Trigger warning: This article contains references to suicide and self-harm.
In November 2025, I admitted myself to a psychiatric ward in Cebu. I initially went in for assessment, nervous and unsure of what would happen next, but I was admitted because my chief complaint was suicidal ideation.
For months, I had been living with persistent thoughts of ending my life. At first, I dismissed them as a normal side effect of tapering off medication I had been taking for some time. I thought this was something I could manage on my own. Instead, the thoughts intensified and became disturbingly specific; thoughts of jumping from the highest floor of a mall.
During the admission process, I had to recount my experience to the attending resident psychiatrist. I spoke about the pain, the anger, and the emotional exhaustion I had been carrying. There was an undeniable irony in the situation: I am a mental health worker, someone who advocates for psychological well-being, yet my own mental health was unraveling.
I explained my triggers in detail. The work I once loved had begun to cause me deep distress. The past I had tried to outrun, the emotions I had suppressed, and the fears and unresolved traumas I had buried eventually caught up with me. I spoke carefully but honestly, knowing that the only way to receive appropriate help was to be as descriptive and transparent as possible.
The facility itself was clean, but the environment was sobering. I encountered patients with a wide range of conditions: individuals exhibiting aggressive behavior tied up in their beds, those with substance-induced psychosis, and patients diagnosed with schizophrenia. As a mental health professional, I was familiar with these realities. Still, witnessing them up close, in a crowded public facility, was deeply saddening. It made the systemic gaps painfully visible and left me with the quiet resolve that I never wanted to return under the same circumstances.
To date, Cebu has only one government-funded psychiatric hospital, operated under the provincial government. Other psychiatric facilities in the city are privately run, with admission costs that can financially devastate families unless they are well-resourced. This reality reflects a broader national issue.
The Philippines faces a critical shortage of mental health professionals. Current estimates indicate that there is approximately one psychiatrist for every 200,000 Filipinos, a figure that falls far below the World Health Organization’s recommendation of at least 10 psychiatrists per 100,000 population.
Psychologists and other mental health practitioners are similarly scarce. The country has an estimated 2,350 to 2,413 licensed psychologists serving a population of over 119 million, translating to roughly one psychologist for every 50,000 Filipinos.
While Cebu may appear to have several practicing psychiatrists, access remains limited, and the cost of medication further compounds the problem. Common antidepressants can range from P13 to P120 per tablet, while long-acting injectable medications for schizophrenia can cost up to P10,000 per dose. Consistent treatment becomes financially unsustainable for many families.
After nearly seven hours, I was discharged. I felt heavily sedated, my body weighed down by medication, sleepiness settling in before clarity could return. My treatment plan was changed from selective serotonin reuptake inhibitors (SSRIs) to an atypical antidepressant costing around P70 per tablet. Over a month, this expense alone consumes nearly 20 percent of my salary, a cost that many Filipinos simply cannot absorb.
Psychiatric consultation is often described as a last resort, but in practice, it has become the most accessible intervention. See a psychiatrist, receive medication, and hope it works. Yet medication alone cannot fix a system that is overstretched and underfunded.
In the days that followed, I returned for a scheduled follow-up. The experience was physically and emotionally exhausting. I found myself among hundreds of patients waiting in a poorly ventilated space. That day, I could not bring myself to stay. I left and opted for an online consultation instead.
Not everyone has that choice. Not everyone has the resources, the internet access, or the financial capacity to seek alternatives beyond the public system.
This experience taught me a difficult but necessary lesson: the Philippines urgently needs more mental health facilities, trained professionals, and a humane approach to care. Mental health services must be accessible, adequately funded, and grounded in dignity. Strong government support is not optional; it is essential.
Mental health is not an elective concern. It is not an afterthought. It is the infrastructure that allows people to stay alive long enough to hope.
