Metro Manila (CNN Philippines Life) — It started as a joke. But as classes shifted online due to the pandemic, then-University of the East Ramon Magsaysay sophomore medical student Regina Geli began seriously considering an unconventional route. Instead of pursuing her third year studies, she decided to file a leave of absence (LOA) for the current school year, choosing to refocus her energies on caring for personal well-being and returning to advocacy work.
In a country fixated with the idea of graduating on time, a 26-year-old who is shaping her own progress beyond the Philippines’ traditional education system is an exception. Highly aware that she is capable of making this leap given her resources, Geli, however, highlights a struggle that escapes no student whatever the social class background.
“I live with my family. Okay naman ‘yung wi-fi connection namin dito. I have devices. But the presence of privileges like those, it’s not a guarantee against anxieties,” she shares.
Like what many students have raised on social media since classes resumed in September, Geli believes that mental health is a learning issue warranting attention, especially given the unprecedented changes and long-standing societal challenges magnified by the COVID-19 outbreak.
Defining own progress
In October, the Department of Education (DepEd) welcomed 24.7 million students from public and private schools, around three million fewer enrollees from the previous school year, amid growing public resistance to pursuing classes given the pandemic. A month prior, the DepEd rejected the call, stating that an academic freeze is a “shortsighted solution” to the learning issues raised.
Since then, educational institutions nationwide have been constantly hounded by the pleas and criticisms of parents, students, and concerned organizations. Under the tags #AcademicFreezeNOW and #LigtasNaBalikEskwela, one can find the multifaceted narratives on the various schools and universities’ implementation of the academic year. Students have resorted to online debriefing and release for help, much like the #PisoParaSaLaptop campaign, which began a few months before the resumption of classes.
The mental health crisis has been called by professionals “the next pandemic.” In a 2017 World Health Organization (WHO) report, it was stated that around 3.3 million Filipinos already suffer from depressive disorders, one of the highest cases in Southeast Asia. Last May, the WHO also warned of an impending global mental health crisis affecting millions due to COVID-19.
This is a grave concern for students like Geli who study in medical schools. Throughout the years, Geli shares she has learned to compartmentalize stressors; mental health issues cannot be given much space in medical education, as it may risk one’s academic standing.
Enduring pandemic-induced anxieties as the last school year came to a close, she began reflecting on her learning experience and discussing the LOA option with her parents — as she ultimately felt the need to pursue self-betterment and progress on her own terms.
Since going on a study break these past months, Geli has transitioned to healthier personal routines, has created a podcast, and has been active in her advocacies previously sidelined when she entered medical school. She is currently volunteering with Healthcare Without Harm, an international organization promoting awareness and greener practices geared towards climate health. Geli also dedicated this period to review her first year and second year school subjects.
She says, “It’s not something to be ashamed of. Taking a leave of absence doesn’t mean [that] you’re not strong enough to handle the school year ‘cause I know I could have handled the school year if push comes to shove. Taking a LOA is really just doing what’s best for you, and giving yourself the best chance and the best pass forward even if it’s not the most traditional sense.”
For her, what discourages students from taking study breaks such as a LOA or a gap year are the Philippines’ traditional views and structures on education, surmising that the educational path is usually laid down for students, and non-traditional modes of learning aren’t as explored or accepted yet in society.
The stigma is gradually being broken down given the greater awareness and public conversations on well-being. But the challenge lies in making people understand that caring for mental health is a process, and it necessitates openness and collaborative participation among parents, children, and schools.
Breaking down spaces
Enzo Roque, a 23-year-old student of the Pamantasan ng Lungsod ng Maynila (PLM), shares a similar perspective. With a degree in public health, Roque has worked on research and mental health projects before entering medical school. Despite being skeptical and anxious about this school year’s implementation, he chose to pursue his sophomore studies, thinking that it would be a waste to skip a year — a decision he now regrets after confronting difficulties with taking online classes at home.
Roque had hoped that the learning set-up would have been redesigned to accommodate the students’ needs and factor in personal issues such as mental health, family, and economic situations that come with the health crisis. Instead, he describes the current educational structure as boxed, returning to its form prior to the pandemic.
Given his experiences, Roque deems the Philippine medical education system as “too fragile” — unable to “bear any movement” — largely due to its structure being dependent on students as medical personnel. He emphasizes that the flaws in the system forces professionals to maintain a narrow mindset regarding the changes demanded by the times.
This lack of openness in a more flexible learning environment as students deal with multiple crises, such as the pandemic and recent typhoon disasters, has contributed to the students’ current struggles with learning, Roque adds.
Last month, as Typhoon Ulysses shattered many communities across the country alongside the Philippine government’s supposed lackluster pandemic and disaster responses, students of the Ateneo de Manila University called for a nationwide academic strike. President Rodrigo Duterte reacted to the campaign, and even threatened the University of the Philippines with budget cuts and accused them of recruiting the youth into joining communist groups.
Yet there are continued calls for an academic freeze. A September change.org petition on canceling school year 2020-2021 addressed to the DepEd has more than 360,000 signatures to date.
For Roque, this climate change issue is a vital factor that schools should be considering in students’ education because it greatly impacts one’s learning environment and resources. There have also been calls for an #AcademicBreakNOW, urging schools to give affected students and teachers support and recovery periods. Netizens and university students including those from PLM have participated in this online campaign, he adds.
Aside from this, dealing with these concerns while the family is around, Roque also comes face-to-face with the personal sacrifices of being a medical student, a reality he previously kept on the low when he studied away from home.
“I guess what really made me think that this is a wrong decision was there was a stretch where I was just sleeping at 3 or 4 a.m.,” he says, explaining that there’s a lack of boundaries between home and school, which causes a different kind of stress and anxiety. “I have to wake up [at] 6 [a.m.] because class was at 7 or 8 [a.m.]. Sometimes, you don’t even sleep because you’d feel like you won’t wake up [for school].”
“It’s not okay but to a certain extent you have to expect that that’s going to happen in this field,” he adds. “But then you leave your room, and then you go around the house and you see your other family members. When you’re still awake, they’re sleeping soundly. When you’re finally up, they’re not even up yet. Naawa na lang ako sa sarili ko.”
The next pandemic
Clinical psychologist and private practitioner Beatrix Aileen Laguisma-Sison says that having space, routines, and clear boundaries are significant to managing studies during this pandemic, which may not be afforded at home. Therefore, it becomes more challenging for students to adjust to remote, online learning.
In her work, she has observed that the troubles in coping with studying today is more apparent with children; older students are better adjusted, depending on the school system and its openness in heeding the needs, and a person’s sense of stability, capacity to manage stress, and ability to organize things to accomplish tasks.
Geli and Roque share that this culture of openness is yet to take form in medical schools due to the traditional paradigm that rules educational structures and bodies. Both believe that for genuine progress to happen, school authorities have to listen to the opinions and concerns of its students.
Amid this prevailing notion, Laguisma-Sison notes that given the crisis, schools are also in the process of understanding the situation and figuring out their next steps, leading them to hold onto old structures. Working with schools across the country, she states that some institutions have become more aware of the students’ mental health issues in recent years. But she firmly believes that the school and home have to be partners in raising further awareness and arriving at a dynamic understanding on mental health.
Laguisma-Sison, who was also an online counselor with the Philippine Mental Health Association at the beginning of the lockdown, emphasizes that efforts addressing mental health are more urgent than ever, with the increasing cases of anxiety attacks, physical abuses within homes, and adolescents attempting to harm themselves.
In a National Center for Mental Health report relased by the Department of Health (DOH) last August, a rapid rise in suicide-related calls were recorded since April, with an average of 53 calls a month compared to a monthly average of 33 calls from January to March 2020.
"You go around the house and you see your other family members. When you’re still awake, they’re sleeping soundly. When you’re finally up, they’re not even up yet. Naawa na lang ako sa sarili ko."
In October, youth groups challenged the DepEd with its appeal to the public to stop linking suicide cases with distance learning, as it is a sensitive issue and initial investigations show that distance learning wasn’t a primary cause. One of the organizations, Samahan ng Progresibong Kabataan, claimed to have monitored 17 cases of suicide in relation to the difficulties experienced with distance learning.
The DepEd has confirmed only a single case of a student dying of suicide connected with COVID-19 and has admitted that mental health issues continue to be a massive challenge both for students and teachers, as of August. The agency also vowed to strengthen its partnerships and efforts in extending psychosocial support.
“It’s really alarming because the change brings about so many restrictions, so many losses,” Laguisma-Sison says of the increase in mental health issues since the pandemic began. “And people who have not resolved [the] stress or people who are unable to manage their stress before the pandemic, mas heightened [iyon] ngayon.”
She also emphasizes that the key to survival and managing stress is prioritizing self-care. This means getting good sleep, doing physical activity, eating right, having time for fun and play — especially for children — and connecting with sources of support. Like in Geli’s experience, it helps to have a supportive group of friends and medical school classmates who keep in touch and still include her in conversations.
Questioning notions of resilience
Aside from the time pressure, Geli attributes students’ hesitation on making less traditional decisions on their studies given the “kaya mo naman ‘yan” culture, nudging students to power through anything that may come their way no matter the costs. She imparts that this mindset needs reshaping; as in her case, taking a break is all about getting quality education, a proper space and mental health.
Laguisma-Sison explains that this phrase often generalizes what a person is going through, signaling a lack of empathy. An example of this occurrence is parents comparing generational experiences and expecting their children to overcome similar challenges in a different time and context. The “kaya mo naman ‘yan” statement will only be helpful for students and their education if it is specific and directed towards understanding the child’s sentiments, providing guidance and encouragement, she advises.
Relating the idea to Filipino resilience and culture, Laguisma-Sison says, “Just because kaya natin, kailangan bang kayanin natin? That we cannot even assert and say na hanggang dito lang tayo. I think it [also] goes back to how religion plays into that aspect of ‘you are more validated if you sacrifice more’…[and] maybe also because of the belief system they [people] grew up into.”
Laguisma-Sison believes that the stigma is gradually being broken down given the greater awareness and public conversations on well-being. But the challenge lies in making people understand that caring for mental health is a process, and it necessitates openness and collaborative participation among parents, children, and schools.
For her, the most pressing issue now is sustaining students’ motivation to learn, emphasizing that how education is handled today will affect a child’s eagerness to learn in the future.
She says, “If this kind of pressure or structure persists without any kind of change or room to breathe, they might not want to learn. They might lose that motivation because they are traumatized with what is happening now. When this pandemic is over, will they still want to go back to school or still want to learn?”
For information on mental health services and immediate assistance via mental health crisis hotlines, please click here.