Brainstorming mental health

We kick off Mental Health Month this October. In last week’s column, I invited you to imagine with me; this time, let’s brainstorm together.

Brainstorming isn’t just for group work and projects. Brainstorming is considered a life skill, particularly in problem-solving. This skill invites us to keep an open mind and explore all possibilities in order to arrive at the best solution. One rule of brainstorming: we do not throw out ideas, no matter how silly or improbable. Aside from (hopefully) a successful outcome, the process of brainstorming helps us practice nonjudgment, treating our thoughts and ideas with respect and careful consideration. We also get to practice slowing down our impulse to dismiss, belittle, and demean. In so doing, we become kinder to ourselves and others.

Gaining the skill of generating as many solutions as possible also helps facilitate hope. If we can trust ourselves to think of multiple solutions to a problem, we are less likely to feel hopeless and helpless, which are red flags for depression and suicidality. Brainstorming is also done with others, making us get comfortable with help-seeking and experiencing others as sources of support. Brainstorming also makes us see that there are multiple ways to address a challenge, which mitigates all-or-nothing thinking. This leads to a lowering of perceived stakes and sense of threat, helping to regulate our stress. Done a certain way, brainstorming can even bring a sense of joy and fun to solving a problem. Challenges, therefore, are not seen only as sources of suffering but also as opportunities to learn and grow.

In the spirit of brainstorming, I’d like to offer some ideas and solutions to our mental health crisis. Each idea has its pros and cons. At this stage in brainstorming, the point is to envision pathways we haven’t considered before. Whereas last week it was about imagination, this time it’s an exploration of how we could make those dreams possible. We can bring back a sense of excitement and enthusiasm, as opposed to feeling cynical and discouraged.

The problem: professional mental health care is inaccessible to the majority of Filipinos. There are too few providers and most of them are in private and urban settings.

Possible solution #1: bring mental health care closer to Filipinos via the community-based primary care model. There are already governmental efforts to do this, via the Philippine Health Insurance Corp.’s mental health benefits package, which allots P9,000 to P16,000 worth of services per patient per year. There is also psychiatric medication freely available in accredited health centers. The issue now is how to get the local health units to maximize these packages, which have too many requirements and rely on a reimbursement model.

Rather than paying per patient, I argue that the best investment an institution can make is to employ a resident mental health professional. Once employed, the costs become predictable (salary vs billable hours) and you have a full-time staff attending to the community’s mental health needs. If the government can prioritize the rush hiring of 10,000 school counseling associates, then it means they can muster the political will to likewise employ mental health workers in the barangay health centers.

Barangay health workers and medical officers are already overwhelmed with work; adding mental health duties with no significant compensation will just ensure that mental health services and programs are neglected. Once you employ a licensed professional, then we can have someone oversee multidisciplinary teams of psychometricians and social workers, as well as student interns. In our experience, relying solely on volunteers is not sustainable. A program is only possible when you have a person paid to lead it.

Possible solution #2: strengthen the quality of mental health services by utilizing strong partnerships and networks. We need to ensure equitable access. This means that public services are just as strong as private ones. We can set up work-study partnerships such that government mental health workers are allotted slots and scholarships for a related advanced degree in a public university, providing a strong financial incentive to choose a public service career. This plugs them into a mentoring system right away, and upskilling occurs continuously as graduate programs and schools are natural sources of supervision. This also facilitates specialization, meaning that, in the long term, they can handle more varied and severe cases, and help the workers’ career progression. People who grow within their jobs are more likely to stay, reducing attrition and job turnover. Employees who study also help themselves make use of the school’s networks, connecting the public health unit to referrals and resources.

Brainstorming doesn’t always give us the best solutions right away, but it can jump-start our motivation and enthusiasm for seeing change through.

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aatuazon@up.edu.ph