CHAPTER 2

Review of Related Literature

The review of related literature is a vital aspect of research, and in this chapter,

researches and studies done locally and abroad are discussed. This review focuses on the studied

mental health status of different sectors of the community, especially students, and how a

pandemic affects the private lives of people. It aims to provide a general understanding of the

mental health of students and the adverse effects of a pandemic.

However, this review does not intend to explore the effects of a pandemic on the

physical, physiological, and other aspects not related to mental health as defined by Pawar

(2018)—emotional, psychological, and social well-being. These aspects include the way we

think, feel, and act. These aspects also include determining how people deal with stress, how

individuals connect with others, and how the general public makes decisions. Mental health is

essential to every stage of life from infants to the elderly.

In addition, according to WHO (2018):

Mental health is the foundation for the well-being and effective functioning of

individuals. It is more than the absence of a mental disorder; it is the ability to think,

learn, and understand one's emotions and the reactions of others. Mental health is a state

of balance, both within and with the environment.

An awareness of fitness, pleasure, and success is called mental well-being (Davis, 2019).

Davis (2019) also added that mental well-being involves a sense of handling stress, a sense of

intention or value, happiness in life, and the maintenance of mental health.

 Different questionnaires are to be used in the conduct of the research to test three factors

of mental health. The first test to be used is the Perth Emotional Reactivity Scale (PERS), which

is a "newly developed 30-item self-report measure of emotional reactivity (affective style). The

PERS measures the typical ease of activation, intensity, and duration of one's emotional

responses, and importantly does so for negative and positive emotions separately” (Becerra,

Preece, Campitelli, & Scott-Pillow, 2017). This questionnaire is used to test the reactivity of a

particular individual under a specific factor. During the pandemic, many students are confined to

their houses, and their emotional state is also affected, so this questionnaire is a good measure to

test the emotional state of students.

Next is the Psychological General Well-being Index (PGWBI), which is “a widely used

scale across many conditions” (Lundgren-Nilsson, Jonsdottir, Ahlborg, & Tennant, 2013). Their

study mentioned that PGWBI “[h]as satisfactory internal construct validity” to test patients

undergoing treatment for stress-related exhaustion. Other researchers like Carotenuto et al.

(2013) used PGWBI to assess stress levels of seafarers since they "are exposed to high levels of

stress that should be accurately investigated, measured, followed up and, if possible, countered."

This questionnaire is a good measure to test the psychological state of students.

The third is the Cornwell Perceived Isolation Scale by Cornwell and Waite (2009), who

have "identified a wide range of indicators of social isolation that pose health risks, including

living alone, having a small social network, infrequent participation in social activities, and

feelings of loneliness." In their test, they used scales to examine the “social disconnectedness”

and “perceived isolation” of the participants from the National Social Life, Health, and Aging

Project. This questionnaire is a good measure to examine the social life of students.
 Resources are taken from reliable sites on the Internet such as Research Gate, Google

Scholar, and Pubmed, with studies from different years, but not more than ten years except for

some concepts accepted as still accurate or not subjected to changes as in questionnaires and

definitions. The literature review is divided into two sections: foreign literature and studies; and

local literature and studies. After which, conceptual framework will be introduced.

Since this body of literatures and studies will serve as the foundation of this research, this

review of related literatures and studies aims to assess the previous pieces of literature and

studies regarding mental health and pandemics, with information from within and outside the

Philippines. This review helps provide a better understanding of the scope of the study—to better

understand the state of mental health of people before and during the COVID-19 pandemic and

to see what happens to these mental health issues while suppression strategies are implemented

by the government.

2.1 Foreign Literature and Studies

The COVID-19 pandemic has introduced uncertainty into significant aspects of society,

including educational institutions. For example, it is unclear how the school closures in March

2020 impacted student achievement or how the rapid conversion of most instruction to an online

platform in this academic year will continue to affect achievement. Despite all this confusion,

there is growing agreement that the closures of school negatively impacted student’s learning.

School closures and social exclusion have affected all students, particularly those living in

poverty. A mental health crisis is erupting, compounding the harm to their learning, as many

students have lost access to school-based programs.

 Mental health problems hamper academic success. Mental illness may affect the

motivation, attention, and social interactions of students, all of which are essential factors in their

academic performance. Students and other vulnerable groups that are struggling with mental

health problems need urgent attention and support. It is vital to evaluate the stress levels of the

population and the emotional, psychosocial, and social adjustment that must be done so that

appropriate support systems are put in place, particularly during the recovery process and in the

future.

Students have had to adjust to the use of online educational tools and platforms, the

abruptness of which also affecting their mental well-being. This review of foreign literatures and

studies aims to provide a solid foundation on the discussion of the mental health of students as

well as how the pandemic impacts such and how students cope with it.

2.1.1 Emotional, Psychological, and Social Impact

Depression, anxiety, stress, and other mental health problems negatively affect the quality

of life. Students should consider resolving these issues earlier rather than later, whether they are

regular or occasional issues. According to Burns et al. (2020), COVID-19 is both a direct and

indirect danger to the health of students as it directly affects the psychological state of the

students and severely declines the socialization of the students.

The psychological state of the students is affected by the pandemic because, according to

Aucejo et al. (2020), the pandemic of COVID-19 had a significant adverse effect on student

engagement in the work market and on post-college career expectations. Previous statistics

further suggest that while the outbreak has had adverse effects on all subgroups, the extent of the

epidemic varies. It was confirmed by Wang (2020) that the COVID-19 pandemic has caused a
spike in depression and stress among the general public. Furthermore, Elmer et al. (2020),

COVID-19-specific stressors have been attributed to a change in mental health gives us the

impression that the COVID-19 pandemic has had a negative impact on student social networks

and mental health.

Moreover, other implications, such as the lack of social connection, have the potential to

damage the well-being of medical students and may increase psychological distress (Lyons et al.,

2020). For instance, Grubic et al. (2020) considered that the prolonged effects of physical

distancing on students might result in decreased motivation and daily routines, increased number

of dropouts to students, and difficulty studying independently.

Golberstein, Wen, and Miller (2019) stated that the combined problems that are faced

during the pandemic and the interventions done to suppress the problem like social isolation and

economic recession may exacerbate mental problems faced by many even before the outbreak

and may lead to more case to adolescents. The notion that existing mental health increases has

been validated by Roy et al. (2020), when they said that “major mental health issues reported

were stress, anxiety, depression, insomnia, denial, anger and fear.” As a consequence, these

psychological effects may result to aggravated issues on emotional state of an individual.

According to Pedrosa et al. (2020), fear and uncertainty are some of the emotions that

people have felt. The aforementioned conclusion in Pedrosa and colleagues’ study has been

validated by Ahorsu et al. (2020), saying that these emotions must be properly addressed to be

studied. Yao et al. (2020) added that these emotions could worsen psychological and emotional

impacts.
 Issues such as abrupt economic decline and hardship, severe social alienation, and

increased unemployment rates can cause an individual to consider committing suicide (Poudel &

Subedi, 2020), and “mass quarantines can lead to multidimensional social consequences and may

potentially heighten existing disparities across various contexts (Chu et al., 2020, Conclusion

section).” Topics such as students who have access to new learning media, use of technology,

expanded time in gaming, and social media use are still some of the top concerns (Mahapatra &

Sharma, 2020).

2.1.2 Addressing the Problem

Mental health can be addressed in a variety of ways. Students can practice coping

strategies at home or seek additional help through virtual resources such as telehealth. Barkham

et al. (2019) declared that resiliency is a vital aspect of health because resilient people can deal

with stress, especially in university. Plus, the stability and well-being of students are vital to

contemplate how students cope up.

In accordance with Lyons et al. (2020), strategies commonly used during the pandemic

are social media applications and video chats. Less than 40 percent of the participants used

mindfulness and meditation in coping with mental stress. Golberstein, Wen, and Miller (2020)

suggested that there must be an early treatment and report of any mental health issue.

In the study by Giovanella (2020), it demonstrates the value of smartphones, laptops, or

other technology systems which can be used to connect with others, and the findings illustrate

the significance of social experiences in the emotional well-being of students and offer a starting

point for the identification and assistance of students who are more vulnerable to social
alienation and detrimental psychological consequences during the COVID-19 pandemic (Elmer,

2020).

2.2 Local Literatures and Studies

Ever since the start of the Covid-19 pandemic, the world has been distraught as the

number of COVID-19 patients, together with the deaths caused by this virus, increased day by

day. The Coronavirus directly affects our body and weakens it, but as this pandemic continues to

go on, it takes a toll on us and proceeds to impact not only in the physical aspect but also

emotionally, mentally, and socially.

As pandemic becomes a major crisis in the Philippines, many local works of literature are

written to provide an understanding of the effects of the pandemic on students’ mental health.

According to Joaquin et al. (2020), In spite of the innovations done by Philippine HEI’s to

deliver learning methods, there are indeed obstacles and difficulties with their methods;

furthermore, due to less interaction in learning, students do not learn as much they can

participate in the conventional classroom (Edge & Loegering, 2021).

Students in remote places do not have access to utilities like roads and gadgets like

mobile phones, laptops, and the internet. Moreover, the issue of the internet, back then before the

pandemic, may have restricted internet connectivity even in metropolitan places. Thus, some of

these problems that have risen may affect the mental health of the students.

2.2.1 Emotional, Psychological, and Social Impact

School closures, home quarantine, and social distancing implemented all around the

world can cause sudden anxiety to people (Talidong & Toquero, 2020). Due to the increase in

anxiety among teachers, they find ways on how to cope with their current situation. Most
teachers use social media and new-found hobbies as coping mechanisms to help alleviate the

anxiety that they are experiencing. Most importantly, Filipinos are known to be family-oriented,

which makes “spending time with family” the best choice for the teachers to help them feel less

stressed in this time of pandemic (Talidong & Toquero, 2020). In the following researches, in

spite of these interventions made by teachers and other local government units, Filipino students

and minors continue to battle the indirect effects of the pandemic.

During the lockdown, the majority of students showed signs of anxiety. Although

students’ anxiety about contracting the Covid-19 increased, there is still evidence that they

practice anxiety management techniques during this pandemic (Baloran, 2020). People have

developed fear and anxiety. It can be overwhelming for most people because a new

communicable disease has emerged and taken lives which makes them anxious and traumatized.

This can take a toll on the people’s well-being, especially their mental health. The quarantine and

social distancing protocols are implemented, and everyone is expected to comply to help

decrease the spread of the coronavirus. Because of this, people suffer from loneliness, which

makes them feel more stressed and anxious, especially people who are suffering from pre-

existing mental health conditions (Bautista & Manuel, 2020).

Rogers (2021) highlighted in her report the effects of pandemic issues on the mental

health of Filipinos. According to her, burnout, sedentism, isolation, sleep sabotage, stress, and

trauma are some of them. Moreover, she said that some of the underlying illnesses that may be

experienced are linked to isolation. However, Magsambol (2020), in his report, said, “The mental

health issues students experience during distance learning are due to an ‘interplay’ of factors,

said one of the country’s top psychiatrists, who added that such issues cannot be solely attributed

to the difficulties of the revamped education system.”

 Children having less capacity to afford distance learning are more prone to emotional

disturbances. Experts warned of the rising effects of children inside the home having a high risk

of depression. These effects have been linked to suicidal thoughts, as reported by Sibucao

(2020), where it is reported that there were three students who committed suicide due to

modules—though there are more reports for this incidence; additionally, Gorecho (2020)

affirmed that financial status is also one of the reasons for students’ suicidal thoughts.

As stated by Arnado & Bayod (2020), “Grief at the loss of loved ones, shock at the loss

of jobs, isolation and restriction of movements, and uncertainty of the future are some of the

psychological effects that people are suffering from because of the Covid-19 pandemic.” It is

also mentioned in their study that Filipinos are known to be resilient, and this pandemic proved

that. The researchers also added that though there are many reported cases of mental health

problems, Filipinos remain flexible. This is because many have their own sources of strength,

and it helps them to remain calm and sane such as a positive mindset, believing in God, and of

course, family love.

According to Tee et al. (2020), there are certain factors that are associated with the greater

psychological impact of the Covid-19 pandemic. Female gender, youth age, like students and

young adults, isolation, worry, and discrimination are causes of higher levels of stress, anxiety,

and depression (Tee et al., 2020). They also added that on a more positive note, the lesser

psychological impact of the Covid-19 pandemic is also associated with some factors. The study

has shown that having confidence in the health care workers’ abilities, being a part of the health

care workers themselves, and having knowledge on timely and adequate health information helps

lessen the negative impact. Also, as stated by Labrague et al. (2020), young adults, mostly

among the female gender, are more prone to emotional and social loneliness than young adults
who are male. It is also stated in their study that younger individuals have decreased levels of

loneliness with the help of their own coping mechanisms and having an adequate support system.

2.2.2 The Approaches of the Government

Advocating mental awareness to Filipinos has been the role of the Department of Health

(DOH), and promoting researches mainly on this subject (Department of Health [DOH], n.d.).

However, despite these interventions, many social media platforms, even before the pandemic,

have shown signs of adolescents and children committing suicide.

Shahani (2014), in her report, said that people with mental disorders or disabilities are

frequently referred to as degrading terms, such as baliw or abno, which reflect ignorance of

Filipinos in thinking about mental problems. However, mental problems are not only

experienced by people that Filipinos commonly think of because these can be different for every

person, and everyone needs medical attention. Even young children may experience this as

Planco (2015, Mental health section, para. 1) said that “depression is the predominant cause of

illness and disability for both boys and girls aged 10 to 19 years old. Suicide is the third leading

cause of death among adolescents.”

Nowadays, we are aware of mental issues and the ways we may deal with them.

However, in the literature done by Bandares-Paulino and Tudy (2020), he said:

we argue that the problem with COVID-19 went forth just dealing with physical

health. First, people suffer not just from being infected but the psychological stress of

possibly getting the virus and the toll of the government lockdown or quarantine. Second,

the Philippine Bayanihan’ We Heal As One Act’ lacks focus on mental health issues,

while the government’s response seemed to focus on security issues. Third, there are
 countries around the world that have acted effectively in protecting people’s mental

health. Lastly, we propose appropriate measures to help address the people’s mental

health while still in the pandemic and for a future one (pp. 378).

Despite these allegations, the government continues to provide mental health assistance.

Upon the extended community quarantine of the Philippines, the Philippine government and its

people have seen the relevance of scientists and health workers who provide knowledge to

society in this time of crisis (Vallejo & Ong, 2020).

2.3 Conceptual Framework

This section is constructed to address the problems that are intended to be answered in

the research. Two theoretical frameworks are combined and restructured to assess the effects of

the COVID-19 Pandemic on the mental health of Grade 11 STEM students.

Figure 1. Prevalence of stress, anxiety, depression among the general population during the

COVID-19 pandemic: a systematic review and meta-analysis (Salari et al., 2020).

 The theoretical framework of Salari et al. (2020) showed how the COVID-19 Pandemic

and other factors can affect anxiety, depression, and stress of the participants. Furthermore, they

introduced aggravating factors such as social, physiological, economic, and coped mechanisms

of people. Therefore, the framework of Salari et al. (2020) presented many factors that can affect

anxiety, depression, and stress alongside the perceived effects of the pandemic.

Nevertheless, it lacks detailed or categorized aspects that are established in the study, and as

an outcome, many factors can be identified since Salari et al. (2020) aimed to provide a general

view of the problem. Pawar (2018) addressed that, wherein he defined mental health as an

umbrella term that encompasses three aspects.

Emotional

Mental
Health

Social
Psychological
well-being

Figure 2. Influence of Some Demographic Variables on Mental Health of the Higher Secondary

Adolescents (Pawar, 2018).

Pawar (2018) identified the three aspects of mental health as emotional, psychological,

and social. This framework is focused on three aspects, it limits the time and effort used since it

is categorized and identified. However, the framework of Pawar (2018) was only defined to

examine the mental health of higher secondary adolescents and the influence of demographics
variables. His study did not address the effects of the COVID-19 pandemic, which were sought

to be identified by Salari et al. (2020). Hence, the conceptual framework was made to fit the

research better.

Mental
Health
COVID-19
Pandemic
Common
Factors

Social well-
Emotional Psychological being

Gender and age of

Grade 11 STEM in
SLU

Figure 3. Conceptual Framework

The conceptual framework of figure 3 best describes the flow of the research and what

the researchers aims to answer. In the conceptual framework, the researchers’ purpose is to

identify the effects of the COVID-19 outbreak on the mental health of Grade 11 STEM students

in SLU under three main categories—emotional, psychological, and social well-being.

Moreover, the researchers will test if there is a significant difference in the common effects of

the COVID-19 pandemic on the mental health of these students in terms of age and gender.
2.3 Research Gap

Most foreign and local literatures and studies reveal the effects of the pandemic in

general and their effects for certain groups; however, in this research, the aim is to narrow down

the scope by looking at the effects of the pandemic on the mental health of senior high school

students, specifically those in the STEM Strand. This is to provide a better understanding on how

this strand copes with stress. Moreover, some literatures have little to no real experiments

because they are merely standalone literature review. Hence, the study aims to fill the gaps in

their research.

Research is the cornerstone of effective public policy. A smart strategy is impossible

without it, and otherwise solid tactical approaches often misfire due to mistakes that some

advanced research could have prevented. That is why local research such as this one is very

critical, even if important insights can be gleaned from national and international studies.

Moreover, the literatures and studies done abroad and locally are like pieces of a whole

that need to be woven together to be the basis of the research. With this, the research that is to be

conducted will give clarifications to the current situation of a select group. Since researchers

from abroad and some local researchers are inspired to provide a greater scope of the effects of

the pandemic, this research will look into a specific cluster of people.

An in-depth analysis of a certain group, if done over time, provides greater knowledge on

how the specific group adjusts to the new normal. Furthermore, a thorough analysis of grade 11

students of Saint Louis University Laboratory High School will provide answers to questions

regarding the common effects of the pandemic and how they are affected in terms of their gender

and age.
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