Every October, as World Mental Health Day comes and goes, public discussions are flooded with well-meaning calls to “break the stigma,” practice self-care, or seek therapy.
While encouraging open conversation about psychological distress is vital, the dominant discourse remains trapped within a narrow, individualized frame. We are told that mental health is a personal matter—a question of neurochemical balances, individual coping mechanisms or personal resilience.
Yet, as community medicine practitioners engaging daily with agrarian and marginalized populations, we see a very different reality. Psychological distress does not exist in a vacuum; it is deeply rooted in the social, economic and political conditions under which people live and work.
To truly address the mental health crisis in our country, we must look beyond the individual and interrogate the structural determinants of health—and the neoliberal framework that systematically abdicates state responsibility.
The WHO definition and the social reality
The World Health Organization (WHO) explicitly defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Furthermore, mental health is understood as a state in which an individual can realize their abilities, cope with normal life stresses, work productively and contribute to their community.
When social conditions prevent people from meeting their basic human needs, framing their suffering as a purely psychiatric or clinical issue is a grave error. Poverty, landlessness, debt, food insecurity and environmental destruction act as severe, chronic stressors. What we are witnessing across vulnerable sectors is not a collection of isolated mental illnesses, but a social epidemic of distress caused by structural inequality.
Neoliberal trap: Commercialization and individual guilt
Under the dominant neoliberal economic model, healthcare—including mental health—has been commercialized and converted into a market commodity. Quality psychological support and psychiatric care are largely privatized, remaining out of reach for the vast majority of Filipinos who survive on informal labor or small-scale farming.
Worse, neoliberal ideology reframes structural problems as personal failures. When a small farmer, driven to financial ruin by severe drought and low crop prices, experiences paralyzing anxiety and depression, the market logic suggests the solution lies in individual resilience or private clinical care.
By hyper-individualizing distress, the state effectively absolves itself of accountability. It escapes scrutiny for its failure to provide adequate social safety nets, irrigation infrastructure, fair crop prices, and climate adaptation support. Mental suffering is turned into private guilt, while the policies that drive people to despair remain intact.
El Niño and the lessons of Kidapawan
The intersection of climate shock, rural neglect, and structural distress is starkly illustrated by the plight of agricultural workers during extreme climate events.
When El Niño strikes, fields dry up, crops fail and debts compound. For thousands of farming families, extreme weather brings immediate existential dread. The surge in agrarian distress and suicides during prolonged droughts is not a failure of individual coping strategies; it is the direct consequence of economic abandonment.
Recall the April 2016 Kidapawan protest. Thousands of drought-stricken farmers gathered on the highways of North Cotabato, not to ask for psychiatric interventions or self-care seminars, but to demand rice and government relief to feed their starving families. They sought structural relief for a structural crisis. Instead of receiving aid and solidarity, their distress was met with state violence and forcible dispersal.
Kidapawan stands as a tragic reminder that when institutions fail to protect livelihoods, they turn socio-environmental crises into state-inflicted trauma.
Shift to transformative care
In recent years, “Trauma-Informed Care” has offered an important shift by asking “What happened to you?” instead of “What is wrong with you?” However, within a privatized medical framework, trauma-informed care can still fall short if it confines itself to clinical walls without challenging the conditions that generate trauma in the first place.
We must move toward Transformative Care.
Transformative Care recognizes that personal healing is inseparable from community empowerment and social justice. It acknowledges the social context of affected individuals and families, shifting the emphasis from passive clinical consumption to collective agency. Transformative Care demands:
- Addressing Root Causes: Protecting land rights, ensuring food sovereignty, securing living wages and implementing real climate justice.
- Community-Grounded Systems: Integrating mental health care into local Primary Health Care networks that prioritize collective healing, peer support and social protection rather than commercialized remedies.
- Reclaiming State Responsibility: Treating health as a fundamental human right and a public obligation, not a privilege for those who can afford it.
Anticipating the climate crisis
As climate scientists warn of increasingly severe El Niño cycles and extreme weather shocks, the government cannot afford to rely on reactive, piecemeal disaster responses.
Anticipating a Super El Niño requires a comprehensive, proactive strategy that integrates mental health into primary disaster preparation. This means guaranteeing debt relief, crop insurance and immediate food support for agrarian communities before despair takes root. It means reinforcing community-based support networks through a strengthened Primary Health Care framework that meets people where they are.
Mental health is not merely a matter of individual wellness; it is a barometer of social justice. Until our health and economic systems address the structural forces that push people to the brink, true healing will remain out of reach for the majority. (davaotoday.com)
