on multi-ethnic studies with Filipino participants do not provide disaggregated data, which limits the scope and inclusion of studies in this review.

This review has confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as a primary barrier resilience and self-reliance as coping strategies were also cited, especially in qualitative studies, but may be important in addressing issues of non-utilization of mental health services. Social support and problem severity were cited as prominent facilitators in help-seeking. However, different structural, cultural and practical barriers and facilitators of psychological help-seeking between overseas and local Filipinos were also found.

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Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines

Andrea B. Martinez

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

Andrea B. Martinez, Jennifer Lau & June S. L. Brown

Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

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Martinez, A.B., Co, M., Lau, J. et al. Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review. Soc Psychiatry Psychiatr Epidemiol 55 , 1397–1413 (2020). https://doi.org/10.1007/s00127-020-01937-2

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DOI : https://doi.org/10.1007/s00127-020-01937-2

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Rev Saude Publica
v.48(6); 2014 Oct

Language: English | Portuguese

Public school teachers’ perceptions about mental health

Percepção de professores de escola pública sobre saúde mental, amanda gonçalves simões soares.

I Projeto Cuca Legal. Departamento de Psiquiatria. Universidade Federal de São Paulo. São Paulo, SP, Brasil

Gustavo Estanislau

II Programa de Reconhecimento e Intervenção em Estados Mentais de Risco. Departamento de Psiquiatria. Universidade Federal de São Paulo. São Paulo, SP, Brasil

Elisa Brietzke

III Laboratório Interdisciplinar de Neurociências Clínicas. Departamento de Psiquiatria. Universidade Federal de São Paulo. São Paulo, SP, Brasil

Fernando Lefèvre

IV Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil

Rodrigo Affonseca Bressan

To examine public school teachers’ perceptions about general health and mental health, and the way in which they obtained this information.

Qualitative research was conducted with 31 primary and secondary school teachers at a state school in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2010. The teachers responded to a questionnaire containing open-ended questions about mental health and general health. The following aspects were evaluated: Teachers’ understanding of the terms “health and “mental health,” the relevance of the need for information on the subject, the method preferred for obtaining information, their experience with different media regarding such matters, and perceptions about the extent to which this available information is sufficient to support their practice. The data were processed using the Qualiquantisoft software and analyzed according to the Discourse of the Collective Subject technique.

From the teachers’ perspective, general health is defined as the proper physiological functioning of the body and mental health is related to the balance between mind and body, as a requirement for happiness. Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium that provides the most information on the topic.

CONCLUSIONS

The data indicate that there is little information available on mental health for teachers, showing that strategies need to be developed to promote mental health in schools.

Analisar percepções de professores de escola pública sobre saúde geral e saúde mental e os meios de obtenção dessas informações.

MÉTODOS

Pesquisa qualitativa com 31 professores do ensino fundamental e médio de uma escola estadual do município de São Paulo, no ano de 2010. Os professores responderam a um questionário com perguntas abertas sobre saúde mental e saúde em geral. Avaliou-se o que os professores compreendiam sobre o termo “saúde” e “saúde mental”, a relevância da necessidade de informação sobre o assunto, o método informativo preferido, a experiência com os diferentes meios de comunicação no que tange a assuntos dessa natureza e a percepção sobre quanto essas informações disponíveis são suficientes para amparar a sua prática. Os dados foram processados no software QUALIQUANTISOFT e analisados segundo técnica do Discurso do Sujeito Coletivo.

Na perspectiva do professor, saúde em geral é definida como o adequado funcionamento fisiológico do organismo e saúde mental relaciona-se ao equilíbrio entre mente e corpo, como requisito para a felicidade. A maioria dos professores (80,6%) demonstrou grande interesse em adquirir conhecimentos sobre saúde mental e receber materiais educativos sobre o assunto. Para os professores, a falta de informação gera insegurança e dificulta o manejo de situações cotidianas envolvendo transtornos mentais. Para 61,3% dos professores, a televisão é o veículo que mais produz informação sobre o tema.

CONCLUSÕES

Os dados indicam que há pouca informação sobre saúde mental disponível para os professores, mostrando ser necessário haver desenvolvimento de estratégias de promoção da saúde mental na escola.

INTRODUCTION

Mental disorders are highly prevalent in childhood. 5 In Brazil, one of the key studies in this area evaluated individuals aged 7-14 years living in the Southeast region and found that 12.7% of the children enrolled in schools had some mental disorder requiring specialized care. 3 Young people affected by mental illness have worse school performance, a low standard of social interaction, problems with the law, higher school dropout and teenage pregnancy rates. 1 , 6 , 12

From a neurodevelopmental perspective, interventions focusing on mental health in schools could prevent the manifestation or reduce the intensity of mental illnesses, preventing problems in the family, academic, and social spheres. Recent systematic reviews have described the effectiveness of various types of preventive interventions in schools for depression, anxiety, and substance abuse, among other disorders. 10 , 13

Globally, health programs targeted at schools evolved in three distinct moments: 13

Moment 1: focus on physical health. Actions: Immunization campaigns, tracking of specific illnesses, such as vision problems, and the prevention of communicable diseases.
Moment 2: psychosocial focus. Actions: Campaigns to prevent drug usage, teenage pregnancy, and initiatives to promote a safe and healthy environment in schools.
Moment 3: focus on mental health. Actions: Campaigns promoting mental health, preventive interventions in healthy individuals or those at risk, and early identification and intervention for ill individuals.

For school programs focused on mental health to be satisfactorily developed in the country, it is necessary to evaluate Brazilian teachers’ and students’ understanding of mental health and the way in which they obtain information on this topic. Therefore, understanding these individuals’ daily lives, needs, behaviors, and social expectations, will enable us to develop effective actions in the process of knowledge construction. 9

In Hong Kong, a study was conducted on educator perceptions about general health. 2 For the sample studied, physical health was related to physical functioning and mental health with the ability to think clearly and coherently. Furthermore, psychosocial health referred to the ability to relate to others.

An evaluative study of attitudes toward mental health problems in the classroom showed that the teachers lacked knowledge of handling such situations, as they received little training. 11 However, trained teachers can improve their students’ health conditions by guiding parents and helping children acquire healthy habits. 4

This study aimed to analyze public school teachers’ perceptions about mental health, and the way in which they obtained this information.

A qualitative study was conducted in a public school in Sao Paulo, SP, in Southeastern Brazil. The study is a part of Projeto Cuca Legal , a which seeks to train teachers to promote mental health in schools.

The teacher training was conducted in eight meetings, through informative lectures, case studies, and discussions.

The sample studied comprised 45 primary education teachers – cycle II – and secondary education teachers in the morning, afternoon, and night shifts. The inclusion criteria consisted of attending the Collective Pedagogical Work Hour (CPWH) b and a classroom workload of at least 12 hours per week. Teachers with a weekly workload of less than 12h or those who did not participate in the CPWH were excluded from the study.

A self-administered questionnaire including ten essay questions was used, with open- and close-ended questions, to document knowledge and concern about mental health and the way in which information about mental health reached the teachers ( Table 1 ). This evaluation occurred two months after the psychoeducational activities of Projeto Cuca Legal a were concluded.

a In the DCS, people can have ideas that correspond to more than one category; hence the sum of the frequencies may differ from 100%.

The data analysis employed the Discourse of the Collective Subject (DCS) 7 technique, developed for research on social opinion, seeking to determine the design of a given community from individually collected reports, in a qualitative and quantitative manner. DCS favors a recovery of the thoughts, values, and beliefs individually internalized via discourse. 8 The Qualiquantisoft software was used to process the statements. 8

Analysis of the statements involves selecting the key expressions from each statement, identifying the central ideas of each key expression, and creating the DCS. 8 Key expressions are the passages that best answer the questions. Central ideas describe the meaning present in each statement in a synthesized and precise manner, i.e., the respondents intended meaning. The combination of similar key expressions and central ideas in a “discourse synthesis” comprises the DSC. 7

Out of the initially selected 45 teachers, 12 missed the interview, one refused to participate, and another stopped working at the school. Thus, 31 teachers participated in the study [21 (67.0%) female, 10 (32.2%) male].

This study was submitted and approved in 2011 by the Research Ethics Committee at the Escola Paulista de Medicina , Universidade Federal do Estado de São Paulo (Protocol 0658/11). All participants signed a free and informed consent form.

ANALYSIS OF RESULTS AND DISCUSSION

Impressions of “health” and “mental health”.

The following data have been analyzed based on the teachers’ responses to the questionnaires administered ( Table 1 ).

According to the results of the DCS analysis, for 58.1% of the teachers, health is related to “physical, mental, and spiritual well-being existing together. It is being well disposed and healthy in every way, which leads a citizen to have self-confidence. It is when you are well both existentially and metaphysically, in the most intimate and profound part of the human being. Being healthy involves the full harmony of one’s physical and mental metabolism, as it’s possible to be healthy in every way”. As for mental health, 41.9% of the teachers defined mental health as follows: “the ability to be free of disorders that cause an emotional imbalance. It’s the mind functioning within the standards established by medicine for this area, i.e., the balance of brain functions, the nervous system, and nervous impulses. Thus, the mind and body work in harmony so that there are no negative feelings and we can overcome difficulties, without using alchohol and drugs to overcome problems”. The percentage of teachers who associated mental health specifically with mental illnesses was 6.4%.

Access to Mental Health information in the media

When asked about encountering mental health information via mass media, 80.6% of the teachers reported never having heard a debate or radio program that addressed the topic; 71.0% had never researched or read anything related to mental health on the Internet; 67.7% had never received printed information about mental health; 61.3% had never read articles on mental health in magazines or newspapers; and 38.7% had never watched videos or television programs that addressed mental health issues.

The percentage of teachers who had access to information through a Health Center was 6.4%. Within the school environment, the topic is considered to be infrequently addressed.

Perceptions about need for Mental Health programs in schools

The study investigated the importance of developing communication strategies to support teachers in their daily life. A large majority (80.6%) of the teachers said the following: “the informative material helps because usually information is superficial and it can clarify what is myth and what has been scientifically proven. It would be another way of orienting ourselves, since we have little knowledge about it, and very often we do not know which course of action to follow because we feel insecure. We need to receive conceptual information about the subject in order to stay updated and know the way in which to deal with it in our daily lives. Sometimes, we seek professional help because we lack information. Information through any media is important; the more information is available, the greater is the understanding of the illness. The informative material should be easy to read and comprehend. Furthermore, the written information should serve as a research source”.

The percentage of teachers identifying lectures and discussions with a medical specialist, printed materials, and online materials as the most interesting strategies is 54.8, 25.8, and 22.6, respectively.

It was found that, for the teachers, mental health is linked to the balance between mind and body, as a requirement for happiness. Few teachers described mental health as mental illness. No discriminatory rationales appeared in the teachers’ statements, but there were reports of insecurity in decision making when dealing with students having mental disorders. The teachers attributed this insecurity to a lack of information about mental health and demonstrated interest in acquiring knowledge on the subject, as they believe this may be useful in their daily interactions with students. Furthermore, developing information strategies was considered important in the learning process, as the teachers consider them as a way to consolidate knowledge.

The results of this study corroborate the data published in two studies that assessed teachers’ perceptions about mental health. Pavri & Monda-Amaya 11 show that due to lack of training, teachers do not know how to deal with problems involving mental health in schools. Fisher c reveals that the teachers interviewed did not negatively perceive students with mental health problems and recognized the importance of psychoeducational programs offered at school. The present study is a pioneering study in Brazil on this topic.

Among the various types of media, TV was the main source of information about mental health, due to greater number of programs related to the subject, when compared with other media. During the data collection period, schizophrenia received more attention on TV due to a soap opera that had a character with the illness. The information in the soap opera began to serve as a source of knowledge for the teachers. In addition to schizophrenia, other topics about mental disorders are also portrayed in miniseries and other programs that promote debates on TV, but they were not mentioned by the teachers. However, the teachers reported that the information obtained via the media is inadequate, superficial, or sensational.

One of the limitations of this study is the use of structured instruments, which potentially limit the extent of the respondents’ answers. However, such type of instrument was selected because it facilitates data standardization. The information obtained from the teachers may not apply to other social or cultural contexts. In addition, data collection was performed after the intervention program, a which may have skewed the results. However, this study was the first to investigate public school teachers’ perceptions about mental health with a robust methodology.

The meanings attributed to mental health by the teachers indicate interest in obtaining knowledge on the subject of mental health, since this can be useful in working with students. The data obtained suggest that, in the educator’s view, little information on mental health is available for teachers, and therefore, there is a great need to develop educational strategies about mental health in schools.

a Universidade Federal de São Paulo. Projeto Cuca Legal. São Paulo; [s.d.][cited 2014 Oct 20]. Available from: http://www.cucalegal.net.br

b CPWH: A meeting or any collective activity, usually weekly, between teachers and coordinators in order to discuss strategies for implementing consistent educational projects or team development. The CPWH usually happens within the school unit and lasts around 2h, which are designated as working hours.

c Fisher EJP. Perceptions of mental illness and learning disorders in public schools: a review of services, perception, and popular culture [master’s thesis]. North Carolina: University School of Arts and Sciences; 2011.

Based on the masters’ dissertation of Soares AGS, titled: “Mapeamento da produção de sentidos atribuídos à Saúde Mental e avaliação da percepção sobre o Programa Psicoeducacional ‘Projeto Cuca Legal’ entre Professores e alunos,” presented to the Postgraduate Program at the Escola Paulista de Medicina, Universidade Federal de São Paulo, in 2011.

‘Much will be said and promised over the next six weeks’

STEVE FORD, EDITOR

You are here: Social care

New role to boost research and education in social care nursing

28 May, 2024 By Steve Ford

A nurse has become the first to be appointed to a new academic role created to support the development of nursing in social care settings, which those behind the move have called a “milestone” for the sector.

The University of Salford and the RCN Foundation have jointly announced that Dr Claire Pryor will become the inaugural RCN Foundation chair in adult social care nursing.

“There is an absolute need to ensure our nurses working in social care settings are recognised, supported, and developed” Claire Pryor

The university said the new role had been created to take a “strategic lead in shaping research and education in adult social care nursing at a local, national and international level”.

Dr Pryor will “translate research into professional practice” to improve nursing care and develop the evidence-base to support the “current and next generation of nurses” in adult social care, it added.

She will be based at Salford’s nursing and midwifery directorate in the School of Health and Society, which is the largest specialist provider of nursing and midwifery education in the North East region.

The university noted that it was a UK focused role and Dr Pryor would work closely with England’s chief nurse for adult social care, Professor Deborah Sturdy.

Dr Pryor’s appointment represents the latest in a series of developments in recent weeks that aim to support social care nursing and raise its profile in the profession.

Earlier this month, Northumbria University launched the UK’s first new specialist practice qualification in community adult social care nursing.

In addition, guidelines were launched to encourage and support the development nationally of placements for student nurses and nursing associates in social care settings.

The government arms’-length body Skills for Care published the guidance in collaboration with Professor Sturdy and the Department of Health and Social Care.

Meanwhile, a nurse from a Bristol-based charity carried the ceremonial lamp at the annual Florence Nightingale Commemorative Service, the first to do so from the adult social care sector.

Emily Pimm, who qualified as a nurse in 2006, works as a social care deputy manager at John Wills House Care Home in Westbury-on-Trym, which is run by the St Monica Trust .

“This appointment marks a significant milestone for the nursing profession and the wider social care sector” Deepa Korea

The appointment also follows the government earlier this year embarking on a campaign to boost the domestic pipeline into adult social care nursing.

The DHSC unveiled a package of measures, backed by £75m funding, to recruit new talent to the sector , including investment in adult social care nursing apprenticeships.

Separately, higher education institutions were encouraged to expand placement opportunities in social care to encourage more nurses into such settings.

Dr Pryor will start her new role on 31 July. She is currently assistant professor of adult nursing at Northumbria, where she specialises in frailty, social care nursing and non-medical prescribing.

She began her career as a nursing assistant in care homes prior to becoming a staff nurse in medical assessment and critical care, and then a nurse practitioner for older people in mental health settings.

Commenting on her appointment, Dr Pryor said: “I am excited and passionate about the new role, and the significant impact the focus on adult social care will bring.

“There is an absolute need to ensure our nurses working in social care settings are recognised, supported, and developed throughout their careers,” she said.

“We need to work toward recognition of social care nurses as a highly skilled, autonomous clinicians, and empower them to use specialist and advanced skills, leading and shaping high quality care across the sector.”

Professor Margaret Rowe, dean of the school of health at Salford, said: “The chair role will drive changes to adult social care across the UK in terms of education, professional practice and research.

“We look forward to the benefits her role will no doubt bring to our students as we continue to develop and educate the next generation of nurses in adult social care,” she said.

The RCN Foundation said it chose the University of Salford to host the role following a competitive process.

Dr Claire Pryor

Deepa Korea, RCN Foundation director, said “We are delighted that the inaugural RCN Foundation chair in adult social care nursing has been appointed at the University of Salford.

“This appointment marks a significant milestone for the nursing profession and the wider social care sector,” she said.

“Having a dedicated chair will not only further advance the academic and practical knowledge in adult social care nursing that it so vitally needed, but also ensure that the important work of this part of the nursing workforce is highlighted.

“The role will also develop further the clinical expertise and leadership needed across the sector to meet the complex needs of those accessing social care,” she added.

The RCN Foundation, chaired by former chief nursing officer for England Professor Jane Cummings, is an independent charity whose purpose is to support and strengthen nursing and midwifery.

It does this by providing grants to nurses and midwives facing hardship or who want to enhance their skills and develop their practice, and by funding nursing and midwifery-led projects.

Increasing rates of teen sexual assault could be contributing to rising adolescent mental health problems

Rikki Hoyland sits with her dog on her lap as she types.

By the time she was 19, Rikki Hoyland had already been sexually assaulted twice.

The first time was when she was just 15, and grieving the loss of a father figure. She had turned to alcohol to cope, and was assaulted by a teenaged peer while unconscious at a party.

Four years later she had put her life back together when another teen she trusted coerced her into sex.

"It's pretty tough. I have nightmares every night," she said.

"I feel uncomfortable in my skin every day. I genuinely just think that all I'm good for is to be used and abused and left.

"I definitely have a lot of anxiety, a lot of depression."

The Queensland youth worker represents a new generation of adolescents experiencing sexual assault at rates never seen before.

Figures from the landmark Australian Child Maltreatment study show peer-on-peer sexual assault is on the rise with nearly one in five young people aged 16 to 24 having been sexually assaulted by another teen.

13.2 per cent were abused by another teen they knew
5.7 per cent were assaulted by a current or former romantic partner

Those aged 16 to 24 were three times more likely to report being sexually assaulted by a current or former partner as teens than those aged over 45.

It is backed up by data from the Australian Survey of Secondary Students and Sexual Health which shows that between 2002 and 2021, the percentage of Year 10 and 12 sexually active students who had unwanted sexual experiences rose from 25 per cent to 41 per cent.

Unwanted sexual experiences included being too drunk or high to consent, peer pressure, partner pressure or being too frightened to say no.

Lead Author of the Australian Child Maltreatment Study, Professor Ben Mathews, said the structure of the study meant this was a genuine rise, because it highlighted people's lived experiences, rather than anything they had reported through the justice system.

"We're talking about very, very substantial numbers of adolescents who are now experiencing sexually abusive behaviour at the hands of their peers, who in former generations were not," he said.

"It does demand some concerted action."

Researchers say there are clear links between the trauma of sexual assault and mental health issues which often first emerge in adolescence, with ABS data showing a nearly 50 per cent spike in mental health issues among young people in the past 15 years.

"There's a general, well-established body of evidence that sexual abuse is extremely harmful for mental health and for health risk behaviours," Professor Mathews said.

"Our study found…[sexual assaults] were also consistently the most strongly associated with health risk behaviours — things like cannabis dependence, smoking, self-harm and suicide attempt."

For Rikki Hoyland, the first assault set her on this exact course.

"After everything went down, I stopped talking to everyone. I isolated myself," she said.

"I was doing a lot of drugs, and I was drinking a lot. I would do anything to try and numb the pain."

The assaults happened after what had already been a rocky family life leading into adolescence and she was suicidal and self-harmed from an early age.

"I was a very angry kid. I would often fight people just because they looked at me funny. I would throw chairs and desks at teachers.

"I was so, so vulnerable."

What's behind the rise?

Academics theorise the rise in sexual assault rates is being caused by social media and access to hardcore pornography.

"Some kids might feel extra pressure to have sexual experiences or sexual encounters so that they feel a sense of status and a sense of peer acceptance," Professor Mathews said.

Figures from the Australian Survey of Secondary Students and Sexual Health showed 14.1 per cent of 14-to-18-year-old Australians viewed pornography daily or almost daily.

Another study from Macquarie University found more than half of boys reported their first exposure to porn between the ages of 12 and 14 and more than one quarter between the ages of 9 and 11.

"There is some evidence that consumption of violent pornography can influence aggressive and coercive sexual behaviour," Professor Mathews said.

'Mano-sphere' shaping violent views

The concern about porn and social media is supported by youth-led advocacy group Teach Us Consent, which heard from more than 7,000 Australian teens who were victims of sexual violence, many of them girls.

Tess Fuller from the group said many teens spoke candidly about the mental health impacts of their assault and that it was associated with higher rates of depression and anxiety.

"It stifled their sexual and social growth. A lot of them found it really difficult to keep attending school and being around that perpetrator."

She said social media was playing a crucial role in shaping teen attitudes.

"There's a radicalisation happening online in the so-called 'manosphere' that is encouraging boys and men to hold increasingly violent and misogynistic views."

One study from the United States found that 9 in 10 of the most popular mainstream pornography videos display violence against women, and, in almost all cases, the women featured respond with pleasure or neutrally.

"It's sending them the message that women should grin and bear (it) or even enjoy violence," Ms Fuller said.

"That men should assume these domineering and violent positions in bedrooms, which is really a norm that lots of boys that we speak to a deeply uncomfortable with.

"We're clearly missing a bunch of healthy male role models for boys to look up to."

Poor mental health drives violence

Ms Fuller said there was also evidence that poor mental health could be a driver of violence towards women, with men who ascribe misogynistic views eight times more likely to have frequent suicidal ideation.

"These forms of masculinity that encourage you to suppress your emotions, not talk about your problems with your friends, and sort of deal with everything by yourself, is in turn encouraging you to lash out on other people and to potentially commit sexual violence."

The Australian Childhood Maltreatment study found overall sexual abuse of minors is still widespread, but there was overall a downward trend, especially among boys as victims, and a reduction in perpetration by adults like family members and institutional carers.

The area that trended up most significantly was teen-on-teen abuse.

Rikki Hoyland now works at Youth InSearch, an early intervention service she relied on heavily in the wake of her assaults.

"It definitely saved my life," she said.

These days she takes comfort in the small things like her dog, Rasty.

"I'm just dealing with it through counselling. I am back on my anxiety medication," she said.

Rikki urged any teens who experienced what she did to ask for help.

"It doesn't make you weak. It makes you stronger and it helps you understand yourself a lot better."

Mental health disorders among young people have soared by nearly 50 per cent in 15 years. The ABC is talking to youth, parents, and researchers about what's driving this pattern, and what can be done to turn things around.

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Introduction. Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [].Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or ...
Bending not breaking: coping among Filipino University students
Despite the needed attention devoted to young adults' mental health needs (Eskin et al., 2016), they are at risk of experiencing frequent mental health issues and psychological concerns. Literature is scarce on the context of coping with psychological distress, particularly among Filipino university students.
Mental health and well-being of children in the Philippine setting
Among Filipino children aged 5 to 15, 10% to 15% are affected by mental health problems. 3 According to the World Health Organization (WHO), 16.8% of Filipino students aged 13 to 17 have attempted suicide at least once within a year before the 2015 Global School-based Student Health survey. 4 This is just one of the many indicators showing the ...
PDF International Journal of Multidisciplinary: Applied Business and
Filipino Teachers' Mental Health Amidst the Covid-19 Pandemic. International Journal of Multidisciplinary: Applied Business and Education Research. 3 (6), 1017 - 1027. doi: 10.11594/ijmaber.03.06.07
The Importance of Mental Health for Teachers
The mental health of Filipino teachers has come under the spotlight in recent years. Thankfully, to support learners, teachers, and the public during times of mental and psychological distress, the Department of Education (DepEd)-Disaster Risk Reduction Management Service (DRRMS) launched a mental health helpline system consisting of contact ...
Distance learning taking toll on teachers' physical, mental health
MANILA, Philippines — A nationwide survey has suggested that distance learning is negatively affecting the physical and mental wellbeing of more than a majority of public school teachers who ...
Mental health of Filipino seafarers and its implications for seafarers
Developing policies and programmes for the promotion of mental health through mental health education among seafarers is important for a couple of reasons. Seafaring remains a dangerous and socially isolating occupation where work-related accidents are likely and will be potentially traumatic to mariners. Research on occupational stressors is ...
Youth not engaged in education, employment, or ...
Prior research has showed the importance of providing integrated support services to prevent and reduce youth not in education, employment, or training (NEET) related challenges. There is limited evidence on NEET youth's perspectives and preferences for employment, education, and training services. The objective of this study was to identify employment, education and training service ...
Filipino help-seeking for mental health problems and associated
Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [].Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or ...
DEPRESSION AMONG PUBLIC SCHOOL TEACHERS IN THE ...
Abstract. The study aimed to disclose and described the prevailing sentiments on the different news articles on mental depression among public school teachers in the Philippines. The study ...
Colleges place students in remedial courses based on GPA
State of play: Previous research points to the value of remedial education—if the student successfully completes the course—in boosting attainment and retention as well as in resolving skill deficiencies, but these courses have come under scrutiny because they can delay time to degree as students struggle to complete a noncredit course. A 2016 report from the National Center for Education ...
Public school teachers' perceptions about mental health
Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium ...
New role to boost research and education in social care nursing
The university said the new role had been created to take a "strategic lead in shaping research and education in adult social care nursing at a local, national and international level". Dr Pryor will "translate research into professional practice" to improve nursing care and develop the evidence-base to support the "current and next ...
Increasing rates of teen sexual assault could be contributing to rising
It is backed up by data from the Australian Survey of Secondary Students and Sexual Health which shows that between 2002 and 2021, the percentage of Year 10 and 12 sexually active students who had ...

Filipino Teachers' Mental Health Amidst the Covid-19 Pandemic

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Stress and Depression in the Workplace of Educators in the Philippines

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Filipino Teachers' Mental Health Amidst the Covid-19 Pandemic

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United Nations

Mental health of Filipino seafarers and its implications for seafarers' education

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Youth not engaged in education, employment, or training: a discrete choice experiment of service preferences in Canada

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Discrete Choice Experiment (DCE)

Participants and procedure

Mental health and substance use measures

Youth engagement

Statistical analysis

Overall service preferences

Latent Class 1: Job and educational services

Latent Class 2: Mental health and wellness services

Latent Class 3: Holistic skills building services

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Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

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Predictors of Help-Seeking for Mental Health Treatment Among Latinos

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Study and participant characteristics

Formal help-seeking behaviors

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Public school teachers’ perceptions about mental health

Gustavo Estanislau

Elisa Brietzke

Fernando Lefèvre

Rodrigo Affonseca Bressan

CONCLUSIONS

MÉTODOS

CONCLUSÕES

INTRODUCTION

ANALYSIS OF RESULTS AND DISCUSSION

Access to Mental Health information in the media

Perceptions about need for Mental Health programs in schools

New role to boost research and education in social care nursing

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Increasing rates of teen sexual assault could be contributing to rising adolescent mental health problems