Feeling anxious? Depressed? Or generally mentally stressed? Come inside the virtual psychosocial clinic run by the Philippine Mental Health Association (PMHA).

When the government imposed a lockdown on Luzon, the Philippine Mental Health Association (PMHA) had to close down its offices in Quezon City. Its psychiatrists and psychologists worried how to service their regular clients.

PMHA is a non-profit organization that caters to some 80 clients a week. Psychiatrists and psychologists provide mental health services such as psychiatric consultation, psychotherapy sessions and psychological testing.

With the lockdown, however, the PMHA had to find a quick solution not just to service their regular clients but also those who may need psychological support during the Covid-19 crisis situation.

The solution: a virtual mental health support facility. It’s called the “PMHA Online Psychosocial Support (Ensuring Wellbeing Amidst COVID-19).”

It is designed to be a safe space where people dealing with mental health issues can consult with PMHA’s mental health professionals and get online counseling sessions during the crisis.

These services are free of charge, at least during the enhanced community quarantine.

There are currently six psychologists and counselors, and three psychiatrists available to provide online consultation from 8 a.m. to 5 p.m., Mondays to Saturdays.

Now on its second week, the facility gets an average of five to six clients simultaneously in an hour.

“In crisis situations, mental health problems usually increase. Even those who are considered ‘normal’ are triggered by the fear or uncertainty of the situation,” said PMHA Executive Director Dr. Carolina Uno-Rayco.

In fact, the World Health Organization estimates the prevalence of common mental disorders, such as depression and anxiety, to more than double in crisis situations.

Bouncing back after the crisis

While the WHO recognizes that it is normal for people in crisis situations to experience distress because of the fear or uncertainty of the situation, those who already have preexisting mental health problems are more vulnerable.

Rayco said these people need support and guidance to be able to navigate through the crisis and “bounce back” when the crisis is over

“They need people who can guide them on practical ways to address the fear and panic that they feel. They need to know that help is still available,” she said.

Anxiety, depression

So far, the most common conditions that psychologists encounter through the virtual facility are anxiety and depression. Problems with sleeping and overthinking are also common issues. Others just want to ask how they can handle their concerns.

“Most of them already have pre-existing issues, but for some, their anxiety is exacerbated due to the pandemic,” Lorraine Jessica Baclig, one of PMHA’s psychologists conducting online counseling observed.

Counseling and consultations are conducted through phone call, email, online Messenger chat or call, or video call through Skype or Zoom, depending on the client’s preference and internet speed.

The mental health counselors will first assess whether clients would benefit from merely "talking it out" or if they need further help, such as medication.

If medication is needed, they will be referred to psychiatrists who can provide medical help online such as giving out electronic prescriptions.

“Some people would only need 1-2 sessions, such as those who panicked or those whose anxiety was triggered. They are given practical self-help methods such as deep-breathing exercises or mindfulness, or simply sharing their feelings with people they trust,” said Rayco.

Same process, same ethics

For psychologist Maria Emichelle C. Noscal, online counseling is not the ideal set up because of limitations with counselor-client interaction.

In an online setting, Noscal said it is difficult to observe facial expressions and nonverbal gestures that at times may tell mental health professionals more than what the client was actually saying.

Noscal conceded, however, that this is a unique crisis situation. Right now, online counseling is the only way for people with mental health problems to still get help during the lockdown.

“The process how we handle them as well as the ethics are the same,” Noscal said. That means treating all conversations with confidentiality and privacy, she said.

She added that the anonymity of online counseling also appeared to have encouraged first-time clients to seek help.

Warning signs

Mental health counselors said the uncertainty of the duration of the lockdown may trigger anxiety in more people in the coming days.

Counselors Noscal and Baclig said these are the warning signs to look out for that may indicate that a person may need professional help.

• Sudden changes in eating and sleeping patterns, which affect one’s ability to function
• Sudden changes in mood or behavior
• Withdrawal and isolation; refusal to connect with friends
• Loss of motivation in pursuing things previously enjoyed.

“It is okay to feel worried or anxious. But if it already affects one’s daily activities or hampers even one’s basic routine, the person needs to seek help,” Noscal said.

She added, open communication among family members is important because it helps people to “unload their fears and worries.”

Baclig warned that unaddressed minor health problems may escalate to serious mental health problems such as major depressive disorder, anxiety disorders, alcoholism or substance disorder.

“That's why it's very important to prevent rather than cure [a mental health disorder] when it's already there,” Baclig said.

If you or a member of your household manifests any of the warning signs listed above, you can reach out to PMHA’s Psychosocial Online Support through

Facebook

Email: pmhacds@gmail.com

SMS: 0917-5652036

Tel. no. (02)8921.4958; 8921.4959

The National Center for Mental Health also has “crisis hotline responders” who can provide psychological first aid and suicide first aid for those in distress. The following hotlines are open 24/7:

Landline: 7989-USAP (8727)

Mobile: 0917-899-USAP (8727)