Kimkim: Understanding Filipino Attitudes Toward Mental Health Support

The Silent Struggle

Recently, conversations around mental health have been growing globally. More efforts are being initiated to empower speaking up, challenge stigmas, and encourage seeking help. However, in the Philippines, most people still approach it with kimkim, the silent struggle of many Filipinos, by keeping things to themselves and suppressing their distress. This hesitation to avail professional help persists, even as the number of individuals experiencing psychological distress continues to rise, alongside other deep and persistent challenges surrounding mental health.

Yet, by closer inspection, this behavior is not accidental, as we will explore how it is influenced by culture and economics and identify the steps that we can take to understand and change this phenomenon.

Current Status of Mental Health in the Philippines

Based on the Mental State of the World report of Washington DC based non-profit organization Sapien Lab, the Philippines' mental health quotient decreased ten points from 78.44 in 2023 to 68.76 in 2024.

The mental health quotient is a comprehensive measurement of holistic mental health function that includes cognition, emotion, and resilience, to name a few. The metric is composed of six (6) states: Distressed (-100 to -50), struggling (-50 to 0), enduring (0-50), managing (50-100), succeeding (100-150), and thriving (150-200) (Antonio, 2025).

Despite the Philippines still ranking in the “Managing” category, the decline in results resonates with the upward trend of mental health concerns in the Philippines from 1990 to 2019, with an average annual increase of 2%, which constitutes 7 to 12.5 million individuals (Alibudbud, 2023).

This is also echoed by the 2020 research of The Philippine WHO Special Initiative for Mental Health, which shows that at least 3.6 million Filipinos suffer from one kind of mental, neurological, and substance use disorder (DOH, ND). Formal treatment remains scarce as reflected on a WHO report in 2020 that the total mental health professionals in both government and non-government sectors in the Philippines are only 1,821 which accounts to 1.68 per 100,000 population, and the total government mental health expenditure as of percentage of total health expenditure is only 2.9% estimated to be 25.9 pesos per person for the entire population. While the passage of the Mental Health Act of 2018 is a step in the right direction, implementation has been slow, and demand is on the rise.

Factors Affecting Filipinos’ Mental Health Seeking Behavior

The need to address the mental health situation in the Philippines is evident; aside from the government’s efforts to solve this issue, there are factors in Filipinos’ mental health seeking behavior that either hinder or encourage them to avail of professional help.

Why do Filipinos Avoid Professional Help?

Cultural & Psychosocial Barriers

Stigma and shame contribute to the persistence of help-seeking barriers among Filipinos, which is expressed through “Hiya” or the sense of embarrassment, and fear of loss of face. Many are also worried about being perceived as crazy, weak, disgracing their family, and being judged negatively by others, which leads to a tendency to conceal distress and avoid professional help (Martinez et al., 2020; Tuliao, 2014; De Leon, 2025).

Confiding with family, friends, or religious figures is most often an option instead of mental health professionals who are considered as “Ibang-tao” or outsiders, which reflects the value of “Kapwa”, the sense of shared identity. Attributing mental illness to supernatural forces and spiritual imbalance also contributes to discouraging people from seeking professional help (Martinez et al., 2020; Tuliao, 2014).

De Leon (2025) also observed that among those who sought help, faced disbelief and stigma from their social circle upon discovering their diagnosis, and hesitated to commit to treatment. Some also became doubtful in the therapeutic process and had difficulty reconciling cultural beliefs with clinical explanations. 

Structural & Systematic Barriers

On top of the shortage of mental health professionals, services concentrated in urban areas, along with their high cost relative to income,e contribute to the challenges (Martinez et al., 2020; Tuliao, 2014). In addition, De Leon (2025) mentioned that some are tempted to discontinue treatment due to the financial burden of therapy and medication. Another factor is low mental health literacy and a lack of culturally specific ways of interpreting distress

Overseas, Filipinos also encounter difficulties in seeking mental health support due to language barriers, unfamiliarity with healthcare systems, discrimination, and perilous immigration or employment status. In addition, mental health literacy and interpreting distress as spiritual in nature hinders the need for professional help (Martinez et al., 2020).

Facilitators of Filipino Help-Seeking Behavior

Psychosocial Facilitators

Recognition of distress and severity of its symptoms often leads to help-seeking. Self-discovery and acceptance of ascribed conditions being difficult to carry alone motivated individuals to look for professional support, which led to feelings of awareness and empowerment. Support from family and friends also contributed to help-seeking behavior through encouragement and provision of emotional and financial resources (De Leon, 2025).

Structural & Systematic Facilitators

Access to affordable, familiar, and convenient services encourages availing professional help. Having a supportive family that shoulders therapy and medication was instrumental, so was finding the right therapist, and building trusting relationships with them was crucial (De Leon 2025). Previous positive experience with professionals and accessible services also reinforces help-seeking (Martinez et al., 2020).

Cultural & Acculturation Facilitators

For Filipinos overseas, acculturation, proficiency in the host country’s language, and lower adherence to traditional norms are associated with increased openness to help-seeking (Martinez et al., 2020).

For young adults, De Leon (2025) observed that openness to discussing mental health publicly, normalization of therapy through social media campaigns, and encouragement from peers also helped reduce stigma and increased their willingness to seek care. Understanding that mental health conditions are medical in nature or genetic also adds to the likelihood of a person seeking help (Ines, 2020).  

Breaking the Cycle

The need to improve mental health support, services, and attitudes towards it cannot be understated, as Filipinos’ help-seeking behavior is shaped by the interplay of cultural, structural, and personal factors. We all can do something about it by capitalizing on facilitators of help-seeking behavior and breaking the silence through:

·         Education: Awareness of mental health conditions and available support.

·         Visibility: Success stories of those of sought help and promotion of providers.

·         Community: Establishment of either online or in-person platforms where people are safe to open-up.

·         Policies: Ensuring that services are accessible, affordable, and culturally sensitive.

·         Empathy: Genuine compassion from family and peers.

Seeking help is not a sign of weakness; it is an act of courage. It means choosing growth over silence, connection over isolation. If you or someone you know is struggling, remember, you are not alone. There is strength in speaking up, and together we can create a mentally fit community.

Sources:

Alibudbud, R. (2023). Towards transforming the mental health services of the Philippines.

The Lancet Regional Health – Western Pacific, Volume 39, 100935

Antonio, J. (2025). Philippines' mental health quotient worsens in 2024 — study. GMA. https://www.gmanetwork.com/news/lifestyle/healthandwellness/943137/philippines-mental-health-quotient-worsens-in-2024-study/story/

De Leon, C. (2025). A Qualitative Inquiry on the Active Mental Health Help-Seeking Behavior of Filipino Young Adults. International Journal of Social Science Research and Review, 8(4), 52-64. https://doi.org/10.47814/ijssrr.v8i4.2604

Department of Health (ND). Your Mind Matters: DOH Calls for Unified Response to Mental Health. DOH. https://doh.gov.ph/press-release/YOUR-MIND-MATTERS-DOH-CALLS-FOR-UNIFIED-RESPONSE-TO-MENTAL-HEALTH

Ines, J. (2020). Predictors of Help-Seeking Intentions Among Filipino College Students. DLSU. https://www.dlsu.edu.ph/wp-content/uploads/pdf/conferences/research-congress-proceedings/2020/FNH-10.pdf

Martinez, A. B., Co, M., Lau, J., & Brown, J. S. L. (2020). Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review. Social psychiatry and psychiatric epidemiology, 55(11), 1397–1413. https://doi.org/10.1007/s00127-020-01937-2

Tuliao, A. P. (2014). Mental health help seeking among Filipinos: a review of the literature. Asia Pacific Journal of Counseling and Psychotherapy, 5 (2), 124–136. https://doi.org/10.1080/21507686.2014.913641

World Health Organization. (2020). WHO Mental Health Atlas 2020 Country Profile: Philippines. WHO. https://www.who.int/publications/m/item/mental-health-atlas-phl-2020-country-profile