Advertisement

Advertisement

Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

  • Open access
  • Published: 20 August 2020
  • Volume 55 , pages 1397–1413, ( 2020 )

Cite this article

You have full access to this open access article

  • Andrea B. Martinez   ORCID: orcid.org/0000-0002-4437-769X 1 , 2 ,
  • Melissa Co 3 ,
  • Jennifer Lau 2 &
  • June S. L. Brown 2  

287k Accesses

51 Citations

143 Altmetric

18 Mentions

Explore all metrics

This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking.

Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis.

Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help.

We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

Similar content being viewed by others

research papers tagalog

Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review

Sophia Bohun Kim & Yeonjung Jane Lee

research papers tagalog

Predictors of Help-Seeking for Mental Health Treatment Among Latinos

Robin E. Gearing, Micki Washburn, … Luis R. Torres

Predictors of professional help-seeking for emotional problems in Afghan and Iraqi refugees in Australia: findings from the Building a New Life in Australia Database

Shameran Slewa-Younan, Pilar Rioseco, … Jonathan Mond

Avoid common mistakes on your manuscript.

Introduction

Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [ 1 ]. Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or misclassification of suicide cases as ‘undetermined deaths’ [ 2 ]. Despite these figures, government spending on mental health is at 0.22% of total health expenditures with a lack of health professionals working in the mental health sector [ 1 , 3 ]. Elevated mental health problems also characterise ‘overseas Filipinos’, that is, Filipinos living abroad [ 4 ]. Indeed, 12% of Filipinos living in the US suffer from psychological distress [ 5 ], higher than the US prevalence rate of depression and anxiety [ 1 ]. Long periods of separation from their families and a different cultural background may make them more prone to acculturative stress, depression, anxiety, substance use and trauma especially those who are exposed to abuse, violence and discrimination whilst abroad [ 6 ].

One crucial barrier to achieving well-being and improved mental health among both ‘local’ and overseas Filipinos is their propensity to not seek psychological help [ 7 , 8 ]. Not only are help-seeking rates much lower than rates found in general US populations [ 9 ], they are also low compared to other minority Asian groups [ 10 ]. Yet, few studies have been published on Filipino psychological help-seeking either in the Philippines or among those overseas [ 11 ]. Most available studies have focused on such factors as stigma tolerance, loss of face and acculturation factors [ 12 , 13 ].

To date, no systematic review of studies on Filipino psychological help-seeking, both living in the Philippines and overseas, has been conducted. In 2014, Tuliao conducted a narrative review of the literature on Filipino mental health help-seeking in the US which provided a comprehensive treatise on cultural context of Filipino help-seeking behavior [ 11 ]. However, new studies have been published since which examine help-seeking in other country contexts, such as Norway, Iceland, Israel and Canada [ 6 , 14 , 15 , 16 ]. Alongside recent studies on local Filipinos, these new studies can provide basis for comparison of the local and overseas Filipinos [ 7 , 8 , 12 , 17 ].

This systematic review aims to critically appraise the evidence on behavioural and attitudinal patterns of psychological help-seeking among Filipinos in the Philippines and abroad and examine barriers and enablers of their help-seeking. While the majority of studies undertaken have been among Filipino migrants especially in the US where they needed to handle additional immigration challenges, studying help-seeking attitudes and behaviours of local Filipinos is important as this may inform those living abroad [ 10 , 13 , 18 ]. This review aims to: (1) examine the commonly reported help-seeking attitudes and behaviors among local and overseas Filipinos with mental health problems; and (2) expound on the most commonly reported barriers and facilitators that influence their help-seeking.

The review aims to synthesize available data on formal help-seeking behavior and attitudes of local and overseas Filipinos for their mental health problems, as well as commonly reported barriers and facilitators. Formal psychological help-seeking behavior is defined as seeking services and treatment, such as psychotherapy, counseling, information and advice, from trained and recognized mental health care providers [ 19 ]. Attitudes on psychological help-seeking refer to the evaluative beliefs in seeking help from these professional sources [ 20 ].

Eligibility criteria

Inclusion criteria for the studies were the following: (1) those that address either formal help-seeking behavior OR attitude related to a mental health AND those that discuss barriers OR facilitators of psychological help-seeking; (2) those that involve Filipino participants, or of Filipino descent; in studies that involve multi-cultural or multi-ethnic groups, they must have at least 20% Filipino participants with disaggregated data on Filipino psychological help-seeking; (3) those that employed any type of study designs, whether quantitative, qualitative or mixed-methods; (4) must be full-text peer-reviewed articles published in scholarly journals or book chapters, with no publication date restrictions; (5) written either in English or Filipino; and (6) available in printed or downloadable format. Multiple articles based on the same research are treated as one study/paper.

Exclusion criteria were: (1) studies in which the reported problems that prompted help-seeking are medical (e.g. cancer), career or vocational (e.g., career choice), academic (e.g., school difficulties) or developmental disorders (e.g., autism), unless specified that there is an associated mental health concern (e.g., anxiety, depression, trauma); (2) studies that discuss general health-seeking behaviors; (3) studies that are not from the perspective of mental health service users (e.g., counselor’s perspective); (4) systematic reviews, meta-analyses and other forms of literature review; and (5) unpublished studies including dissertations and theses, clinical reports, theory or methods papers, commentaries or editorials.

Search strategy and study selection

The search for relevant studies was conducted through electronic database searching, hand-searching and web-based searching. Ten bibliographic databases were searched in August to September 2018: PsychInfo, Global Health, MedLine, Embase, EBSCO , ProQuest , PubMed , Science Direct, Scopus and Emerald Insight. The following search terms were used: “help-seeking behavior” OR “utilization of mental health services” OR “access to mental health services” OR “psychological help-seeking” AND “barriers to help-seeking” OR “facilitators of help-seeking” AND “mental health” OR “mental health problem” OR “mental disorder” OR “mental illness” OR “psychological distress” OR “emotional problem” AND “Filipino” OR “Philippines”. Filters were used to select only publications from peer-reviewed journals. Internet searches through Google Scholar and websites of Philippine-based publications were also performed using the search term “Filipino mental health help-seeking” as well as hand-searching of reference lists of relevant studies. A total of 3038 records were obtained. Duplicates were removed and a total of 2659 records were screened for their relevance based on their titles and abstracts.

Preliminary screening of titles and abstracts of articles resulted in 162 potentially relevant studies, their full-text papers were obtained and were reviewed for eligibility by two reviewers (AM and MC). Divergent opinions on the results of eligibility screening were deliberated and any further disagreement was resolved by the third reviewer (JB). A total of 15 relevant studies (from 24 papers) published in English were included in the review and assessed for quality. There were seven studies with multiple publications (two of them have 3 papers) and a core paper was chosen on the basis of having more comprehensive key study data on formal help-seeking. Results of the literature search are reported in Fig.  1 using the PRISMA diagram [ 21 ]. A protocol for this review was registered at PROSPERO Registry of the Centre for Reviews and Dissemination of the University of York ( https://www.crd.york.ac.uk/PROSPERO ; ID: CRD42018102836).

figure 1

PRISMA flow diagram

Data extraction and quality assessment

Data extracted by the main author were crosschecked by a second reviewer (JB). A data extraction table with thematic headings was prepared and pilot tested for two quantitative and two qualitative studies to check data comparability. Extraction was performed using the following descriptive data: (1) study information (e.g. name of authors, publication date, study location, setting, study design, measurement tools used); (2) socio-demographic characteristics of participants (e.g. sample size, age, gender); and (3) overarching themes on psychological help-seeking behavior and attitudes, as well as barriers and facilitators of help-seeking.

Two reviewers (AM and MC) did quality assessment of the studies separately, using the following criteria: (1) relevance to the research question; (2) transparency of the methods; (3) robustness of the evidence presented; and (4) soundness of the data interpretation and analysis. Design-specific quality assessment tools were used in the evaluation of risk of bias of the studies, namely: (1) Critical Appraisal Skills Programme Qualitative Checklist [ 22 ]; and (2) Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project [ 23 ]. The appraisals for mixed-methods studies were done separately for quantitative and qualitative components to ensure trustworthiness [ 24 ] of the quality of each assessment.

For studies reported in multiple publications, quality assessment was done only on the core papers [ 25 ]. All the papers ( n  = 6) assessed for their qualitative study design (including the 4 mixed-methods studies) met the minimum quality assessment criteria of fair ( n  = 1) and good ( n  = 5) and were, thus, included in the review. Only 11 out of the 13 quantitative studies (including the 4 mixed-methods studies) satisfied the minimum ratings for the review, with five getting strong quality rating. The two mixed-methods studies that did not meet the minimum quality rating for quantitative designs were excluded as sources of quantitative data but were used in the qualitative data analysis because they satisfied the minimum quality rating for qualitative designs.

Strategy for data analysis

Due to the substantial heterogeneity of the studies in terms of participant characteristics, study design, measurement tools used and reporting methods of the key findings, narrative synthesis approach was used in data analysis to interpret and integrate the quantitative and qualitative evidence [ 26 , 27 ]. However, one crucial methodological limitation of studies in this review is the lack of agreement on what constitutes formal help-seeking. Some researchers include the utilization of traditional or indigenous healers as formal help-seeking, while others limit the concept to professional health care providers. As such, consistent with Rickwood and Thomas’ definition of formal help-seeking [ 19 ], data extraction and analysis were done only on those that reported utilization of professional health care providers.

Using a textual approach, text data were coded using both predetermined and emerging codes [ 28 ]. They were then tabulated, analyzed, categorized into themes and integrated into a narrative synthesis [ 29 ]. Exemplar quotations and author interpretations were also used to support the narrative synthesis. The following were the themes on barriers and facilitators of formal help-seeking: (1) psychosocial barriers/facilitators, which include social support from family and friends, perceived severity of mental illness, awareness of mental health issues, self-stigmatizing beliefs, treatment fears and other individual concerns; (2) socio-cultural barriers/facilitators, which include the perceived social norms and beliefs on mental health, social stigma, influence of religious beliefs, and language and acculturation factors; and (3) systemic/structural and economic barriers/facilitators, which include financial or employment status, the health care system and its accessibility, availability and affordability, and ethnicity, nativity or immigration status.

Study and participant characteristics

The 15 studies were published between 2002 and 2018. Five studies were conducted in the US, four in the Philippines and one study each was done in Australia, Canada, Iceland, Israel and Norway. One study included participants working in different countries, the majority were in the Middle East. Data extracted from the four studies done in the Philippines were used to report on the help-seeking behaviors and attitudes, and barriers/facilitators to help-seeking of local Filipinos, while the ten studies conducted in different countries were used to report on help-seeking of overseas Filipinos. Nine studies were quantitative and used a cross-sectional design except for one cohort study; the majority of them used research-validated questionnaires. Four studies used mixed methods with surveys and open-ended questionnaires, and another two were purely qualitative studies that used interviews and focus group discussions. Only three studies recruited participants through random sampling and the rest used purposive sampling methods. All quantitative studies used questionnaires in measures of formal help-seeking behaviors, and western-standardized measures to assess participants’ attitudes towards help-seeking. Qualitative studies utilized semi-structured interview guides that were developed to explore the psychological help-seeking of participants.

A total of 5096 Filipinos aged 17–70 years participated in the studies. Additionally, 13 studies reported on the mean age of participants, with the computed overall mean age at 39.52 (SD 11.34). The sample sizes in the quantitative studies ranged from 70 to 2285, while qualitative studies ranged from 10 to 25 participants. Of the participants, 59% ( n  = 3012) were female which is probably explained by five studies focusing on Filipino women. Ten studies were conducted in community settings, five in health or social centre-based settings and 1 in a university (Table 1 ).

Formal help-seeking behaviors

12 studies examined the formal help-seeking behaviors of Filipinos (Table 2 ), eight of them were from community-based studies and four were from centre-based studies. Nine studies reported on formal help-seeking of overseas Filipinos and three reported on local Filipinos.

Community-based vs health/social centres Data from quantitative community studies show that the rates of formal help-seeking behaviors among the Filipino general population ranged from 2.2% [ 30 ] to 17.5% [ 6 ]. This was supported by reports from qualitative studies where participants did not seek help at all. The frequency of reports of formal help-seeking from studies conducted in crisis centres and online counseling tended to be higher. For instance, the rate of engagement in online counseling among overseas Filipinos was 10.68% [ 31 ], those receiving treatment in crisis centers was 39.32% [ 17 ] while 100% of participants who were victims of intimate partner violence were already receiving help from a women’s support agency [ 8 , 32 ].

Local vs overseas Filipinos’ formal help-seeking The rate of formal psychological help-seeking of local Filipinos was at 22.19% [ 12 ] while overseas rates were lower and ranged from 2.2% of Filipino Americans [ 30 ] to 17.5% of Filipinos in Israel [ 6 ]. Both local and overseas Filipinos indicated that professional help is sought only as a last resort because they were more inclined to get help from family and friends or lay network [ 7 , 16 ].

Attitudes towards formal help-seeking

13 studies reported on participants’ attitudes towards seeking formal help. Seven studies identified family and friends as preferred sources of help [ 7 , 14 , 16 ] rather than mental health specialists and other professionals even when they were already receiving help from them [ 17 , 32 ]. When Filipinos seek professional help, it is usually done in combination with other sources of care [ 13 ] or only used when the mental health problem is severe [ 14 , 16 , 33 ]. Other studies reported that in the absence of social networks, individuals prefer to rely on themselves [ 32 , 33 ].

Community-based vs health/social centres Community-based studies reported that Filipinos have negative attitudes marked by low stigma tolerance towards formal help-seeking [ 7 , 14 , 16 ]. However, different findings were reported by studies conducted in crisis centres. Hechanova et al. found a positive attitude towards help-seeking among users of online counseling [ 31 ], whereas Cabbigat and Kangas found that Filipinos in crisis centres still prefer receiving help from religious clergy or family members, with mental health units as the least preferred setting in receiving help [ 17 ]. This is supported by the findings of Shoultz and her colleagues who reported that Filipino women did not believe in disclosing their problems to others [ 32 ].

Local vs overseas Filipinos Filipinos, regardless of location, have negative attitudes towards help-seeking, except later-generation Filipino migrants who have been acculturated in their host countries and tended to have more positive attitudes towards mental health specialists [ 10 , 13 , 15 , 34 ]. However, this was only cited in quantitative studies. Qualitative studies reported the general reluctance of both overseas and local Filipinos to seek help.

Barriers in formal help-seeking

All 15 studies examined a range of barriers in psychological help-seeking (Table 3 ). The most commonly endorsed barriers were: (1) financial constraints due to high cost of service, lack of health insurance, or precarious employment condition; (2) self-stigma, with associated fear of negative judgment, sense of shame, embarrassment and being a disgrace, fear of being labeled as ‘crazy’, self-blame and concern for loss of face; and (3) social stigma that puts the family’s reputation at stake or places one’s cultural group in bad light.

Local vs overseas Filipinos In studies conducted among overseas Filipinos, strong adherence to Asian values of conformity to norms is an impediment to help-seeking but cited only in quantitative studies [ 10 , 13 , 15 , 34 ] while perceived resilience, coping ability or self-reliance was mentioned only in qualitative studies [ 14 , 16 , 33 ]. Other common barriers to help-seeking cited by overseas Filipinos were inaccessibility of mental health services, immigration status, sense of religiosity, language problem, experience of discrimination and lack of awareness of mental health needs [ 10 , 13 , 18 , 34 ]. Self-reliance and fear of being a burden to others as barriers were only found among overseas Filipinos [ 6 , 16 , 32 ]. On the other hand, local Filipinos have consistently cited the influence of social support as a hindrance to help-seeking [ 7 , 17 ].

Stigmatized attitude towards mental health and illness was reported as topmost barriers to help-seeking among overseas and local Filipinos. This included notions of mental illness as a sign of personal weakness or failure of character resulting to loss of face. There is a general consensus in these studies that the reluctance of Filipinos to seek professional help is mainly due to their fear of being labeled or judged negatively, or even their fear of fueling negative perceptions of the Filipino community. Other overseas Filipinos were afraid that having mental illness would affect their jobs and immigration status, especially for those who are in precarious employment conditions [ 6 , 16 ].

Facilitators of formal help-seeking

All 15 studies discussed facilitators of formal help-seeking, but the identified enablers were few (Table 4 ). Among the top and commonly cited factors that promote help-seeking are: (1) perceived severity of the mental health problem or awareness of mental health needs; (2) influence of social support, such as the presence/absence of family and friends, witnessing friends seeking help, having supportive friends and family who encourage help-seeking, or having others taking the initiative to help; and (3) financial capacity.

Local vs overseas Filipinos Studies on overseas Filipinos frequently cited financial capacity, immigration status, language proficiency, lower adherence to Asian values and stigma tolerance as enablers of help-seeking [ 15 , 30 , 32 , 34 ], while studies done on local Filipinos reported that awareness of mental health issues and previous positive experience of seeking help serve as facilitator [ 7 , 12 ].

Community-based vs health/social centres Those who were receiving help from crisis centres mentioned that previous positive experience with mental health professionals encouraged their formal help-seeking [ 8 , 17 , 31 ]. On the other hand, community-based studies cited the positive influence of encouraging family and friends as well as higher awareness of mental health problems as enablers of help-seeking [ 12 , 14 , 16 ].

To the best of our knowledge, this is the first systematic review conducted on psychological help-seeking among Filipinos, including its barriers and facilitators. The heterogeneity of participants (e.g., age, gender, socio-economic status, geographic location or residence, range of mental health problems) was large.

Filipino mental health help-seeking behavior and attitudes The rate of mental health problems appears to be high among Filipinos both local and overseas, but the rate of help-seeking is low. This is consistent with findings of a study among Chinese immigrants in Australia which reported higher psychological distress but with low utilization of mental health services [ 35 ]. The actual help-seeking behavior of both local and overseas Filipinos recorded at 10.72% ( n  = 461) is lower than the 19% of the general population in the US [ 36 ] and 16% in the United Kingdom (UK) [ 37 ], and even far below the global prevalence rate of 30% of people with mental illness receiving treatment [ 38 ]. This finding is also comparable with the low prevalence rate of mental health service use among the Chinese population in Hong Kong [ 39 ] and in Australia [ 35 ], Vietnamese immigrants in Canada [ 30 ], East Asian migrants in North America [ 41 ] and other ethnic minorities [ 42 ] but is in sharp contrast with the increased use of professional help among West African migrants in The Netherlands [ 43 ].

Most of the studies identified informal help through family and friends as the most widely utilized source of support, while professional service providers were only used as a last resort. Filipinos who are already accessing specialist services in crisis centres also used informal help to supplement professional help. This is consistent with reports on the frequent use of informal help in conjunction with formal help-seeking among the adult population in UK [ 44 ]. However, this pattern contrasts with informal help-seeking among African Americans who are less likely to seek help from social networks of family and friends [ 45 ]. Filipinos also tend to use their social networks of friends and family members as ‘go-between’ [ 46 ] for formal help, serving to intercede between mental health specialists and the individual. This was reiterated in a study by Shoultz et al. (2009) in which women who were victims of violence are reluctant to report the abuse to authorities but felt relieved if neighbours and friends would interfere for professional help in their behalf [ 32 ].

Different patterns of help-seeking among local and overseas Filipinos were evident and may be attributed to the differences in the health care system of the Philippines and their host countries. For instance, the greater use of general medical services by overseas Filipinos is due to the gatekeeper role of general practitioners (GP) in their host countries [ 47 ] where patients have to go through their GPs before they get access to mental health specialists. In contrast, local Filipinos have direct access to psychiatrists or psychologists without a GP referral. Additionally, those studies conducted in the Philippines were done in urban centers where participants have greater access to mental health specialists. While Filipinos generally are reluctant to seek help, later-generation overseas Filipinos have more positive attitudes towards psychological help-seeking. Their exposure and acculturation to cultures that are more tolerant of mental health stigma probably influenced their more favorable attitude [ 41 , 48 ].

Prominent barrier themes in help-seeking Findings of studies on frequently endorsed barriers in psychological help-seeking are consistent with commonly reported impediments to health care utilization among Filipino migrants in Australia [ 49 ] and Asian migrants in the US [ 47 , 50 ]. The same barriers in this review, such as preference for self-reliance as alternative coping strategy, poor mental health awareness, perceived stigma, are also identified in mental health help-seeking among adolescents and young adults [ 51 ] and among those suffering from depression [ 52 ].

Social and self-stigmatizing attitudes to mental illness are prominent barriers to help-seeking among Filipinos. Social stigma is evident in their fears of negative perception of the Filipino community, ruining the family reputation, or fear of social exclusion, discrimination and disapproval. Self-stigma manifests in their concern for loss of face, sense of shame or embarrassment, self-blame, sense of being a disgrace or being judged negatively and the notion that mental illness is a sign of personal weakness or failure of character [ 16 ]. The deterrent role of mental health stigma is consistent with the findings of other studies [ 51 , 52 ]. Overseas Filipinos who are not fully acculturated to the more stigma-tolerant culture of their host countries still hold these stigmatizing beliefs. There is also a general apprehension of becoming a burden to others.

Practical barriers to the use of mental health services like accessibility and financial constraints are also consistently rated as important barriers by Filipinos, similar to Chinese Americans [ 53 ]. In the Philippines where mental health services are costly and inaccessible [ 54 ], financial constraints serve as a hindrance to formal help-seeking, as mentioned by a participant in the study of Straiton and his colleagues, “In the Philippines… it takes really long time to decide for us that this condition is serious. We don’t want to use our money right away” [ 14 , p.6]. Local Filipinos are confronted with problems of lack of mental health facilities, services and professionals due to meager government spending on health. Despite the recent ratification of the Philippines’ Mental Health Act of 2018 and the Universal Health Care Act of 2019, the current coverage for mental health services provided by the Philippine Health Insurance Corporation only amounts to US$154 per hospitalization and only for acute episodes of mental disorders [ 55 ]. Specialist services for mental health in the Philippines are restricted in tertiary hospitals located in urban areas, with only one major mental hospital and 84 psychiatric units in general hospitals [ 1 ].

Overseas Filipinos cited the lack of health insurance and immigration status without health care privileges as financial barrier. In countries where people have access to universal health care, being employed is a barrier to psychological help-seeking because individuals prefer to work instead of attending medical check-ups or consultations [ 13 ]. Higher income is also associated with better mental health [ 56 ] and hence, the need for mental health services is low, whereas poor socio-economic status is related to greater risk of developing mental health problems [ 57 , 58 ]. Lack of familiarity with healthcare system in host countries among new Filipino migrants also discourages them from seeking help.

Studies have shown that reliance on, and accessibility of sympathetic, reliable and trusted family and friends are detrimental to formal help-seeking since professional help is sought only in the absence of this social support [ 6 , 8 ]. This is consistent with the predominating cultural values that govern Filipino interpersonal relationships called kapwa (or shared identity) in which trusted family and friends are considered as “hindi-ibang-tao” (one-of-us/insider), while doctors or professionals are seen as “ibang-tao” (outsider) [ 59 ]. Filipinos are apt to disclose and be more open and honest about their mental illness to those whom they considered as “hindi-ibang-tao” (insider) as against those who are “ibang-tao” (outsider), hence their preference for family members and close friends as source of informal help [ 59 ]. For Filipinos, it is difficult to trust a mental health specialist who is not part of the family [ 60 ].

Qualitative studies in this review frequently mentioned resilience and self-reliance among overseas Filipinos as barriers to help-seeking. As an adaptive coping strategy for adversity [ 61 ], overseas Filipinos believe that they were better equipped in overcoming emotional challenges of immigration [ 16 ] without professional assistance [ 14 ]. It supports the findings of studies on overseas Filipino domestic workers who attributed their sense of well-being despite stress to their sense of resilience which prevents them from developing mental health problems [ 62 ] and among Filipino disaster survivors who used their capacity to adapt as protective mechanism from experience of trauma [ 63 ]. However, self-reliant individuals also tend to hold stigmatizing beliefs on mental health and as such resort to handling problems on their own instead of seeking help [ 51 , 64 ].

Prominent facilitator themes in help-seeking In terms of enablers of psychological help-seeking, only a few facilitators were mentioned in the studies, which supported findings in other studies asserting that factors that promote help-seeking are less often emphasized [ 42 , 51 ].

Consistent with other studies [ 44 , 49 ], problem severity is predictive of intention to seek help from mental health providers [ 18 , 30 ] because Filipinos perceive that professional services are only warranted when symptoms have disabling effects [ 5 , 53 ]. As such, those who are experiencing heightened emotional distress were found to be receptive to intervention [ 17 ]. In most cases, symptom severity is determined only when somatic or behavioral symptoms manifest [ 13 ] or occupational dysfunction occurs late in the course of the mental illness [ 65 ]. This is most likely due to the initial denial of the problem [ 66 ] or attempts at maintaining normalcy of the situation as an important coping mechanism [ 67 ]. Furthermore, this poses as a hindrance to any attempts at early intervention because Filipinos are likely to seek professional help only when the problem is severe or has somatic manifestations. It also indicates the lack of preventive measure to avert any deterioration in mental health and well-being.

More positive attitudes towards help-seeking and higher rates of mental health care utilization have been found among later-generation Filipino immigrants or those who have acquired residency status in their host country [ 10 , 15 ]. Immigration status and length of stay in the host country are also associated with language proficiency, higher acculturation and familiarity with the host culture that are more open to discussing mental health issues [ 13 ], which present fewer barriers in help-seeking. This is consistent with facilitators of formal help-seeking among other ethnic minorities, such as acculturation, social integration and positive attitude towards mental health [ 43 ].

Cultural context of Filipinos’ reluctance to seek help Several explanations have been proposed to account for the general reluctance of Filipinos to seek psychological help. In Filipino culture, mental illness is attributed to superstitious or supernatural causes, such as God’s will, witchcraft, and sorcery [ 68 , 69 ], which contradict the biopsychosocial model used by mental health care professionals. Within this cultural context, Filipinos prefer to seek help from traditional folk healers who are using religious rituals in their healing process instead of availing the services of professionals [ 70 , 71 ]. This was reaffirmed by participants in the study of Thompson and her colleagues who said that “psychiatrists are not a way to deal with emotional problems” [ 74 , p.685]. The common misconception on the cause and nature of mental illness, seeing it as temporary due to cold weather [ 14 ] or as a failure in character and as an individual responsibility to overcome [ 16 , 72 ] also discourages Filipinos from seeking help.

Synthesis of the studies included in the review also found conflicting findings on various cultural and psychosocial influences that served both as enablers and deterrents to Filipino help-seeking, namely: (1) level of spirituality; (2) concern on loss of face or sense of shame; and (3) presence of social support.

Level of spirituality Higher spirituality or greater religious beliefs have disparate roles in Filipino psychological help-seeking. Some studies [ 8 , 14 , 16 ] consider it a hindrance to formal help-seeking, whereas others [ 10 , 15 ] asserted that it can facilitate the utilization of mental health services [ 15 , 73 ]. Being predominantly Catholics, Filipinos had drawn strength from their religious faith to endure difficult situations and challenges, accordingly ‘leaving everything to God’ [ 74 ] which explains their preference for clergy as sources of help instead of professional mental health providers. This is connected with the Filipino attribution of mental illness to spiritual or religious causes [ 62 ] mentioned earlier. On the contrary, Hermansdottir and Aegisdottir argued that there is a positive link between spirituality and help-seeking, and cited connectedness with host culture as mediating factor [ 15 ]. Alternately, because higher spirituality and religiosity are predictors of greater sense of well-being [ 75 ], there is, thus, a decreased need for mental health services.

Concern on loss of face or sense of shame The enabler/deterrent role of higher concern on loss of face and sense of shame on psychological help-seeking was also identified. The majority of studies in this review asserted the deterrent role of loss of face and stigma consistent with the findings of other studies [ 51 ], although Clement et al. stated that stigma is the fourth barrier in deterring help-seeking [ 76 ]. Mental illness is highly stigmatized in the Philippines and to avoid the derogatory label of ‘crazy’, Filipinos tend to conceal their mental illness and consequently avoid seeking professional help. This is aligned with the Filipino value of hiya (sense of propriety) which considers any deviation from socially acceptable behavior as a source of shame [ 11 ]. The stigmatized belief is reinforced by the notion that formal help-seeking is not the way to deal with emotional problems, as reflected in the response of a Filipino participant in the study by Straiton et. al., “It has not occurred to me to see a doctor for that kind of feeling” [ 14 , p.6]. However, other studies in this review [ 12 , 13 ] posited contrary views that lower stigma tolerance and higher concern for loss of face could also motivate psychological help-seeking for individuals who want to avoid embarrassing their family. As such, stigma tolerance and loss of face may have a more nuanced influence on help-seeking depending on whether the individual avoids the stigma by not seeking help or prevent the stigma by actively seeking help.

Presence of social support The contradictory role of social networks either as helpful or unhelpful in formal help-seeking was also noted in this review. The presence of friends and family can discourage Filipinos from seeking professional help because their social support serves as protective factor that buffer one’s experience of distress [ 77 , 78 ]. Consequently, individuals are less likely to use professional services [ 42 , 79 ]. On the contrary, other studies have found that the presence of friends and family who have positive attitudes towards formal help-seeking can promote the utilization of mental health services [ 8 , 80 ]. Friends who sought formal help and, thus, serve as role models [ 14 ], and those who take the initiative in seeking help for the distressed individual [ 32 ] also encourage such behavior. Thus, the positive influence of friends and family on mental health and formal help-seeking of Filipinos is not merely to serve only as emotional buffer for stress, but to also favourably influence the decision of the individual to seek formal help.

Research implications of findings

This review highlights particular evidence gaps that need further research: (1) operationalization of help-seeking behavior as a construct separating intention and attitude; (2) studies on actual help-seeking behavior among local and overseas Filipinos with identified mental health problems; (3) longitudinal study on intervention effectiveness and best practices; (4) studies that triangulate findings of qualitative studies with quantitative studies on the role of resilience and self-reliance in help-seeking; and (5) factors that promote help-seeking.

Some studies in this review reported help-seeking intention or attitude as actual behaviors even though they are separate constructs, hence leading to reporting biases and misinterpretations. For instance, the conflicting findings of Tuliao et al. [ 12 ] on the negative association of loss of face with help-seeking attitude and the positive association between loss of face and intention to seek help demonstrate that attitudes and intentions are separate constructs and, thus, need further operationalization. Future research should strive to operationalize concretely these terms through the use of robust measurement tools and systematic reporting of results. There is also a lack of data on the actual help-seeking behaviors among Filipinos with mental illness as most of the reports were from the general population and on their help-seeking attitudes and intentions. Thus, research should focus on those with mental health problems and their actual utilization of healthcare services to gain a better understanding of how specific factors prevent or promote formal help-seeking behaviors.

Moreover, the majority of the studies in this review were descriptive cross-sectional studies, with only one cohort analytic study. Future research should consider a longitudinal study design to ensure a more rigorous and conclusive findings especially on testing the effectiveness of interventions and documenting best practices. Because of the lack of quantitative research that could triangulate the findings of several qualitative studies on the detrimental role of resilience and self-reliance, quantitative studies using pathway analysis may help identify how these barriers affect help-seeking. A preponderance of studies also focused on discussing the roles of barriers in help-seeking, but less is known about the facilitators of help-seeking. For this reason, factors that promote help-seeking should be systematically investigated.

Practice, service delivery and policy implications

Findings of this review also indicate several implications for practice, service delivery, intervention and policy. Cultural nuances that underlie help-seeking behavior of Filipinos, such as the relational orientation of their interactions [ 81 ], should inform the design of culturally appropriate interventions for mental health and well-being and improving access and utilization of health services. Interventions aimed at improving psychological help-seeking should also target friends and family as potential and significant influencers in changing help-seeking attitude and behavior. They may be encouraged to help the individual to seek help from the mental health professional. Other approaches include psychoeducation that promotes mental health literacy and reduces stigma which could be undertaken both as preventive and treatment strategies because of their positive influence on help-seeking. Strategies to reduce self-reliance may also be helpful in encouraging help-seeking.

This review also has implications for structural changes to overcome economic and other practical barriers in Filipino seeking help for mental health problems. Newly enacted laws on mental health and universal healthcare in the Philippines may jumpstart significant policy changes, including increased expenditure for mental health treatment.

Since lack of awareness of available services was also identified as significant barrier, overseas Filipinos could be given competency training in utilizing the health care system of host countries, possibly together with other migrants and ethnic minorities. Philippine consular agencies in foreign countries should not merely only resort to repatriation acts, but could also take an active role in service delivery especially for overseas Filipinos who experience trauma and/or may have immigration-related constraints that hamper their access to specialist care.

Limitations of findings

A crucial limitation of studies in this review is the use of different standardized measures of help-seeking that render incomparable results. These measures were western-based inventories, and only three studies mentioned using cultural validation, such as forward-and-back-translations, to adapt them to cross-cultural research on Filipino participants. This may pose as a limitation on the cultural appropriateness and applicability of foreign-made tests [ 73 ] in capturing the true essence of Filipino experience and perspectives [ 74 ]. Additionally, the majority of the studies used non-probability sampling that limits the generalizability of results. They also failed to measure the type of assistance or actual support sought by Filipinos, such as psychoeducation, referral services, supportive counseling or psychotherapy, and whether or not they are effective in addressing mental health concerns of Filipinos. Another inherent limitation of this review is the lack of access to grey literature, such as thesis and dissertations published in other countries, or those published in the Philippines and are not available online. A number of studies on multi-ethnic studies with Filipino participants do not provide disaggregated data, which limits the scope and inclusion of studies in this review.

This review has confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as a primary barrier resilience and self-reliance as coping strategies were also cited, especially in qualitative studies, but may be important in addressing issues of non-utilization of mental health services. Social support and problem severity were cited as prominent facilitators in help-seeking. However, different structural, cultural and practical barriers and facilitators of psychological help-seeking between overseas and local Filipinos were also found.

WHO (2017) Mental health atlas 2017. World Health Organization

Redaniel MT, Lebanan-Dalida MA, Gunnell D (2011) Suicide in the Philippines: time trend analysis (1974–2005) and literature review. BMC Public Health 11(1):536

Article   PubMed   PubMed Central   Google Scholar  

WHO (2011) Mental health atlas 2011. World Health Organization

Nguyen D, Bornheimer LA (2014) Mental health service use types among Asian Americans with a psychiatric disorder: Considerations of culture and need. J Behav Health Serv Res 41(4):520–528

Article   PubMed   Google Scholar  

Nicdao EG, Duldulao AA, Takeuchi DT (2015) Psychological distress, nativity, and help-seeking among Filipino Americans. In: Education, social factors, and health beliefs in health and health care services. Emerald Group Publishing Limited, pp 107–120

Green O, Ayalon L (2016) Whom do migrant home care workers contact in the case of work-related abuse? An exploratory study of help-seeking behaviors. J Interpers Violence 31(19):3236–3256

Ho GW, Bressington D, Leung SF, Lam K, Leung A, Molassiotis A et al (2018) Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study. Soc Psychiatry Psychiatr Epidemiol 53(10):1039–1049

Bernardo AB, Estrellado AF (2017) Locus-of-hope and help-seeking intentions of Filipino women victims of intimate partner violence. Curr Psychol 36(1):66–75

Article   Google Scholar  

Kessler RC, Frank RG, Edlund M, Katz SJ, Lin E, Leaf P (1997) Differences in the use of psychiatric outpatient services between the United States and Ontario. N Engl J Med 336(8):551–557

Article   CAS   PubMed   Google Scholar  

Abe-Kim J, Takeuchi DT, Hong S, Zane N, Sue S, Spencer MS et al (2007) Use of mental health–related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American study. Am J Public Health 97(1):91–98

Tuliao AP (2014) Mental health help seeking among Filipinos: a review of the literature. Asia Pac J Couns Psychother 5(2):124–136

Google Scholar  

Tuliao AP, Velasquez PAE, Bello AM, Pinson MJT (2016) Intent to seek counseling among Filipinos: examining loss of face and gender. Couns Psychol 44(3):353–382

Gong F, Gage SL, Tacata LA Jr (2003) Helpseeking behavior among Filipino Americans: a cultural analysis of face and language. J Community Psychol 31(5):469–488

Straiton ML, Ledesma HML, Donnelly TT (2018) “It has not occurred to me to see a doctor for that kind of feeling”: a qualitative study of Filipina immigrants’ perceptions of help seeking for mental health problems. BMC Women’s Health 18(1):73

Hermannsdóttir BS, Aegisdottir S (2016) Spirituality, connectedness, and beliefs about psychological services among filipino immigrants in Iceland. Counsel Psychol 44(4):546–572

Vahabi M, Wong JP (2017) Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada. BMC Public Health 17(1):498

Cabbigat FK, Kangas M (2018) Help-seeking behaviors in non-offending caregivers of abused children in the Philippines. J Aggress Maltreat Trauma 27(5):555–573

Nguyen D, Lee R (2012) Asian immigrants' mental health service use: an application of the life course perspective. Asian Am J Psychol 3(1):53

Rickwood D, Thomas K (2012) Conceptual measurement framework for help-seeking for mental health problems. Psychol Res Behav Manag 5:173

Divin N, Harper P, Curran E, Corry D, Leavey G (2018) Help-seeking measures and their use in adolescents: a systematic review. Adolesc Res Rev 3:113–122

Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097

Singh J (2013) Critical appraisal skills programme. J Pharmacol Pharmacotherapeutics 4(1):76

E Effective Public Health Practice Project (1998) Quality assessment tool for quantitative studies

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P et al (2018) The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf 34(4):285–291

Boland A, Cherry G, Dickson R (2017) Doing a systematic review: a student's guide. Sage, Thousand Oaks

Charrois TL (2015) Systematic reviews: what do you need to know to get started? Can J Hosp Pharm 68(2):144

PubMed   PubMed Central   Google Scholar  

Sandelowski M, Barroso J, Voils CI (2007) Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Res Nurs Health 30(1):99–111

Cresswell J, Cresswell D (2018) Research design: Qualitative, quantitative and mixed methods approaches. SAGE, London

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, Britten N, Roen K, Duffy S (2006) Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme Version 1:b92

Nguyen D (2011) Acculturation and perceived mental health need among older Asian immigrants. J Behav Health Serv Res 38(4):526–533

Hechanova MRM, Tuliao AP, Teh LA, Alianan AS, Acosta A (2013) Problem severity, technology adoption, and intent to seek online counseling among overseas Filipino workers. Cyberpsychol Behav Soc Netw 16(8):613–617

Shoultz J, Magnussen L, Manzano H, Arias C, Spencer C (2010) Listening to Filipina women: perceptions, responses and needs regarding intimate partner violence. Issues Ment Health Nurs 31(1):54–61

Thompson S, Manderson L, Woelz-Stirling N, Cahill A, Kelaher M (2002) The social and cultural context of the mental health of Filipinas in Queensland. Aust N Z J Psychiatry 36(5):681–687

David E (2010) Cultural mistrust and mental health help-seeking attitudes among Filipino Americans. Asian Am J Psychol 1(1):57

Lu SH, Dear BF, Johnston L, Wootton BM, Titov N (2014) An internet survey of emotional health, treatment seeking and barriers to accessing mental health treatment among Chinese-speaking international students in Australia. Couns Psychol Q 27(1):96–108

Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry 59(1):77–84

Oliver MI, Pearson N, Coe N, Gunnell D (2005) Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. Br J Psychiatry 186(4):297–301

Henderson C, Evans-Lacko S, Thornicroft G (2013) Mental illness stigma, help seeking, and public health programs. Am J Public Health 103(5):777–780

Mo PK, Mak WW (2009) Help-seeking for mental health problems among Chinese. Soc Psychiatry Psychiatr Epidemiol 44(8):675–684

Kirmayer LJ, Weinfeld M, Burgos G, Du Fort GG, Lasry J, Young A (2007) Use of health care services for psychological distress by immigrants in an urban multicultural milieu. Can J Psychiatry 52(5):295–304

Na S, Ryder AG, Kirmayer LJ (2016) Toward a culturally responsive model of mental health literacy: facilitating help-seeking among East Asian immigrants to North America. Am J Community Psychol 58(1–2):211–225

Li W, Dorstyn DS, Denson LA (2016) Predictors of mental health service use by young adults: a systematic review. Psychiatric Serv 67(9):946–956

Knipscheer JW, Kleber RJ (2008) Help-seeking behavior of west African Migrants. J Community Psychol 36(7):915–928

Brown JS, Evans-Lacko S, Aschan L, Henderson MJ, Hatch SL, Hotopf M (2014) Seeking informal and formal help for mental health problems in the community: a secondary analysis from a psychiatric morbidity survey in South London. BMC Psychiatry 14(1):275

Snowden LR (1998) Racial differences in informal help seeking for mental health problems. J Community Psychol 26(5):429–438

Pasco ACY, Morse JM, Olson JK (2004) Cross-cultural relationships between nurses and Filipino Canadian patients. J Nurs Scholarsh 36(3):239–246

Clough J, Lee S, Chae DH (2013) Barriers to health care among Asian immigrants in the United States: a traditional review. J Health Care Poor Underserved 24(1):384–403

Ihara ES, Chae DH, Cummings JR, Lee S (2014) Correlates of mental health service use and type among Asian Americans. Adm Policy Mental Health Mental Health Serv Res 41(4):543–551

Maneze D, DiGiacomo M, Salamonson Y, Descallar J, Davidson PM (2015) Facilitators and barriers to health-seeking behaviours among Filipino migrants: inductive analysis to inform health promotion. BioMed Res Int 2015:506269

Article   CAS   PubMed   PubMed Central   Google Scholar  

Choi JY (2009) Contextual effects on health care access among immigrants: Lessons from three ethnic communities in Hawaii. Soc Sci Med 69(8):1261–1271

Gulliver A, Griffiths KM, Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10(1):113

Doblyte S, Jiménez-Mejías E (2017) Understanding help-seeking behavior in depression: a qualitative synthesis of patients’ experiences. Qual Health Res 27(1):100–113

Kung WW (2004) Cultural and practical barriers to seeking mental health treatment for Chinese Americans. J Community Psychol 32(1):27–43

Saxena S, Thornicroft G, Knapp M, Whiteford H (2007) Resources for mental health: scarcity, inequity, and inefficiency. Lancet 370(9590):878–889

Tomacruz S (2018) PhilHealth should cover psychiatric consultation fees—Angara. Rappler. https://www.rappler.com/nation/204570-senator-sonny-angara-philhealth-consultation-fees-mental-illnesses . Accessed 22 Oct 2019

Cuesta MB, Budría S (2015) Income deprivation and mental well-being: the role of non-cognitive skills. Econ Human Biol 17:16–28

Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31

Pereira B, Andrew G, Pednekar S, Pai R, Pelto P, Patel V (2007) The explanatory models of depression in low income countries: listening to women in India. J Affect Disord 102(1–3):209–218

Pe‐Pua R, Protacio‐Marcelino EA (2000) Sikolohiyang Pilipino (Filipino psychology): a legacy of Virgilio G. Enriquez. Asian J Soc Psychol 3(1):49–71. https://doi.org/10.1111/1467-839X.00054

Schumacher HE, Guthrie GM (1984) Culture and counseling in the Philippines. Int J Intercult Relat 8(3):241–253

Luthar S, Cicchetti D (2000) The construct of resilience: implications for interventions and social policies. Dev Psychopathol 12:857–885

Article   PubMed Central   Google Scholar  

van der Ham AJ, Ujano-Batangan MT, Ignacio R, Wolffers I (2014) Toward healthy migration: an exploratory study on the resilience of migrant domestic workers from the Philippines. Transcult Psychiatry 51(4):545–568

Hechanova MRM, Waelde LC, Docena PS, Alampay LP, Alianan AS, Flores MJB et al (2015) The development and initial evaluation of Katatagan: a resilience intervention for Filipino disaster survivors. Philipp J Psychol 48(2):105–131

Jennings KS, Cheung JH, Britt TW, Goguen KN, Jeffirs SM, Peasley AL et al (2015) How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model. Psychiatr Rehabil J 38(2):109

Huang ZJ, Wong FY, Ronzio CR, Yu SM (2007) Depressive symptomatology and mental health help-seeking patterns of U.S.- and foreign-born mothers. Matern Child Health J 11(3):257–267

Ali K, Farrer L, Fassnacht DB, Gulliver A, Bauer S, Griffiths KM (2017) Perceived barriers and facilitators towards help-seeking for eating disorders: a systematic review. Int J Eat Disord 50(1):9–21

Straiton ML, Ledesma HML, Donnelly TT (2017) A qualitative study of Filipina immigrants’ stress, distress and coping: the impact of their multiple, transnational roles as women. BMC Womens Health 17(1):72

Tan ML, Tan MT (2008) Revisiting usog, pasma, kulam. UP Press, Quezon City

Edman JL, Kameoka VA (1997) Cultural differences in illness schemas: an analysis of Filipino and American illness attributions. J Cross Cult Psychol 28(3):252–265

Hwang W, Miranda J, Chung C (2007) Psychosis and shamanism in a Filipino–American immigrant. Cult Med Psychiatry 31(2):251–269

Lovering S (2006) Cultural attitudes and beliefs about pain. J Transcult Nurs 17(4):389–395

Thompson S, Hartel G, Manderson L, Stirling N, Kelaher M (2002) The mental health status of Filipinas in Queensland. Aust N Z J Psychiatry 36(5):674–680

Abe-Kim J, Gong F, Takeuchi D (2004) Religiosity, spirituality, and help-seeking among Filipino Americans: religious clergy or mental health professionals? J Community Psychol 32(6):675–689

Lagman RA, Yoo GJ, Levine EG, Donnell KA, Lim HR (2014) “Leaving it to God” religion and spirituality among Filipina immigrant breast cancer survivors. J Relig Health 53(2):449–460

Cohen AB (2002) The importance of spirituality in well-being for Jews and Christians. J Happiness Stud 3(3):287–310

Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N et al (2015) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 45(1):11–27

Gee GC, Chen J, Spencer MS, See S, Kuester OA, Tran D et al (2006) Social support as a buffer for perceived unfair treatment among Filipino Americans: differences between San Francisco and Honolulu. Am J Public Health 96(4):677–684

Coker AL, Smith PH, Thompson MP, McKeown RE, Bethea L, Davis KE (2002) Social support protects against the negative effects of partner violence on mental health. J Womens Health Gend Based 11(5):465–476

Miville ML, Constantine MG (2006) Sociocultural predictors of psychological help-seeking attitudes and behavior among Mexican American college students. Cult Divers Ethnic Minority Psychol 12(3):420

Tuliao AP, Velasquez PAE (2017) Online counselling among Filipinos: do Internet-related variables matter? Asia Pac J Couns Psychother 8(1):53–65

Mujtaba BG, Balboa A (2009) Comparing Filipino and American task and relationship orientations. J Appl Manag Entrepreneurship 14(2):82

Download references

Author information

Authors and affiliations.

Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines

Andrea B. Martinez

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

Andrea B. Martinez, Jennifer Lau & June S. L. Brown

Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Andrea B. Martinez .

Ethics declarations

Conflict of interest.

The authors declare that they have no conflict of interests in this work.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Martinez, A.B., Co, M., Lau, J. et al. Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review. Soc Psychiatry Psychiatr Epidemiol 55 , 1397–1413 (2020). https://doi.org/10.1007/s00127-020-01937-2

Download citation

Received : 03 January 2020

Accepted : 07 August 2020

Published : 20 August 2020

Issue Date : November 2020

DOI : https://doi.org/10.1007/s00127-020-01937-2

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Help-seeking
  • Mental health service use
  • Barriers and facilitators
  • Mental health
  • Philippines
  • Find a journal
  • Publish with us
  • Track your research

Philippine E-Journals

Bridging ideas. Empowering innovation.

About Philippine E-Journals

Newly published journals.

Other Published Journals

Previous_Frame

Dangal Research Journal

research papers tagalog

Science and Technology Journal

The s&t journal is a semi-annual refereed publication for multi-disciplinary research studies. it features articles advancing the knowledge of natural and applied sciences, trade and industry, health ....

research papers tagalog

iCONNECT Multidisciplinary Research Journal

Iconnect multidisciplinary research journal is the official research journal of iacademy through the office of research & development. all research and creative articles published in this journal ar....

research papers tagalog

DINSULAN – sa Ingles ay “inkwell”, ang sisidlan ng tinta upang ang manunulat ay makabuo ng mga ideya. Nagsisilbi itong lunsaran ng kaisipan ng mga manunulat upang maisatitik ang mga makabuluha...

research papers tagalog

Newly Published Issues

Other Published Issues

PUP Journal of Science and Technology

The pup journal of science and technology (pupjst) is a chedaccredited, double-blind, peer reviewed journal that publishes original articles on theor... vol 12, no. 1, 2019 january 2019 - april 16, 2024.

Thumbnail2

Universal Journal of Educational Research

Universal journal of educational research (ujer) is an international peer-reviewed journal publication supervised by saint joseph college, maasin cit... vol 3, no. 1, 2024 march 2024 - april 16, 2024.

Thumbnail2

... Vol 3, No. 1, 2020 January 2020 - April 11, 2024

Thumbnail2

LAMDAG is a fitting concept that captures the intent of the Graduate School journal to serve as an avenue for the publication of Graduate School fa... Vol 13, No. 1, 2023 January 2023 - April 08, 2024

Thumbnail2

Clarivate Analytics Accredited Journals

Other Clarivate Analytics Accredited Journals

Philosophia: International Journal of Philosophy

Philosophia: international journal of philosophy is published every january and may of each year.a philosophia, as usual, presents all types of philosophical points of vi....

Thumbnail3

Asian Journal of Biodiversity

The asian journal of biodiversity; is an international peer reviewed and multidisciplinary journal that provides a venue for scholars to publish their research findings. ....

Thumbnail3

The Asia-Pacific Education Researcher

The asia-pacific education researcher is indexed and abstracted in the social sciences citation index, social scisearch, and journal citation reports/social science editi....

Thumbnail3

IAMURE International Journal of Ecology and Conservation

The iamure international journal of ecology and conservation aims to publish new discoveries in ecology and conservation which are contributed by member researchers fr....

Thumbnail3

SCOPUS Accredited Journals

Other SCOPUS Accredited Journals

Recoletos Multidisciplinary Research Journal

The recoletos multidisciplinary research journal is the official journal of higher education of the university of san jose-recoletos, cebu city, and is published bi-annually by the center for polic....

Thumbnail5

Philosophia: International Journal of Philosophy is published every January and May of each year.A Philosophia, as usual, presents all types of philosophical points of view. It is open to all branches...

Thumbnail5

DLSU Business & Economics Review

The dlsu business & economics review (b&e review) publishes high quality theoretical, empirical, and methodological research in the fields of accounting, business management, commercial law, econom....

Thumbnail5

The Asia-Pacific Education Researcher is indexed and abstracted in the Social Sciences Citation Index, Social Scisearch, and Journal Citation Reports/Social Science Edition. The journal is listed in t...

Thumbnail5

Philippine E-Journals Worldwide

Data based on Google analytics of PEJ

839 Epifanio de los Santos Avenue, Diliman, Quezon City, 1103 Metro Manila

+63 (02) 8929 5088 local 134

  • Privacy Policy

839 Epifanio de los Santos Avenue Diliman Quezon City 1103 Metro Manila

logo

Copyright © 2024  KITE E-Learning Solutions |   Exclusively distributed by CE-Logic | Terms and Conditions

research papers tagalog

research papers tagalog

  • Publication type?
  • Article, research, review
  • Fiction prose or poetry
  • Personal journal entry
  • Photo Documents
  • Files: PDF\DOC\RAR\ZIP etc.
  • An audiobook or other audio file
  • Additional options:
  • Create a poll

logo

Why is it important to save your scholarly work in a digital library?

  • Wide access: The Internet allows researchers and scholars around the world easy access to your scholarly work. This is especially important for those who live or work in remote countries or regions or sparsely populated areas where access to scholarly publications may be limited.
  • Preservation and dissemination of knowledge: The preservation and dissemination of scientific works on the Internet ensures the preservation and dissemination of knowledge that can be used to advance science. This helps avoid duplication of research and facilitates access to previous works, which contributes to faster human progress.
  • Citation: Storing research papers online at a specific address provides a permanent link to your work, making it easier for other scientists to cite and use your research. It also helps to increase your citation index in academia.
  • Archiving: Storing research papers online ensures that they are archived and preserved for the future. This is important so that researchers can access previous works and use them in their own research.
  • Dissemination of ideas: Keeping scientific papers online provides an opportunity to disseminate ideas and research results to a wide audience. This can lead to a broader discussion of ideas and a faster dissemination of knowledge in the scientific community.

What can I save in a digital library?

  • E-books: digital versions of books , which can be saved in PDF, DJVU, or other e-book formats.
  • Scientific articles: scientific publications that can be saved in text form for reading from a computer screen or other gadget or in PDF or other electronic article formats (in which case articles can also be read from both desktop and mobile device screens).
  • Journals: digital versions of journals that can be saved in PDF or other electronic journal formats.
  • Audio and video materials: lecture recordings, music , movies and other video and audio files. Audio files are stored in a special storage , and we recommend uploading videos to Youtube and then inserting a link to them in your publications in the library.
  • Documents: different types of documents , such as brochures, manuals, reports, articles, and other documents. There is a special section for files in the library.
  • Maps and drawings: different types of graphic images, including maps, charts, drawings, diagrams, and other types of images. They can be stored in the Photo Documents section.
  • Electronic textbooks and learning materials: digital versions of textbooks, study guides, and other learning materials.
  • Electronic newspapers: digital versions of newspapers that can be saved in PDF or other electronic newspaper formats.
  • Photos: digital images of photos and other graphic materials.
  • Archival materials: digital versions of documents and other materials from archives and museums.
  • Research information: digital versions of articles, reports, dissertations, and other research-related materials.
  • Electronic diaries: digital versions of diaries and other personal entries . The library has a special section for author diaries, where you can keep entries in chronological order.
  • Electronic patents: digital versions of patents and other documents related to intellectual property.
  • Internet Archives: electronic versions of web pages and other online materials that can be saved in archiving programs and uploaded for preservation in the library.
  • Computer programs and applications: digital versions of software, applications, and games.
  • Electronic dictionaries and reference books: digital versions of various dictionaries and reference books on various topics.
  • Music: digital versions of music, albums, and other audio materials .
  • Digital maps: electronic versions of maps, geographic and topographic data.

Why is the digital library free for authors and readers?

  • Accessibility. Free access to information makes it available to all users, regardless of their financial status or location. This is important to ensure equal access to education and information for all.
  • Dissemination of knowledge. The purpose of digital libraries is to disseminate knowledge and information throughout the world. Free access to information contributes to this goal because it allows people to access the latest scientific discoveries and other important information resources.
  • Social effect. Many authors, especially those who publish their works in the electronic library, do not receive direct financial benefits from their publications, but do so in order to promote science and disseminate knowledge. Providing free access to their work helps them achieve this goal.

research papers tagalog

research papers tagalog

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

  •  We're Hiring!
  •  Help Center
  • Most Cited Papers
  • Most Downloaded Papers
  • Newest Papers
  • Save to Library
  • Last »
  • Filipino Literature Follow Following
  • Tagalog Follow Following
  • Court Interpreting Follow Following
  • Food and Beverage Management Follow Following
  • OPerations research and statistics Follow Following
  • Career Guidance Counseling Follow Following
  • Filipino Studies Follow Following
  • Administration and Supervision Follow Following
  • Philippine History Follow Following
  • Filipino Philosophy Follow Following

Enter the email address you signed up with and we'll email you a reset link.

  • Academia.edu Publishing
  •   We're Hiring!
  •   Help Center
  • Find new research papers in:
  • Health Sciences
  • Earth Sciences
  • Cognitive Science
  • Mathematics
  • Computer Science
  • Academia ©2024

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List

Logo of springeropen

Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

Andrea b. martinez.

1 Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines

2 Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

3 Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England

Jennifer Lau

June s. l. brown.

This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking.

Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis.

Filipinos across the world have general reluctance and unfavourable attitude towards formal help-seeking despite high rates of psychological distress. They prefer seeking help from close family and friends. Barriers cited by Filipinos living in the Philippines include financial constraints and inaccessibility of services, whereas overseas Filipinos were hampered by immigration status, lack of health insurance, language difficulty, experience of discrimination and lack of acculturation to host culture. Both groups were hindered by self and social stigma attached to mental disorder, and by concern for loss of face, sense of shame, and adherence to Asian values of conformity to norms where mental illness is considered unacceptable. Filipinos are also prevented from seeking help by their sense of resilience and self-reliance, but this is explored only in qualitative studies. They utilize special mental health care only as the last resort or when problems become severe. Other prominent facilitators include perception of distress, influence of social support, financial capacity and previous positive experience in formal help.

We confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as primary barrier, while resilience and self-reliance as coping strategies were cited in qualitative studies. Social support and problem severity were cited as prominent facilitators.

Introduction

Mental illness is the third most common disability in the Philippines. Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the Philippines the country with the third highest rate of mental health problems in the Western Pacific Region [ 1 ]. Suicide rates are pegged at 3.2 per 100,000 population with numbers possibly higher due to underreporting or misclassification of suicide cases as ‘undetermined deaths’ [ 2 ]. Despite these figures, government spending on mental health is at 0.22% of total health expenditures with a lack of health professionals working in the mental health sector [ 1 , 3 ]. Elevated mental health problems also characterise ‘overseas Filipinos’, that is, Filipinos living abroad [ 4 ]. Indeed, 12% of Filipinos living in the US suffer from psychological distress [ 5 ], higher than the US prevalence rate of depression and anxiety [ 1 ]. Long periods of separation from their families and a different cultural background may make them more prone to acculturative stress, depression, anxiety, substance use and trauma especially those who are exposed to abuse, violence and discrimination whilst abroad [ 6 ].

One crucial barrier to achieving well-being and improved mental health among both ‘local’ and overseas Filipinos is their propensity to not seek psychological help [ 7 , 8 ]. Not only are help-seeking rates much lower than rates found in general US populations [ 9 ], they are also low compared to other minority Asian groups [ 10 ]. Yet, few studies have been published on Filipino psychological help-seeking either in the Philippines or among those overseas [ 11 ]. Most available studies have focused on such factors as stigma tolerance, loss of face and acculturation factors [ 12 , 13 ].

To date, no systematic review of studies on Filipino psychological help-seeking, both living in the Philippines and overseas, has been conducted. In 2014, Tuliao conducted a narrative review of the literature on Filipino mental health help-seeking in the US which provided a comprehensive treatise on cultural context of Filipino help-seeking behavior [ 11 ]. However, new studies have been published since which examine help-seeking in other country contexts, such as Norway, Iceland, Israel and Canada [ 6 , 14 – 16 ]. Alongside recent studies on local Filipinos, these new studies can provide basis for comparison of the local and overseas Filipinos [ 7 , 8 , 12 , 17 ].

This systematic review aims to critically appraise the evidence on behavioural and attitudinal patterns of psychological help-seeking among Filipinos in the Philippines and abroad and examine barriers and enablers of their help-seeking. While the majority of studies undertaken have been among Filipino migrants especially in the US where they needed to handle additional immigration challenges, studying help-seeking attitudes and behaviours of local Filipinos is important as this may inform those living abroad [ 10 , 13 , 18 ]. This review aims to: (1) examine the commonly reported help-seeking attitudes and behaviors among local and overseas Filipinos with mental health problems; and (2) expound on the most commonly reported barriers and facilitators that influence their help-seeking.

The review aims to synthesize available data on formal help-seeking behavior and attitudes of local and overseas Filipinos for their mental health problems, as well as commonly reported barriers and facilitators. Formal psychological help-seeking behavior is defined as seeking services and treatment, such as psychotherapy, counseling, information and advice, from trained and recognized mental health care providers [ 19 ]. Attitudes on psychological help-seeking refer to the evaluative beliefs in seeking help from these professional sources [ 20 ].

Eligibility criteria

Inclusion criteria for the studies were the following: (1) those that address either formal help-seeking behavior OR attitude related to a mental health AND those that discuss barriers OR facilitators of psychological help-seeking; (2) those that involve Filipino participants, or of Filipino descent; in studies that involve multi-cultural or multi-ethnic groups, they must have at least 20% Filipino participants with disaggregated data on Filipino psychological help-seeking; (3) those that employed any type of study designs, whether quantitative, qualitative or mixed-methods; (4) must be full-text peer-reviewed articles published in scholarly journals or book chapters, with no publication date restrictions; (5) written either in English or Filipino; and (6) available in printed or downloadable format. Multiple articles based on the same research are treated as one study/paper.

Exclusion criteria were: (1) studies in which the reported problems that prompted help-seeking are medical (e.g. cancer), career or vocational (e.g., career choice), academic (e.g., school difficulties) or developmental disorders (e.g., autism), unless specified that there is an associated mental health concern (e.g., anxiety, depression, trauma); (2) studies that discuss general health-seeking behaviors; (3) studies that are not from the perspective of mental health service users (e.g., counselor’s perspective); (4) systematic reviews, meta-analyses and other forms of literature review; and (5) unpublished studies including dissertations and theses, clinical reports, theory or methods papers, commentaries or editorials.

Search strategy and study selection

The search for relevant studies was conducted through electronic database searching, hand-searching and web-based searching. Ten bibliographic databases were searched in August to September 2018: PsychInfo, Global Health, MedLine, Embase, EBSCO , ProQuest , PubMed , Science Direct, Scopus and Emerald Insight. The following search terms were used: “help-seeking behavior” OR “utilization of mental health services” OR “access to mental health services” OR “psychological help-seeking” AND “barriers to help-seeking” OR “facilitators of help-seeking” AND “mental health” OR “mental health problem” OR “mental disorder” OR “mental illness” OR “psychological distress” OR “emotional problem” AND “Filipino” OR “Philippines”. Filters were used to select only publications from peer-reviewed journals. Internet searches through Google Scholar and websites of Philippine-based publications were also performed using the search term “Filipino mental health help-seeking” as well as hand-searching of reference lists of relevant studies. A total of 3038 records were obtained. Duplicates were removed and a total of 2659 records were screened for their relevance based on their titles and abstracts.

Preliminary screening of titles and abstracts of articles resulted in 162 potentially relevant studies, their full-text papers were obtained and were reviewed for eligibility by two reviewers (AM and MC). Divergent opinions on the results of eligibility screening were deliberated and any further disagreement was resolved by the third reviewer (JB). A total of 15 relevant studies (from 24 papers) published in English were included in the review and assessed for quality. There were seven studies with multiple publications (two of them have 3 papers) and a core paper was chosen on the basis of having more comprehensive key study data on formal help-seeking. Results of the literature search are reported in Fig.  1 using the PRISMA diagram [ 21 ]. A protocol for this review was registered at PROSPERO Registry of the Centre for Reviews and Dissemination of the University of York ( https://www.crd.york.ac.uk/PROSPERO ; ID: CRD42018102836).

An external file that holds a picture, illustration, etc.
Object name is 127_2020_1937_Fig1_HTML.jpg

PRISMA flow diagram

Data extraction and quality assessment

Data extracted by the main author were crosschecked by a second reviewer (JB). A data extraction table with thematic headings was prepared and pilot tested for two quantitative and two qualitative studies to check data comparability. Extraction was performed using the following descriptive data: (1) study information (e.g. name of authors, publication date, study location, setting, study design, measurement tools used); (2) socio-demographic characteristics of participants (e.g. sample size, age, gender); and (3) overarching themes on psychological help-seeking behavior and attitudes, as well as barriers and facilitators of help-seeking.

Two reviewers (AM and MC) did quality assessment of the studies separately, using the following criteria: (1) relevance to the research question; (2) transparency of the methods; (3) robustness of the evidence presented; and (4) soundness of the data interpretation and analysis. Design-specific quality assessment tools were used in the evaluation of risk of bias of the studies, namely: (1) Critical Appraisal Skills Programme Qualitative Checklist [ 22 ]; and (2) Quality Assessment Tool for Quantitative Studies by the Effective Public Health Practice Project [ 23 ]. The appraisals for mixed-methods studies were done separately for quantitative and qualitative components to ensure trustworthiness [ 24 ] of the quality of each assessment.

For studies reported in multiple publications, quality assessment was done only on the core papers [ 25 ]. All the papers ( n  = 6) assessed for their qualitative study design (including the 4 mixed-methods studies) met the minimum quality assessment criteria of fair ( n  = 1) and good ( n  = 5) and were, thus, included in the review. Only 11 out of the 13 quantitative studies (including the 4 mixed-methods studies) satisfied the minimum ratings for the review, with five getting strong quality rating. The two mixed-methods studies that did not meet the minimum quality rating for quantitative designs were excluded as sources of quantitative data but were used in the qualitative data analysis because they satisfied the minimum quality rating for qualitative designs.

Strategy for data analysis

Due to the substantial heterogeneity of the studies in terms of participant characteristics, study design, measurement tools used and reporting methods of the key findings, narrative synthesis approach was used in data analysis to interpret and integrate the quantitative and qualitative evidence [ 26 , 27 ]. However, one crucial methodological limitation of studies in this review is the lack of agreement on what constitutes formal help-seeking. Some researchers include the utilization of traditional or indigenous healers as formal help-seeking, while others limit the concept to professional health care providers. As such, consistent with Rickwood and Thomas’ definition of formal help-seeking [ 19 ], data extraction and analysis were done only on those that reported utilization of professional health care providers.

Using a textual approach, text data were coded using both predetermined and emerging codes [ 28 ]. They were then tabulated, analyzed, categorized into themes and integrated into a narrative synthesis [ 29 ]. Exemplar quotations and author interpretations were also used to support the narrative synthesis. The following were the themes on barriers and facilitators of formal help-seeking: (1) psychosocial barriers/facilitators, which include social support from family and friends, perceived severity of mental illness, awareness of mental health issues, self-stigmatizing beliefs, treatment fears and other individual concerns; (2) socio-cultural barriers/facilitators, which include the perceived social norms and beliefs on mental health, social stigma, influence of religious beliefs, and language and acculturation factors; and (3) systemic/structural and economic barriers/facilitators, which include financial or employment status, the health care system and its accessibility, availability and affordability, and ethnicity, nativity or immigration status.

Study and participant characteristics

The 15 studies were published between 2002 and 2018. Five studies were conducted in the US, four in the Philippines and one study each was done in Australia, Canada, Iceland, Israel and Norway. One study included participants working in different countries, the majority were in the Middle East. Data extracted from the four studies done in the Philippines were used to report on the help-seeking behaviors and attitudes, and barriers/facilitators to help-seeking of local Filipinos, while the ten studies conducted in different countries were used to report on help-seeking of overseas Filipinos. Nine studies were quantitative and used a cross-sectional design except for one cohort study; the majority of them used research-validated questionnaires. Four studies used mixed methods with surveys and open-ended questionnaires, and another two were purely qualitative studies that used interviews and focus group discussions. Only three studies recruited participants through random sampling and the rest used purposive sampling methods. All quantitative studies used questionnaires in measures of formal help-seeking behaviors, and western-standardized measures to assess participants’ attitudes towards help-seeking. Qualitative studies utilized semi-structured interview guides that were developed to explore the psychological help-seeking of participants.

A total of 5096 Filipinos aged 17–70 years participated in the studies. Additionally, 13 studies reported on the mean age of participants, with the computed overall mean age at 39.52 (SD 11.34). The sample sizes in the quantitative studies ranged from 70 to 2285, while qualitative studies ranged from 10 to 25 participants. Of the participants, 59% ( n  = 3012) were female which is probably explained by five studies focusing on Filipino women. Ten studies were conducted in community settings, five in health or social centre-based settings and 1 in a university (Table ​ (Table1 1 ).

*Quality assessment based on the criteria of EPHPP Quality Assessment Tool for quantitative studies

**Quality assessment based on the criteria of CASP Qualitative Checklist for qualitative studies

Formal help-seeking behaviors

12 studies examined the formal help-seeking behaviors of Filipinos (Table ​ (Table2), 2 ), eight of them were from community-based studies and four were from centre-based studies. Nine studies reported on formal help-seeking of overseas Filipinos and three reported on local Filipinos.

Report on formal help-seeking behaviors

Community-based vs health/social centres Data from quantitative community studies show that the rates of formal help-seeking behaviors among the Filipino general population ranged from 2.2% [ 30 ] to 17.5% [ 6 ]. This was supported by reports from qualitative studies where participants did not seek help at all. The frequency of reports of formal help-seeking from studies conducted in crisis centres and online counseling tended to be higher. For instance, the rate of engagement in online counseling among overseas Filipinos was 10.68% [ 31 ], those receiving treatment in crisis centers was 39.32% [ 17 ] while 100% of participants who were victims of intimate partner violence were already receiving help from a women’s support agency [ 8 , 32 ].

Local vs overseas Filipinos’ formal help-seeking The rate of formal psychological help-seeking of local Filipinos was at 22.19% [ 12 ] while overseas rates were lower and ranged from 2.2% of Filipino Americans [ 30 ] to 17.5% of Filipinos in Israel [ 6 ]. Both local and overseas Filipinos indicated that professional help is sought only as a last resort because they were more inclined to get help from family and friends or lay network [ 7 , 16 ].

Attitudes towards formal help-seeking

13 studies reported on participants’ attitudes towards seeking formal help. Seven studies identified family and friends as preferred sources of help [ 7 , 14 , 16 ] rather than mental health specialists and other professionals even when they were already receiving help from them [ 17 , 32 ]. When Filipinos seek professional help, it is usually done in combination with other sources of care [ 13 ] or only used when the mental health problem is severe [ 14 , 16 , 33 ]. Other studies reported that in the absence of social networks, individuals prefer to rely on themselves [ 32 , 33 ].

Community-based vs health/social centres Community-based studies reported that Filipinos have negative attitudes marked by low stigma tolerance towards formal help-seeking [ 7 , 14 , 16 ]. However, different findings were reported by studies conducted in crisis centres. Hechanova et al. found a positive attitude towards help-seeking among users of online counseling [ 31 ], whereas Cabbigat and Kangas found that Filipinos in crisis centres still prefer receiving help from religious clergy or family members, with mental health units as the least preferred setting in receiving help [ 17 ]. This is supported by the findings of Shoultz and her colleagues who reported that Filipino women did not believe in disclosing their problems to others [ 32 ].

Local vs overseas Filipinos Filipinos, regardless of location, have negative attitudes towards help-seeking, except later-generation Filipino migrants who have been acculturated in their host countries and tended to have more positive attitudes towards mental health specialists [ 10 , 13 , 15 , 34 ]. However, this was only cited in quantitative studies. Qualitative studies reported the general reluctance of both overseas and local Filipinos to seek help.

Barriers in formal help-seeking

All 15 studies examined a range of barriers in psychological help-seeking (Table ​ (Table3). 3 ). The most commonly endorsed barriers were: (1) financial constraints due to high cost of service, lack of health insurance, or precarious employment condition; (2) self-stigma, with associated fear of negative judgment, sense of shame, embarrassment and being a disgrace, fear of being labeled as ‘crazy’, self-blame and concern for loss of face; and (3) social stigma that puts the family’s reputation at stake or places one’s cultural group in bad light.

Key themes on barriers to formal help-seeking

Local vs overseas Filipinos In studies conducted among overseas Filipinos, strong adherence to Asian values of conformity to norms is an impediment to help-seeking but cited only in quantitative studies [ 10 , 13 , 15 , 34 ] while perceived resilience, coping ability or self-reliance was mentioned only in qualitative studies [ 14 , 16 , 33 ]. Other common barriers to help-seeking cited by overseas Filipinos were inaccessibility of mental health services, immigration status, sense of religiosity, language problem, experience of discrimination and lack of awareness of mental health needs [ 10 , 13 , 18 , 34 ]. Self-reliance and fear of being a burden to others as barriers were only found among overseas Filipinos [ 6 , 16 , 32 ]. On the other hand, local Filipinos have consistently cited the influence of social support as a hindrance to help-seeking [ 7 , 17 ].

Stigmatized attitude towards mental health and illness was reported as topmost barriers to help-seeking among overseas and local Filipinos. This included notions of mental illness as a sign of personal weakness or failure of character resulting to loss of face. There is a general consensus in these studies that the reluctance of Filipinos to seek professional help is mainly due to their fear of being labeled or judged negatively, or even their fear of fueling negative perceptions of the Filipino community. Other overseas Filipinos were afraid that having mental illness would affect their jobs and immigration status, especially for those who are in precarious employment conditions [ 6 , 16 ].

Facilitators of formal help-seeking

All 15 studies discussed facilitators of formal help-seeking, but the identified enablers were few (Table ​ (Table4). 4 ). Among the top and commonly cited factors that promote help-seeking are: (1) perceived severity of the mental health problem or awareness of mental health needs; (2) influence of social support, such as the presence/absence of family and friends, witnessing friends seeking help, having supportive friends and family who encourage help-seeking, or having others taking the initiative to help; and (3) financial capacity.

Key themes on facilitators in help-seeking

Local vs overseas Filipinos Studies on overseas Filipinos frequently cited financial capacity, immigration status, language proficiency, lower adherence to Asian values and stigma tolerance as enablers of help-seeking [ 15 , 30 , 32 , 34 ], while studies done on local Filipinos reported that awareness of mental health issues and previous positive experience of seeking help serve as facilitator [ 7 , 12 ].

Community-based vs health/social centres Those who were receiving help from crisis centres mentioned that previous positive experience with mental health professionals encouraged their formal help-seeking [ 8 , 17 , 31 ]. On the other hand, community-based studies cited the positive influence of encouraging family and friends as well as higher awareness of mental health problems as enablers of help-seeking [ 12 , 14 , 16 ].

To the best of our knowledge, this is the first systematic review conducted on psychological help-seeking among Filipinos, including its barriers and facilitators. The heterogeneity of participants (e.g., age, gender, socio-economic status, geographic location or residence, range of mental health problems) was large.

Filipino mental health help-seeking behavior and attitudes The rate of mental health problems appears to be high among Filipinos both local and overseas, but the rate of help-seeking is low. This is consistent with findings of a study among Chinese immigrants in Australia which reported higher psychological distress but with low utilization of mental health services [ 35 ]. The actual help-seeking behavior of both local and overseas Filipinos recorded at 10.72% ( n  = 461) is lower than the 19% of the general population in the US [ 36 ] and 16% in the United Kingdom (UK) [ 37 ], and even far below the global prevalence rate of 30% of people with mental illness receiving treatment [ 38 ]. This finding is also comparable with the low prevalence rate of mental health service use among the Chinese population in Hong Kong [ 39 ] and in Australia [ 35 ], Vietnamese immigrants in Canada [ 30 ], East Asian migrants in North America [ 41 ] and other ethnic minorities [ 42 ] but is in sharp contrast with the increased use of professional help among West African migrants in The Netherlands [ 43 ].

Most of the studies identified informal help through family and friends as the most widely utilized source of support, while professional service providers were only used as a last resort. Filipinos who are already accessing specialist services in crisis centres also used informal help to supplement professional help. This is consistent with reports on the frequent use of informal help in conjunction with formal help-seeking among the adult population in UK [ 44 ]. However, this pattern contrasts with informal help-seeking among African Americans who are less likely to seek help from social networks of family and friends [ 45 ]. Filipinos also tend to use their social networks of friends and family members as ‘go-between’ [ 46 ] for formal help, serving to intercede between mental health specialists and the individual. This was reiterated in a study by Shoultz et al. (2009) in which women who were victims of violence are reluctant to report the abuse to authorities but felt relieved if neighbours and friends would interfere for professional help in their behalf [ 32 ].

Different patterns of help-seeking among local and overseas Filipinos were evident and may be attributed to the differences in the health care system of the Philippines and their host countries. For instance, the greater use of general medical services by overseas Filipinos is due to the gatekeeper role of general practitioners (GP) in their host countries [ 47 ] where patients have to go through their GPs before they get access to mental health specialists. In contrast, local Filipinos have direct access to psychiatrists or psychologists without a GP referral. Additionally, those studies conducted in the Philippines were done in urban centers where participants have greater access to mental health specialists. While Filipinos generally are reluctant to seek help, later-generation overseas Filipinos have more positive attitudes towards psychological help-seeking. Their exposure and acculturation to cultures that are more tolerant of mental health stigma probably influenced their more favorable attitude [ 41 , 48 ].

Prominent barrier themes in help-seeking Findings of studies on frequently endorsed barriers in psychological help-seeking are consistent with commonly reported impediments to health care utilization among Filipino migrants in Australia [ 49 ] and Asian migrants in the US [ 47 , 50 ]. The same barriers in this review, such as preference for self-reliance as alternative coping strategy, poor mental health awareness, perceived stigma, are also identified in mental health help-seeking among adolescents and young adults [ 51 ] and among those suffering from depression [ 52 ].

Social and self-stigmatizing attitudes to mental illness are prominent barriers to help-seeking among Filipinos. Social stigma is evident in their fears of negative perception of the Filipino community, ruining the family reputation, or fear of social exclusion, discrimination and disapproval. Self-stigma manifests in their concern for loss of face, sense of shame or embarrassment, self-blame, sense of being a disgrace or being judged negatively and the notion that mental illness is a sign of personal weakness or failure of character [ 16 ]. The deterrent role of mental health stigma is consistent with the findings of other studies [ 51 , 52 ]. Overseas Filipinos who are not fully acculturated to the more stigma-tolerant culture of their host countries still hold these stigmatizing beliefs. There is also a general apprehension of becoming a burden to others.

Practical barriers to the use of mental health services like accessibility and financial constraints are also consistently rated as important barriers by Filipinos, similar to Chinese Americans [ 53 ]. In the Philippines where mental health services are costly and inaccessible [ 54 ], financial constraints serve as a hindrance to formal help-seeking, as mentioned by a participant in the study of Straiton and his colleagues, “In the Philippines… it takes really long time to decide for us that this condition is serious. We don’t want to use our money right away” [ 14 , p.6]. Local Filipinos are confronted with problems of lack of mental health facilities, services and professionals due to meager government spending on health. Despite the recent ratification of the Philippines’ Mental Health Act of 2018 and the Universal Health Care Act of 2019, the current coverage for mental health services provided by the Philippine Health Insurance Corporation only amounts to US$154 per hospitalization and only for acute episodes of mental disorders [ 55 ]. Specialist services for mental health in the Philippines are restricted in tertiary hospitals located in urban areas, with only one major mental hospital and 84 psychiatric units in general hospitals [ 1 ].

Overseas Filipinos cited the lack of health insurance and immigration status without health care privileges as financial barrier. In countries where people have access to universal health care, being employed is a barrier to psychological help-seeking because individuals prefer to work instead of attending medical check-ups or consultations [ 13 ]. Higher income is also associated with better mental health [ 56 ] and hence, the need for mental health services is low, whereas poor socio-economic status is related to greater risk of developing mental health problems [ 57 , 58 ]. Lack of familiarity with healthcare system in host countries among new Filipino migrants also discourages them from seeking help.

Studies have shown that reliance on, and accessibility of sympathetic, reliable and trusted family and friends are detrimental to formal help-seeking since professional help is sought only in the absence of this social support [ 6 , 8 ]. This is consistent with the predominating cultural values that govern Filipino interpersonal relationships called kapwa (or shared identity) in which trusted family and friends are considered as “hindi-ibang-tao” (one-of-us/insider), while doctors or professionals are seen as “ibang-tao” (outsider) [ 59 ]. Filipinos are apt to disclose and be more open and honest about their mental illness to those whom they considered as “hindi-ibang-tao” (insider) as against those who are “ibang-tao” (outsider), hence their preference for family members and close friends as source of informal help [ 59 ]. For Filipinos, it is difficult to trust a mental health specialist who is not part of the family [ 60 ].

Qualitative studies in this review frequently mentioned resilience and self-reliance among overseas Filipinos as barriers to help-seeking. As an adaptive coping strategy for adversity [ 61 ], overseas Filipinos believe that they were better equipped in overcoming emotional challenges of immigration [ 16 ] without professional assistance [ 14 ]. It supports the findings of studies on overseas Filipino domestic workers who attributed their sense of well-being despite stress to their sense of resilience which prevents them from developing mental health problems [ 62 ] and among Filipino disaster survivors who used their capacity to adapt as protective mechanism from experience of trauma [ 63 ]. However, self-reliant individuals also tend to hold stigmatizing beliefs on mental health and as such resort to handling problems on their own instead of seeking help [ 51 , 64 ].

Prominent facilitator themes in help-seeking In terms of enablers of psychological help-seeking, only a few facilitators were mentioned in the studies, which supported findings in other studies asserting that factors that promote help-seeking are less often emphasized [ 42 , 51 ].

Consistent with other studies [ 44 , 49 ], problem severity is predictive of intention to seek help from mental health providers [ 18 , 30 ] because Filipinos perceive that professional services are only warranted when symptoms have disabling effects [ 5 , 53 ]. As such, those who are experiencing heightened emotional distress were found to be receptive to intervention [ 17 ]. In most cases, symptom severity is determined only when somatic or behavioral symptoms manifest [ 13 ] or occupational dysfunction occurs late in the course of the mental illness [ 65 ]. This is most likely due to the initial denial of the problem [ 66 ] or attempts at maintaining normalcy of the situation as an important coping mechanism [ 67 ]. Furthermore, this poses as a hindrance to any attempts at early intervention because Filipinos are likely to seek professional help only when the problem is severe or has somatic manifestations. It also indicates the lack of preventive measure to avert any deterioration in mental health and well-being.

More positive attitudes towards help-seeking and higher rates of mental health care utilization have been found among later-generation Filipino immigrants or those who have acquired residency status in their host country [ 10 , 15 ]. Immigration status and length of stay in the host country are also associated with language proficiency, higher acculturation and familiarity with the host culture that are more open to discussing mental health issues [ 13 ], which present fewer barriers in help-seeking. This is consistent with facilitators of formal help-seeking among other ethnic minorities, such as acculturation, social integration and positive attitude towards mental health [ 43 ].

Cultural context of Filipinos’ reluctance to seek help Several explanations have been proposed to account for the general reluctance of Filipinos to seek psychological help. In Filipino culture, mental illness is attributed to superstitious or supernatural causes, such as God’s will, witchcraft, and sorcery [ 68 , 69 ], which contradict the biopsychosocial model used by mental health care professionals. Within this cultural context, Filipinos prefer to seek help from traditional folk healers who are using religious rituals in their healing process instead of availing the services of professionals [ 70 , 71 ]. This was reaffirmed by participants in the study of Thompson and her colleagues who said that “psychiatrists are not a way to deal with emotional problems” [ 74 , p.685]. The common misconception on the cause and nature of mental illness, seeing it as temporary due to cold weather [ 14 ] or as a failure in character and as an individual responsibility to overcome [ 16 , 72 ] also discourages Filipinos from seeking help.

Synthesis of the studies included in the review also found conflicting findings on various cultural and psychosocial influences that served both as enablers and deterrents to Filipino help-seeking, namely: (1) level of spirituality; (2) concern on loss of face or sense of shame; and (3) presence of social support.

Level of spirituality Higher spirituality or greater religious beliefs have disparate roles in Filipino psychological help-seeking. Some studies [ 8 , 14 , 16 ] consider it a hindrance to formal help-seeking, whereas others [ 10 , 15 ] asserted that it can facilitate the utilization of mental health services [ 15 , 73 ]. Being predominantly Catholics, Filipinos had drawn strength from their religious faith to endure difficult situations and challenges, accordingly ‘leaving everything to God’ [ 74 ] which explains their preference for clergy as sources of help instead of professional mental health providers. This is connected with the Filipino attribution of mental illness to spiritual or religious causes [ 62 ] mentioned earlier. On the contrary, Hermansdottir and Aegisdottir argued that there is a positive link between spirituality and help-seeking, and cited connectedness with host culture as mediating factor [ 15 ]. Alternately, because higher spirituality and religiosity are predictors of greater sense of well-being [ 75 ], there is, thus, a decreased need for mental health services.

Concern on loss of face or sense of shame The enabler/deterrent role of higher concern on loss of face and sense of shame on psychological help-seeking was also identified. The majority of studies in this review asserted the deterrent role of loss of face and stigma consistent with the findings of other studies [ 51 ], although Clement et al. stated that stigma is the fourth barrier in deterring help-seeking [ 76 ]. Mental illness is highly stigmatized in the Philippines and to avoid the derogatory label of ‘crazy’, Filipinos tend to conceal their mental illness and consequently avoid seeking professional help. This is aligned with the Filipino value of hiya (sense of propriety) which considers any deviation from socially acceptable behavior as a source of shame [ 11 ]. The stigmatized belief is reinforced by the notion that formal help-seeking is not the way to deal with emotional problems, as reflected in the response of a Filipino participant in the study by Straiton et. al., “It has not occurred to me to see a doctor for that kind of feeling” [ 14 , p.6]. However, other studies in this review [ 12 , 13 ] posited contrary views that lower stigma tolerance and higher concern for loss of face could also motivate psychological help-seeking for individuals who want to avoid embarrassing their family. As such, stigma tolerance and loss of face may have a more nuanced influence on help-seeking depending on whether the individual avoids the stigma by not seeking help or prevent the stigma by actively seeking help.

Presence of social support The contradictory role of social networks either as helpful or unhelpful in formal help-seeking was also noted in this review. The presence of friends and family can discourage Filipinos from seeking professional help because their social support serves as protective factor that buffer one’s experience of distress [ 77 , 78 ]. Consequently, individuals are less likely to use professional services [ 42 , 79 ]. On the contrary, other studies have found that the presence of friends and family who have positive attitudes towards formal help-seeking can promote the utilization of mental health services [ 8 , 80 ]. Friends who sought formal help and, thus, serve as role models [ 14 ], and those who take the initiative in seeking help for the distressed individual [ 32 ] also encourage such behavior. Thus, the positive influence of friends and family on mental health and formal help-seeking of Filipinos is not merely to serve only as emotional buffer for stress, but to also favourably influence the decision of the individual to seek formal help.

Research implications of findings

This review highlights particular evidence gaps that need further research: (1) operationalization of help-seeking behavior as a construct separating intention and attitude; (2) studies on actual help-seeking behavior among local and overseas Filipinos with identified mental health problems; (3) longitudinal study on intervention effectiveness and best practices; (4) studies that triangulate findings of qualitative studies with quantitative studies on the role of resilience and self-reliance in help-seeking; and (5) factors that promote help-seeking.

Some studies in this review reported help-seeking intention or attitude as actual behaviors even though they are separate constructs, hence leading to reporting biases and misinterpretations. For instance, the conflicting findings of Tuliao et al. [ 12 ] on the negative association of loss of face with help-seeking attitude and the positive association between loss of face and intention to seek help demonstrate that attitudes and intentions are separate constructs and, thus, need further operationalization. Future research should strive to operationalize concretely these terms through the use of robust measurement tools and systematic reporting of results. There is also a lack of data on the actual help-seeking behaviors among Filipinos with mental illness as most of the reports were from the general population and on their help-seeking attitudes and intentions. Thus, research should focus on those with mental health problems and their actual utilization of healthcare services to gain a better understanding of how specific factors prevent or promote formal help-seeking behaviors.

Moreover, the majority of the studies in this review were descriptive cross-sectional studies, with only one cohort analytic study. Future research should consider a longitudinal study design to ensure a more rigorous and conclusive findings especially on testing the effectiveness of interventions and documenting best practices. Because of the lack of quantitative research that could triangulate the findings of several qualitative studies on the detrimental role of resilience and self-reliance, quantitative studies using pathway analysis may help identify how these barriers affect help-seeking. A preponderance of studies also focused on discussing the roles of barriers in help-seeking, but less is known about the facilitators of help-seeking. For this reason, factors that promote help-seeking should be systematically investigated.

Practice, service delivery and policy implications

Findings of this review also indicate several implications for practice, service delivery, intervention and policy. Cultural nuances that underlie help-seeking behavior of Filipinos, such as the relational orientation of their interactions [ 81 ], should inform the design of culturally appropriate interventions for mental health and well-being and improving access and utilization of health services. Interventions aimed at improving psychological help-seeking should also target friends and family as potential and significant influencers in changing help-seeking attitude and behavior. They may be encouraged to help the individual to seek help from the mental health professional. Other approaches include psychoeducation that promotes mental health literacy and reduces stigma which could be undertaken both as preventive and treatment strategies because of their positive influence on help-seeking. Strategies to reduce self-reliance may also be helpful in encouraging help-seeking.

This review also has implications for structural changes to overcome economic and other practical barriers in Filipino seeking help for mental health problems. Newly enacted laws on mental health and universal healthcare in the Philippines may jumpstart significant policy changes, including increased expenditure for mental health treatment.

Since lack of awareness of available services was also identified as significant barrier, overseas Filipinos could be given competency training in utilizing the health care system of host countries, possibly together with other migrants and ethnic minorities. Philippine consular agencies in foreign countries should not merely only resort to repatriation acts, but could also take an active role in service delivery especially for overseas Filipinos who experience trauma and/or may have immigration-related constraints that hamper their access to specialist care.

Limitations of findings

A crucial limitation of studies in this review is the use of different standardized measures of help-seeking that render incomparable results. These measures were western-based inventories, and only three studies mentioned using cultural validation, such as forward-and-back-translations, to adapt them to cross-cultural research on Filipino participants. This may pose as a limitation on the cultural appropriateness and applicability of foreign-made tests [ 73 ] in capturing the true essence of Filipino experience and perspectives [ 74 ]. Additionally, the majority of the studies used non-probability sampling that limits the generalizability of results. They also failed to measure the type of assistance or actual support sought by Filipinos, such as psychoeducation, referral services, supportive counseling or psychotherapy, and whether or not they are effective in addressing mental health concerns of Filipinos. Another inherent limitation of this review is the lack of access to grey literature, such as thesis and dissertations published in other countries, or those published in the Philippines and are not available online. A number of studies on multi-ethnic studies with Filipino participants do not provide disaggregated data, which limits the scope and inclusion of studies in this review.

This review has confirmed the low utilization of mental health services among Filipinos regardless of their locations, with mental health stigma as a primary barrier resilience and self-reliance as coping strategies were also cited, especially in qualitative studies, but may be important in addressing issues of non-utilization of mental health services. Social support and problem severity were cited as prominent facilitators in help-seeking. However, different structural, cultural and practical barriers and facilitators of psychological help-seeking between overseas and local Filipinos were also found.

Compliance with ethical standard

The authors declare that they have no conflict of interests in this work.

Southeast Asia Digital Library

  • Huskie Link
  • Anywhere Apps
  • Huskies Get Hired
  • Student Email
  • Password Self-Service

Advanced Search

  • Quick Links
  • Archival Collections
  • Manuscripts
  • Periodicals
  • Photographs
  • General Information
  • SEADL Materials
  • Online Research Resources
  • Art in the age of Doi Moi
  • Diaries and Travel Writings of King Chulalongkorn of Siam
  • Digital Archive of Buddhist Murals and Cloth Paintings in Thailand
  • Early Imprints from Southeast Asia
  • Endangered Cham Manuscripts of Vietnam
  • Anti-Communist Posters and Booklets in Thailand
  • Hán-Nôm Special Collection Digitization project
  • Historical Archives and Photographs: Cebuano Studies Center, Philippines
  • Indonesian Illuminated Manuscripts
  • Indonesian Television Archive
  • Jawi Transliteration Project
  • Laos Temple Murals
  • Living Memory of the Khmer
  • Living Memory Project
  • Mandalay Marionettes Theater Puppet Show
  • May Ebihara Collection: Ethnographic Research in Rural Community, 1959-1995
  • On The Record: Indonesian Literary Figures
  • Palm-Leaf Manuscripts at the National Library of Cambodia
  • Palm-Leaf Manuscripts of Thailand
  • Pa'o Religious and Literary Manuscripts
  • Pesantren Sabilil Muttaqin (PSM) Manuscripts
  • SEADL Undergraduate Paper Award
  • Selections from the Donn V. Hart Southeast Asia Collection
  • Then and Now: Historical Photographs of Cambodia
  • UKM-NIU Digitization Project
  • Victim-Former Khmer Rouge Dialogue
  • Virtual Southeast Asia
  • Call For Proposals

Philippines: Online Research Resources

Open access journals.

Asian-Pacific Law & Policy Journal, University of Hawaii This website provides online Journal articles about law and policy study in Asia-Pacific regions. Browse the journal or type a related topic in search after connecting to the link.

Journal of Asian Studies This is a website of the Journal of Asian Studies. It covers a range of research topics about Asia, and some articles are free for download.

Journal of Education, Management and Development Studies (JEMDS)

The Journal of Education, Management and Development Studies (JEMDS) publishes original research papers, reviews, and case studies related to broad areas of disciplines, including Education, Agriculture and Biological Sciences, Environment and Natural Resources, Health Sciences, Social and Behavioral Sciences, Public Management, Business Management and Entrepreneurship, Development Management, and Gender and Development. This also covers multidisciplinary and interdisciplinary studies on sustainable development in regional, national and global perspectives.

Journal of Health and Caring Sciences

The Journal of Health and Caring Sciences (JHCS) is an OPEN-ACCESS, international, peer-reviewed, interdisciplinary, official health and caring science publication of the San Beda University. It welcomes submission in various formats, including but not limited to original completed research studies, systematic reviews, case studies, book reviews, commentaries, letter to the editor and innovative research proposals which explores timely and emerging topics on human health, wellness and caring science.

Kyoto Review of Southeast Asia This website provides reviews of socio-political topics related to the Philippines and Southeast Asia. Type a related topic in search after connecting to the link.

Philippine E-Journals

Digital Collections

Center for Southeast Asian Studies, University of Hawaii This website contains a collection of 301 pictures of the Philippines, taken in 2000.

Digital Collection, the United States and Its Territories, the Age of Imperialism (1870-1925), the University of Michigan Library This is the University of Michigan Library’s Southeast Asia Collection of full text monographs and government documents published in the United States, Spain and the Philippines between 1870 and 1925.

Digital Collections, University of Washington Libraries This websites contains old photograph collection of the Philippines in the early 1900s and other countries in Southeast Asia. Type a related topic in search after connecting to the link.

Library of Congress Philippine Elections Web Archive The Philippine Elections web archive documents the Philippine general elections of 2010 and 2019.

Mangyan Bamboo Collection from Mindoro, Philippines, circa 1900-1939, at the Library of Congress The Asian Division's Southeast Asian Rare Book Collection counts among its most unique items a collection of 71 bamboo slats and 6 cylinders from the island of Mindoro in the Philippines. These items are etched with either verses or prose in the Mangyan script.

Philippines Maps, Perry-Castaneda Library, Map Collection, University of Texas Libraries This website holds a collection of old Philippines maps. It provides online version of a scanned-quality map produced by the U.S. Central Intelligence Agency.

SEAsite, Southeast Asia Picture Database (Northern Illinois University) This site provides a digital photograph collection of contemporary Philippines and Southeast Asia.

Southeast Asia Vision Collection (Cornell University Library) This site provides full download of old texts and rare book collections about Philippines and countries in Southeast Asia. Type a related topic in search after connecting to the link.

Southeast Asian Images and Texts, University of Wisconsin Digital Collection This website contains a digital photograph collection from the Philippines during the American colonial period and Laos in 1957, 1959 and 1969.

The Digital Library of the Commons, Indiana University This site provides full download of articles about the Philippines and countries in Southeast Asia. Type a related topic in search after connecting to the link.

The National Library of Australia This website provides a digital photograph collection of the early and contemporary Philippines and Southeast Asia. Type a related topic in search after connecting to the link.

The Spanish-American War in Motion Pictures Home Page This website contains information in the Philippines during the war.

COMMENTS

  1. PDF KARANASAN NG ISANG BATANG INA: ISANG PANANALIKSIK

    1. Sa mga magulang, kailangan maging malawak ang kanilang isipan at malaman kung ano nga ba ang mga maaaring pagdaanan ng mga batang ina. Makakatulong ito upang mapangaralan at magabayan nila ang kanilang mga anak upang maiwasan ang pagiging isang batang ina. 2.

  2. Ang Tagapamagitang Epekto Ng Teknolohiya Sa Pagtuturo at ...

    Ang pananaliksik na ito ay nag-aaral ng kung paano nakakaapekto ang teknolohiya sa pagtuturo at pagkatuto ng mga guro sa Pilipinas. Sinusuri nito ang mga salik na nakakaugnay sa kahandaan ng mga guro na gamitin ang teknolohiya sa kanilang mga klase, gaya ng kanilang kaalaman, kasanayan, at pananaw. Gamit ang crossref na pamamaraan, nakakuha ang mga mananaliksik ng mga datos mula sa iba't ibang ...

  3. Lawak ng Pagpapahalaga ng mga Estudyante sa Asignaturang Filipino

    Sakop nito ang Pinal na performans ng mga estudyante sa asignaturang Filipino. Ang mga respondente sa pag-aaral na ito ay ang mga estudyante na nakakuha na ng Filipino11/21 sa unang termino ng ...

  4. (PDF) Isang Pagsusuri sa Persepsyon sa at Aktwal na Kahusayang

    Abstract. Layunin ng pag-aaral na ito na mataya ang aktwal na pagtuturo ng guro sa Filipino ayon sa sariling persepsyon ng guro, ng kanilang mag-aaral at ng kanilang tagapamahala tungkol sa mga ...

  5. (PDF) Ang Ugnayan ng Wika, Pananaliksik at ...

    This paper aims to show the huge contribution that the Filipino language can make in enriching the research culture within Philippine higher educational institutions that can later on impact on ...

  6. (PDF) "Mga Salik na Nakaaapekto sa Pagkatuto ng Mag-aaral sa

    2024 American Journal of Humanities and Social Sciences Research (AJHSSR) American Journal of Humanities and Social Sciences Research (AJHSSR) e-ISSN : 2378-703X Volume-08, Issue-03, pp-109-120 www.ajhssr.com Research Paper Open Access "Mga Salik na Nakaaapekto sa Pagkatuto ng Mag-aaral sa Asignaturang Filipino" Andrey James B. Falcasantos1, Ashley Joy P. Buduan1, Rhea L. Mendoza2, Junny T ...

  7. Filipino help-seeking for mental health problems and associated

    Purpose This systematic review aims to synthesise the evidence on behavioural and attitudinal patterns as well as barriers and enablers in Filipino formal help-seeking. Methods Using PRISMA framework, 15 studies conducted in 7 countries on Filipino help-seeking were appraised through narrative synthesis. Results Filipinos across the world have general reluctance and unfavourable attitude ...

  8. Philippine EJournals| Home

    The Philippine E-Journals (PEJ) is an online collection of academic publications of different higher education institutions and professional organizations. Its sophisticated database allows users to easily locate abstracts, full journal articles, and links to related research materials. 231 Journals. 20630 Articles. 29759 Authors. 126 Publishers.

  9. PDF Taglish in Metro Manila: an Analysis of Tagalog-english Code-switching

    Tagalog-speaking region, and is now characteristic of bilinguals outside the Metro Manila urban reach. In my research, I have observed Taglish speakers as far as Tacloban, Leyte in the Waray- and Cebuano-speaking Eastern Visayas, hundreds of miles from the capital. The code-switching system

  10. Tagalog Research Papers

    This paper presents an analysis of the case of gender-copy in Tagalog. Tagalog (now Filipino as the National Language ) is known to have undergone an intense influence from Spanish during the Spanish colonial rule in the Philippines (early 16th - end of 19th century).

  11. Philippine Digital Library (PDL)

    Preserving the past, collecting the present, and helping to build the future \ LIB.PH. LIB.PH is a digital library, repository and archive for the preservation of scientific and literary works of Filipino and foreign authors. The project works on the principles of free participation: everyone can register and save their scientific or literary ...

  12. Tatlong Gulong ng Buhay: The Tricycle Drivers and their Lived

    Furthermore, it aims to explore the lived ex periences o f tricycle drivers duri ng the pandemic, speci fically: (1) to. describe the lived experiences of the respondents, (2) to d escribe the ...

  13. How to write Research Paper| Tagalog explanation #research # ...

    This video is all about tips and guides on how to make a research paper with tagalog explanations.#researchpaper #research #howtomakeresearchpaperHow to writ...

  14. Research paper in filipino

    a sample research paper in filipino subject. Education Technology. 1 of 26. Download Now. Download to read offline. Research paper in filipino - Download as a PDF or view online for free.

  15. Filipino Research Papers

    In this paper, we document a three-year initiative aimed at supporting the well-being and academic success of Filipino youth attending a Toronto public high school. Drawing from our commitments to culturally sustaining pedagogy and... more. Download. by Cristina Guerrero Banyai, OCT, Ph.D. and +1.

  16. Filipino help-seeking for mental health problems and associated

    Supplementary paper: Nguyen (2012) 269 Filipino Americans in multi-ethnic study, with 57.25% (n = 154) females and 42.75% (n = 115) males and mean age of 61.8 (SD 9.9 ) US ... to adapt them to cross-cultural research on Filipino participants. This may pose as a limitation on the cultural appropriateness and applicability of foreign-made tests ...

  17. Wikang Filipino: Hininga, Kapangyarihan at Puwersa

    Mga Susing Salita: Wikang Filipino, Kapangyarihan, Puwersa, Bienvenido Lumbera, Umberto Eco. Abstract. This paper will discuss why we must value our o wn language. One of the focus of the. paper ...

  18. Philippines: Online Research Resources

    This is the University of Michigan Library's Southeast Asia Collection of full text monographs and government documents published in the United States, Spain and the Philippines between 1870 and 1925. Digital Collections, University of Washington Libraries. This websites contains old photograph collection of the Philippines in the early 1900s ...

  19. Filipino Identity: The Haunting Question

    The paper is of relevance both to scholarly researchers and to others with practical interests in the region, as it will enable them to better know the people that they are or will be dealing with. ... Early in my research on the Filipino urban middle-class mentality, my host asked: "Niels, what is a Filipino?" Answering his own question ...

  20. (PDF) MGA ESTILO NG PAG-AARAL AT EPEKTO NITO SA ...

    PDF | On Oct 1, 2017, Peter Joshua Racca Titco published MGA ESTILO NG PAG-AARAL AT EPEKTO NITO SA AKADEMIKONG PAGKATUTO NG MGA MAG-AARAL NG BAITANG 12 SA MGA STRAND NG ABM, HUMSS AT STEM NG LA ...