Earlier this year, my students went on a quest from one classroom to the next: they wanted to know their peers' beliefs and opinions about schizophrenia. I could not have been a prouder and more delighted professor. The future of mental health research in the Philippines is bright.
Then, someone tried to dim the lights.
Other faculty required that I be physically present in the classroom. Students taking the survey, they said, might need the help of a mental health professional. They might be in distress answering supposedly "sensitive" questions. Undergrads in their last semester of a grueling public health course that seeps the brain while requiring emotional martyrdom in a school environment with equipment and facilities probably twice older than the students themselves – my group now needed a babysitter. Faculty believed that the students needed some hand-holding, and probably a bedtime story of Dalawa Ang Daddy Ni Billy to go with their baby pacifier. (READ: How these millennials are fighting mental illness with art, Scripture)
Thinking about whether you would live with someone who is hearing voices might lead to uncontrollable tears. Reflecting on whether someone who thinks they are Superman is weak or capable might lead to aggression – or worse, a compulsive need to pull your hair, taste, and twirl it into your mouth, and swallow it. Would you marry someone with schizophrenia? Hold on. This question might make your head explode.
A question on a chemistry final is more distressing.
We need lengthy psychological tests for job applicants, but a Pap smear or a bone marrow biopsy is not needed. We demand a psychologist physically present during a mental health survey – forget a cardiologist when asking you about your smoking habits, a political scientist when asking whom you will vote for this coming elections, or a behavioral economist when asking about how you practice water conservation during this inexplicable asinine fiasco in the metro.
It is compulsory that students or employees take a leave of absence until their depression or anxiety subsides. Our loved ones with mental illness must stay home. For their safety and the safety of others, they should not work, go to school, or do volunteer work. (READ: The cruelty of mental illness)
I am often invited to speak about mental health, but actually expected to talk about mental health problems. We draw a direct line between mental well-being and mental illness. (READ: [OPINION] A psychiatrist's view: Common misconceptions about mental health)
Mental health research is no different. We are required to come up with specific safety protocols that we do not demand of other research topics. We think asking you about suicide will increase your risk for committing suicide even though overwhelming data suggests that this is not the case. Our benchmark for safety is higher when it comes to mental health research.
These actions have a name. It's benevolent bias – a harmful attitude that is rooted in our belief that people with mental health problems are less competent. It provides a powerful justification to exploit them. We, including health professionals and academics, build a dogmatic straightjacket where we disguise our discriminatory behaviors by casting them in positive terms. We sell this ideology to justify our superior position.
All the "help," "additional services," and "requirements" are then supported by those with mental health problems and their families. Those dealing with mental health illness need people to take care of them. We appear to be helpful, but in reality, it legitimizes our beliefs that people with mental health problems are inferior.
Our attitudes toward women mirror this. We are rife with benevolent sexism. We believe that in disasters, women are out to be rescued before men. We believe that men ought to protect women, open doors for them, or pay for the dinner on a date. We see them as more emotional, more caring, more pure.
Their beauty explains the plentiful rape cases, as President Rodrigo Duterte would say. Sexism disguised as a compliment – now that is beautiful.
These are rooted in good ol' patriarchy.
Our kindness toward mental health does more harm than good. It is hard to shake off because it provides a direct benefit. We prioritize their safety, we offer more services. The recent mental health legislation is the ultimate large-scale benevolent bias.
It seems also insulting if ever our sympathy is rejected. Families feel pressured to accept our help, if nothing else but to graciously conform to social norms. If you have depression and a psychiatrist offers you medication, try explaining benevolent bias as a reason for rejecting the prescription. If you are a psychiatrist, try saying that your prescription is really about your know-it-all superior attitude. This is too uncomfortable, and so we press on.
We cannot reasonably expect to normalize mental health and well-being but treat it as separate or different. We cannot hope to integrate mental health care into primary care if we view people with mental health problems as "other." Our primary health care centers do not need mental health specialists. They need general practitioners who know how to do basic assessment and counseling. Our mental health research culture cannot thrive if we see depression or anxiety as specifically different from other research topics we wish to explore.
For as long as we see mental health as special, our stigma wins. – Rappler.com
Dr Ronald del Castillo is a professor of psychology, public health, and health policy at the University of the Philippines Manila. The views here are his own.