A snapshot of mental health research experience in PH: A Balik Scientist’s story

First, I wish to thank the DOST-PCHRD and Angeles University Foundation for presenting me with the initial opportunities to return to the Philippines as a Balik Scientist and to contribute to numerous teaching, research, and service activities across the country. Even after 25 years of being away in the United States, returning home to the Philippines felt as though it has been only 25 days—which was quite bittersweet:

  • Sweet because everything that I love about the people and the culture has not changed.
  • Bitter, because the conditions of life also appear to have not changed or improved enough over the last quarter century. From my perspective, life in the Philippines—especially in Metro Manila where I grew up—seems to have become even more challenging than before. Despite this, I am very happy to now return regularly as a public health scientist and public servant, and help in every way I can to improve the quality of lives of the Filipino people.
 
PAST: Background and Journey

I was born in Malolos, Bulacan, and raised in Valenzuela, Metro Manila. Attended Our Lady of Lourdes Elementary (until grade 4) and Santa Cecilia Elementary (grade 5) before my family moved to Los Angeles, California in 1993 when I was only 11 years old.
Fast forward to 2017—after 25 years in the US, three university degrees, and six years as a public health professor at Hawaii Pacific University (HPU)—the stars unexpectedly lined up to allow me to begin my long overdue journey back home to the Philippines, personally and professionally. To quickly frame my academic background:

  • Bachelor of Science in Kinesiology (specialized in Exercise Science)
  • Master of Arts in Health Education (specialized in Nutrition & Built Environment)
  • PhD in Health Behavior & Health Education (specialized in Mental Health, Stress, Coping, & Resilience)
Since leaving the motherland in 1993, I have always sensed a huge heartstring still attached that always reminded me of home. I remember having a fun and wonderful childhood, but I also remember the many health problems that I faced as a child in Manila including having asthma, intestinal worms, measles, mumps, falling into a sewage canal, frequent fevers, a week of waist-down paralysis (looking back, I am guessing it was polio), experiencing several near-death accidents, the ubiquitous poverty, the absence of clean tap water, the open meat markets without proper sanitation/refrigeration, the lack of healthcare access, and even almost getting kidnapped off of the street in front of my home.

Throughout my studies and work in the US, I often reminisced about my childhood experiences, my friends and families, and wanting to return to help improve public health in the Philippines. I constantly dream of a Philippines where children do not have to experience the said adversities. Looking back now, I am reminded of the decision I made to study public health in college, and it was because I wanted to end the cycle of deaths in my family that were due to heart disease, cancer, and drug abuse, among others. That is not how I want to die. I wish to die happily from natural old age and peacefully in my sleep. That is how I want everyone to die.

Guest lectures at Angeles University Foundation, De La Salle University, Holy Angel University, University of the Assumption, University of San Agustin, and University of the Philippines Manila.


In 2017, when I first began returning to the Philippines, my only mission was to establish relationships with as many Philippine universities as I could find that offered public health programs. At my university (HPU), there are many Filipino-American students, but most have never been to the Philippines, they have lost any sense of their Filipino roots, and some even reject their Filipino identity. HPU has over 200 international programs around the world but zero in the Philippines, so I have made it a personal mission to change that and create study abroad programs for students and faculty between HPU and Philippine institutions. This endeavor brought me to Angeles University Foundation, Ateneo de Manila University, De La Salle University-Manila, Holy Angel University, Saint Louis University, Silliman University, University of San Agustin, University of the Assumption, University of the East, and University of the Philippines (Manila and Diliman).   

During one of my mental health lectures at Angeles University Foundation was when the Balik Scientist Program was first mentioned by Dr. Rey Bundalian (VP of Research & Development). He then introduced me to Dr. Olga Tulabut (Assistant VP of Academic Affairs) who kindly invited me to join their team as a co-researcher with support from the Balik Scientist Program of the DOST-PCHRD.  


PRESENT: Mental Health Research

The research project led by Dr. Tulabut—titled “Mental Health Across Ages: Identifying Issues & Trends in Pampanga” and funded by the Philippine CHED DARE TO Research Grant—aims to collect baseline data and to study the mental health of the residents of Pampanga across all age groups. The interdisciplinary members of the research team include faculty and staff from Angeles University Foundation, Hawaii Pacific University, and University of the Assumption with expertise from the fields of psychology, psychiatry, guidance and counseling, nursing, medicine, education, information technology, and public health. Findings will be used to inform and guide the development of health policies and programs in government agencies, private institutions, and community centers, specifically to promote the mental health of the general public and to respond to the calls of the nation’s new Mental Health Law. 



My schedule of activities and deliverables as a Balik Scientist, hosted by Angeles University Foundation

The data collection phase of this multi-year project concluded in November 2019. The results revealed interesting mixed findings that confirmed and challenged the research team’s expectations. To summarize:

  • Among youth (Grades 1-5), about half or more of the study sample exhibited anxiety problems related to elevated panic symptoms (46%) and obsessive-compulsive symptoms (60%); in terms of depression, about 24% reported elevated to very elevated levels of functional problems.
  • Among adolescents (Grades 7-12), 40% reported moderate to severe generalized anxiety, 36% moderate to severe social anxiety, 31% provisional post-traumatic stress disorder (PTSD), 49% moderate to severe levels of depression, 54% have intentionally harmed themselves, and 17% have intentionally harmed themselves at least 5 times.
  • Among adults (20 years or older), 6% reported moderate to severe generalized anxiety, 2% moderate to severe social anxiety, 6% reported provisional PTSD, 7% moderate to severe depression, and less than 1% inflicted self-harm.
Remember, these results are from data gathered before COVID-19 interfered with our lives, and so we expect that the public’s mental health status may even be worse now. This snapshot of mental health from the general population of Pampanga sheds light on priority areas, how to intervene to promote health and prevent illness, and where these interventions could take place (e.g., schools, workplaces, communities, healthcare centers). 


FUTURE: Lessons Learned So Far and Our Next Steps

Data from this research is only a scratch on the surface of the tip of the enormous mental health iceberg. This groundbreaking effort—led by Angeles University Foundation and University of the Assumption—is among the first of many more to come. There is still so much that we do not yet understand. However, thanks to the recent Mental Health Law and to the DOST-PCHRD for prioritizing mental health in the national research agenda, the Philippines is finally recognizing and responding to the mental health needs of the Filipino people—particularly, to support important research that will help inform the development of effective and evidence-based programs and services that will meet the unique needs of the diverse communities throughout our country. 

It has been exciting to see the present works of other local institutions and researchers who are also studying the mental health of Filipinos and contributing to our knowledge base, especially now during these unprecedented times that have incredibly disrupted everything about our lives, our happiness, and our health. I look forward to working together with others and collectively build momentum in this movement.

Some next steps on my part as a continuing Balik Scientist are upcoming research projects with scholars and practitioners from Angeles University Foundation, University of San Agustin, the National Center for Mental Health, as well as several public and private healthcare centers. The purpose of these studies will be to assess the mental health of hospital workers and social workers during the COVID-19 crisis, and to develop innovative screening instruments, interventions, and programs (e.g., translation and cultural adaptation of psychometric tools, and invention of mobile apps for screening and telehealth services). I am also assisting some universities with the development of fully-online graduate programs—Master of Public Health (MPH) and Doctor of Public Health (DrPH)—to train the next generations of public health and mental health professionals.

To conclude for now, may this article serve as a call to scientists, practitioners, and students from various disciplines to pursue and contribute to research in mental health. This is also a call to our communities and organizations to seek, demand, and participate in these research efforts. Lastly, may this call serve as a reminder for all of us to collaborate, so that we could work together to fully map out and see what mental health looks like from the northernmost tip of Luzon to the southernmost tip of Mindanao. Before we can help ourselves and improve our own health as a nation and as a people, it is imperative that we have to first understand ourselves—using research data to see where we are now in terms of our well-being, where we should be in the future, and how we will collectively, effectively, and efficiently get there.


Research team members from Angeles University Foundation and University of the Assumption (Pampanga)


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As part of the PCHRD's mental health communication campaign, we have partnered with Balik Scientist Dr. Christian Gloria to release communication materials about mental health research.  The first was an introductory article written about mental health in the Philippines. This article is authored by Dr. Gloria himself to narrate his experiences as a mental health researcher and Balik Scientist in the Philippines.

The Balik Scientist Program
The Balik Scientist Program (BSP) is the brain gain initiative of the government which aims to tap into the ingenuity and expertise of Filipinos abroad to strengthen the S&T capabilities of local researchers in the academe, public and private sectors, and industry. The program was initiated to reverse the effects of brain drain, to provide researchers and scientists whose expertise are not available locally, and to accelerate the flow of new strategic technologies that are vital to national development.