International Review of Psychiatry

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The plight and promise of mental health providers

in the face of a warming planet: perspectives and
experiences from the Philippines

John Jamir Benzon R. Aruta, Sena S. Salcedo, Johnrev Guilaran & Renzo R.
Guinto

To cite this article: John Jamir Benzon R. Aruta, Sena S. Salcedo, Johnrev Guilaran & Renzo
R. Guinto (2022) The plight and promise of mental health providers in the face of a warming
planet: perspectives and experiences from the Philippines, International Review of Psychiatry,
34:5, 530-533, DOI: 10.1080/09540261.2022.2123701

To link to this article: https://doi.org/10.1080/09540261.2022.2123701

Published online: 14 Sep 2022.

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INTERNATIONAL REVIEW OF PSYCHIATRY
2022, VOL. 34, NO. 5, 530–533
https://doi.org/10.1080/09540261.2022.2123701

COMMENTARY

The plight and promise of mental health providers in the face of a warming
planet: perspectives and experiences from the Philippines
John Jamir Benzon R. Arutaa , Sena S. Salcedob,c, Johnrev Guilarand and Renzo R. Guintoe,f
a
Department of Psychology, School of Medical and Life Sciences, Sunway University, Subang Jaya, Malaysia; bMental Health First
Response, Manila, Philippines; cSt Arnold Center for Integral Development, Quezon City, Philippines; dDivision of Social Sciences,
College of Arts and Sciences, University of the Philippines Visayas, Miagao, Philippines; ePlanetary and Global Health Program, St.
Luke’s Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines; fSunway Centre for Planetary
Health, Sunway University, Subang Jaya, Malaysia

ABSTRACT ARTICLE HISTORY

A growing body of research shows the inimical impact of climate change on people’s mental Received 8 April 2022
health. However, attention to mental health providers at the frontlines is rather sparse, espe- Accepted 8 September 2022
cially in climate-vulnerable countries. This commentary aims to present the perspectives and
KEYWORDS
experiences of mental health providers within the context of climate change in the Philippines.
Climate change; mental
Specifically, this paper explicates the challenges faced by mental health providers in trying to health; mental health
address the increasing climate-related distress experienced by many Filipinos and the recent providers; Philippines
progress in promoting climate change and mental health nexus in the country. The recommen-
dations offered in this commentary will hopefully provide the basis for a more comprehensive
mental health framework that incorporates climate change and supports mental health pro-
viders in their pursuit to preserve Filipino mental health on a warming planet.

Introduction: climate change and mental
health in the Philippines
Climate change is already causing detrimental impacts
on people’s mental health worldwide (Cianconi et al.,
2020; Palinkas & Wong, 2020), with climate-vulner-
able countries facing severe mental health consequen-
ces (Aruta & Guinto, 2022). The Philippines is
especially vulnerable to the brunt of climate change,
primarily due to its geographical features and loca-
tion, compounded by limited adaptive capacity
reflected in chronic problems related to governance,
infrastructure, and economic resources (De Leon &
Pittock, 2017). The threats to people’s lives, homes,
and livelihoods brought about by climate change-
driven extreme weather events (e.g. multiple and
strong cyclones, intense flooding, and droughts) and
the amplifying effects of the current COVID-19 pan-
demic can pose serious consequences to their mental
health (Rocha et al., 2021). Despite the widespread
recognition of climate change as a key domestic and
global policy issue, there remains a lack of targeted
policies and programs that aim to protect Filipinos’
mental health from climate change. In the same vein,
the country’s mental health framework, best exempli-
fied by the 2019 Mental Health Act, still lacks explicit
integration of climate change considerations (Guinto
et al., 2021).
Mental health professionals (e.g. counsellors, psy-
chologists, psychometricians, and psychiatrists) in the
Philippines play an important role in addressing the
mental health needs of all Filipinos (Simon, 2022),
especially those who are most affected by the conse-
quences brought about by climate change. However,
approaches to mental health in the country are still
yet to include climate change into the picture, since
the contributions of mental health professionals are
only traditionally sought when a disaster such as a
typhoon strikes, with limited reference made to long-
term climate change. As conversations around mental
health in the Philippines are starting to involve a rec-
ognition of its systemic and socio-ecological drivers,
there tends to be a bias towards factors with widely
established direct causal pathways (e.g. chronic stress
due to poverty, disaster exposure, and vulnerability)
(Edwards et al., 2021; Rocha et al., 2021). Meanwhile,
more distal factors or those with indirect pathways

CONTACT Renzo R. Guinto guinto.rl.f@slmc-cm.edu.ph Planetary and Global Health Program, St. Luke’s Medical Center, College of Medicine-
William H. Quasha Memorial, Quezon City, Philippines
ß 2022 Institute of Psychiatry and Johns Hopkins University

(e.g. slow-onset environmental changes, sea-level rise,
etc.) are usually neglected.
The mental health field in the country is becoming
increasingly active in developing mental health and
psychological resilience programs in the context of
disasters caused by natural hazards (Rocha et al.,
2021). However, how mental health problems are
conceptualised, and how programs to address these
problems are formulated, remain mostly oblivious of
the role of climate change as a predisposing and pre-
cipitating factor to mental health issues. This is con-
cerning given the emerging evidence that Filipinos,
especially the youth, are already experiencing extreme
levels of climate anxiety and other climate-related dis-
tress (Hickman et al., 2021).
The status of Filipino mental health workers
Efforts from various organisations are crucial, as men-
tal health professionals are bearing the brunt of the
climate crisis. The limited number of licenced individ-
uals who can offer their mental health expertise and
services will not be able to keep up with the increas-
ing need for mental health care due to climate-related
and climate change-induced distress in the coming
years (Hickman et al., 2021; Reyes et al., 2021). To
date, there are only around 4,200 registered guidance
counsellors, 1,600 registered psychologists, and 500
psychiatrists in the country, who are accommodating
the mental health needs of at least 110 million
Filipinos. However, it is important to note that not all
mental health professionals in the country are actively
practicing as a substantial number are based in aca-
demic settings, primarily involved in teaching and
administrative roles, exacerbating the problem of scar-
city of professional mental health providers.
Moreover, community providers and volunteers are
restricted in providing mental health support due to
existing laws, such as the Republic Act (RA) 9258 or
the Guidance and Counselling Act of 2004 and RA
10029 or the Philippine Psychology Act of 2009, that
prohibit non-licenced individuals from engaging in
any mental health practice.
Fortunately, the approval of the Mental Health Act
in 2018 provides opportunities for community-based
mental health workers to aid mental health professio-
nals. A mental health worker, according to the law, is
a trained person, volunteer, or advocate involved in
promoting mental health and providing support for
the delivery of mental health services, provided there
is close supervision from a mental health professional.
This can allow licenced psychologists, counsellors,
INTERNATIONAL REVIEW OF PSYCHIATRY 531
and psychiatrists to focus on providing the main
mental health services (e.g. assessment, diagnosis, and
interventions) while mental health workers aid in the
delivery of auxiliary and support services (e.g. screen-
ing, information campaigns, and program delivery).
It is important to note that mental health profes-
sionals themselves can also be at risk of developing
physical and mental health problems, resulting from
burnout, physical fatigue, and emotional exhaustion
(Aruta et al., 2022; Roxas et al., 2019). This can fur-
ther worsen the mental health workforce shortage and
even hinder effective mental health treatment out-
comes for their clients (Yang & Hayes, 2020). Mental
health professionals developing psychological prob-
lems may also suffer from discrimination within their
professional field and stigma from the public (Boyd
et al., 2016). All these problems can be further exacer-
bated in the context of a changing climate.
Hence, it is vital to protect mental health providers
who are at the frontlines in preserving people’s men-
tal health and well-being in times of adversity. We
propose that increasing the number of practicing
mental health professionals through strengthened and
expanded education and training can help lessen the
patient burden absorbed by very few mental health
workers. Moreover, creating provisions that can pro-
vide wellness support, coping, and rehabilitation to
mental health professionals must be an important
component of the country’s professional bodies and
regulations. More importantly, alleviating the burden
on the mental healthcare system and reducing the
need for mental health professionals through effective
mental health prevention interventions (e.g. prenatal/
early infancy projects, youth development, social sup-
port, resilience-building programs, etc.) made avail-
able to all sectors of society (i.e. children, youth,
adults, elderly, and minority groups) must be at the
centre of mental health policy and programming.
Emerging initiatives and capacity-building
opportunities
Furthermore, it is crucial to identify the upstream fac-
tors that influence the development, onset, and trig-
gering of mental health concerns (Kazdin, 2008).
However, addressing climate change as a predisposing
and precipitating factor to mental health problems is
much bigger than the individual mental health profes-
sional. Therefore, there is a dire need for mental
health professionals and policy-makers to broaden
their perspectives on mental health and recognise the
actual threat that the global climate crisis brings.
532 J. J. B. R. ARUTA ET AL.
Fortunately, there are recent steps taken by differ-
ent professional organisations to promote mental
health professionals’ awareness of climate change and
mental health nexus, with the hopes of further influ-
encing policy. For instance, the Environmental
Psychology Special Interest Group of the
Psychological Association of the Philippines
(EPSIGPAP) was established in March 2020.
EPSIGPAP primarily aims to promote the application
of psychology in protecting the natural environment
and to elucidate the linkages between ecosystems, cli-
mate change, and mental health. In 2021 and 2022,
the PAP has also started providing climate change
and mental health workshops to aspiring young psy-
chologists who are members of the Psychological
Association of the Philippines Junior Affiliates
(PAPJA), an association for undergraduate psychology
students in colleges and universities across the coun-
try (Psychological Association of the Philippines,
2022). Moreover, the upcoming PAP National
Conference in 2022 centres on the theme of climate
change and mental health, which can be a catalyst for
sparking greater interest in research and clinical and
counselling practice among psychologists and other
allied mental health experts in the Philippines.
Similarly, the Philippine Psychiatric Association fea-
tured the links between mental health, climate change,
and planetary health in its recently concluded annual
convention. Indeed, the steps taken by mental health
professional organisations demonstrate promising
progress in advocacy and practice around the climate
change and mental health nexus in the country. The
recent significant developments in the mental health
field in the Philippines including the passage of the
Mental Health Act and the actions taken by profes-
sional organisations to increase awareness and interest
in climate change and mental health nexus can serve
as lessons for other developing and climate-vulnerable
countries in advancing this nascent research and
action agenda in their respective contexts.
In addition, mental health professionals play a key
role in mitigating the detrimental effects of climate
change on the psychological health of many Filipinos
and in building emotional resilience in times of cli-
mate-related adversities. Hence, systemic changes,
widening of perspectives, and capacity-building in the
mental health profession are also critical in meeting
this end. We reason that one way is to push for
reforms in mental health graduate-level and other
training programs in the country’s higher education
system. The current “generalist” training on mental
health assessment, counselling, and psychotherapy can
be complemented with more specialised training that
includes evidence-based mental health approaches
within the context of climate change. Next, continu-
ing and strengthening the current efforts to highlight
climate change and mental health nexus in profes-
sional organisations in psychology and allied mental
health fields is necessary and can go a long way.
Capacity-building programs that aim to help mental
health professionals develop skills in addressing the
different mental health problems attributed to climate
change (e.g. climate anxiety, ecological grief, etc.)
must be developed and implemented. Furthermore,
building active research programs that explore the
nuanced psychological responses of Filipinos to both
proximal (e.g. increasing intensification of typhoons)
and distal consequences (sea-level rise, increasing
temperature, ecosystem loss) of climate change must
be established and supported.
Conclusion: the need for a system view
Finally, it is important to recognise that all these rec-
ommendations can never materialise if climate change
will not be viewed from a systems perspective (Berry
et al., 2018). That is, recognising that climate change
is a systemic problem that requires systemic solutions
and not only those that target the individual level.
Although individual-level interventions (e.g. psycho-
logical resilience-building, counselling, and psycho-
therapy) can be useful in addressing the mental
health consequences of climate change, these may
prove inadequate without identifying interconnections
of climate change with societal factors including the
economy and local and international politics, among
others, which should be the basis for changes in men-
tal health policies and interventions (Berry et al.,
2018). Research activities, interventions, and policies
must be directed towards different levels of society
(i.e. individual, family, community, society, culture) to
ensure the effective mitigation of climate change and
the successful preservation of people’s mental health.
With the slow pace of decarbonisation worldwide,
the climate emergency will, unfortunately, continue to
affect the mental health and well-being of Filipinos in
the coming years. Therefore, the country’s community
of mental health workers must embrace climate
change as part of its healing mission and step up its
efforts to respond to the emerging mental health
needs brought about by the climate crisis. The chal-
lenges raised in this commentary as well as the rec-
ommendations offered will hopefully provide the
basis for a more comprehensive mental health

framework that incorporates climate change and sup-
ports mental health providers in their pursuit to pre-
serve Filipino mental health on a warming planet.
Disclosure statement
The authors declared no competing interests.
ORCID
John Jamir Benzon R. Aruta http://orcid.org/0000-0003-
4155-1063
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