A man wears a protective face mask in a slum area in Tondo, Manila, on April 18, 2020. Photo: AFP via NurPhoto

The recent spike in calls to the Hopeline hotline for Filipinos feeling depressed has come as no surprise to Jean Goulbourn.

The coronavirus threat has spurred a near 200% increase in calls in the past month, a reflection of fear, anger and disappointment at unfulfilled government promises for relief assistance, says Goulbourn, the hotline’s founder.

“We’re getting calls that we never did before – 70 to 85% are high anxiety. We had a 13-year-old who called to ask, ‘Do you think my family will get the virus? We are very poor,’” Goulbourn said.

If the threat of the coronavirus spread hasn’t scared people, the government’s messaging about it may also be stoking mental health conditions.

White coffins have been positioned around Metro-Manila to enforce the government’s shut-in order. “Stay at home or stay inside”, with an arrow pointing to an image of a coffin, is the message attached to each box.

To be sure, Filipinos were struggling with depression long before the threat of the coronavirus shut them in their homes or stranded them abroad.

In a country of more than 100 million people, Goulbourn says there are fewer than 5,000 licensed psychiatrists, psychologists and guidance counselors available for anyone feeling lost or wanting to self-harm.

Hopeline founder Jean Goulbourn in a file photo. Image: Natasha Goulbourn Foundation

Last year, Goulbourn says that around five to seven attempted suicides per day were rushed to hospitals in Metro-Manila alone, according to information shared with her by medical professionals.

It’s an estimate, she stresses, as there are few hard statistics and even fewer current ones on suicides, largely because shame and stigma lead families to plead with doctors to record the cause of death as something else – a heart ailment, an accident, anything but suicide.

Goulbourn and her family did not try to hide their truth. Instead, they took the pain of their youngest daughter’s death by suicide in 2001 and learned all they could about depression, mental health and wellness.

Then they established the Natasha Goulbourn Foundation in 2007 with a team of doctors as trustees and advisers.

Together they launched campaigns and programs to educate Filipinos on how to recognize and treat depression and, above all, to remove the shame attached to it.

Nine years ago, the Foundation set up “Hopeline 24/7 emotional crisis line” with a small crew of people answering phone calls and linking what could be high-risk callers to psychiatrists and therapists.

When Goulbourn, a fashion designer known in the Philippines for her Silk Cocoon atelier, was approached last year by a few companies with condo buildings and shopping malls, she sensed a breakthrough on her long-running campaign for investment against despair.

Generic image of a Filipino youth in Metro-Manila. Photo: Facebook

The property managers were concerned about the high number of people jumping to their deaths from their buildings and asked if her foundation would train their security guards and desk managers to recognize signs of depression.

“Each one of us can do something,” she says, emphasizing corporations as much as the central government, churches and city mayors. Investment in services are needed as much as a cultural change in attitude towards both depression and the self-harm it can cause. 

Although the Philippines tends to rank moderately well in the United Nations’ World Happiness Report, moving from 71st in 2018 to 69th in 2019, suicide in the country is a hidden, harsh reality, says Goulbourn.

How much of a reality is hard to tell from the Philippine Department of Health website. It only references global or 15-year-old statistics that indicate an increase in suicides two decades ago.

It also cites a 2011 World Health Organization’s Global School-Based Health Survey that reported 16% of students aged 13–15 had at some time seriously considered suicide, while 13% had “actually attempted suicide one or more times during the past year.”

“Why are Filipinos too poor and yet too happy?” Josephus Jimenez wrote in the Philippine Star newspaper citing the World Happiness Report.

He also noted that the country had ranked in the top five on a global optimism index.

“That means that the Filipinos are full of hopes that this year and the next will bring better times for us all,” he wrote. He attributed the smiles and positive outlook to faith, family and a lot of Facebook.

That’s clearly not true for all Filipinos, particularly now with many trapped and at risk of losing their livelihoods by the government’s virus-containing “enhanced community quarantine” measures.

A young girl wearing a mask amid the coronavirus scare as she sits outside her home in Manila. Photo: AFP/Maria Tan

Hopeline has heard from many elderly widows now living on their own and struggling with isolation because a family member died from the virus or they live in another town or overseas.

“Most don’t know how to do Zoom or work with digital gadgets,” Goulbourn says, which deepens their isolation.

With a phone number recently added to help Filipino workers stranded outside of the country cope with the isolation, calls are now coming in from non-Filipinos, she says.

The helpline is available to all subscribers of the Globe mobile telephone service, which has supported Hopeline since its inception.

Not only is the coronavirus increasing anxiety and thus callers, Goulbourn worries it’s also threatening the financial life support of such services as Hopeline and other groups dedicated to mental health awareness and suicide prevention in the Philippines.

Despite being confined to her home, Goulbourn continues campaigning for funding to sustain the hotline as well as expand services and the number of mental health responders.

Her foundation, which changed its name to NGF Mindstrong in September 2019 and became a representative of the International Association of Suicide Prevention, is now urging local government units to begin building a counseling system within health centers.  

In June, or when schools finally resume, the Wellness Emotional Resilience Program is slated to roll out nationally with the Department of Education to provide homeroom guidance as part of the curriculum for grades 4 to 12 to “build students’ self-esteem and ability to better cope with problems,” says Goulbourn.

A woman wears a mask as a precautionary measure against the spread of Covid-19 in Manila on March 13, 2020. Photo: AFP/Maria Tan

And NGF Mindstrong is promoting what it calls a “movement” among student leaders at five universities with proactive mental health activities, such as peer counselling, to work towards “zero suicides.”

Goulbourn says she wants to be prepared for the aftermath of when the threat of the coronavirus has been contained.

“By June, July, August we’ll see if resilience is strong or if the economic problems will cause high-risk depression and bring up suicides,” she says. “I don’t want to think of it. I want to be wrong. But I also want our Foundation to be prepared.”