Today, I defied gravity.

I refer to the force pinning me down to the sofa. For hours, I negotiated with my own body and mind, trying to gather enough courage to leave the house and go to the public mental health facility.

The last time I was here, the queue was so long that it took seven hours to see the doctor. As the body ached in intense abdominal pain, I tried not to cave in. Today, I arrived at past seven in the morning and I was No. 40. I managed to get a seat. That is already a small victory for the expected long day.

Most patients need to be accompanied. I am fortunate that I can still do this on my own.

There is a certain kind of fortitude required to spend an entire day waiting in a public hospital. But this “strength” is a product of a decaying public healthcare, of a system designed to make people used to surviving what should never have been normal. When the system designed to care for us is also pulling us down, this “strength” is dangerous.

In this hospital, only one psychiatrist is assigned for all patients. This explains the hours of long lines of patients every day.

Based on a 2026 study of University of the Philippines, there are 409 PhilHealth-accredited psychiatrists in the country, translating to 0.38 psychiatrists per 100,000 population. It also noted that the country’s ratio of psychiatrists and population has been decreasing since 2016. This shortage is not only about numbers but also about people’s access to health services.

If people struggling with their mental health opt for private consultations, the average cost ranges from P1,500 ($23.89) to P5,000 ($79.63) per session.

For the poor who are forced to join the long lines, the cost of psychiatric care is not an incidental expense. It can deprive families of food for several days, not to mention money allocated for utility bills, transportation, and rent.

The situation is much worse for minimum wage earners or contractual employees living from paycheck to paycheck. Sacrificing one whole day to get immediate psychiatric care means income loss.

Think tank Ibon Foundation said that around 70 million Filipinos belong to the poorest and low-income classes, earning between P10,000 ($159.27) and P22,000 ($350.39) monthly.

The high cost of consultation left poor patients to rely on a rotten public mental health system. Of course, the shame and stigma tend to prevent people from seeking psychiatric help.

The 2023 data from the Department of Health (DOH) showed that more than 3.6 million Filipinos suffer from mental health conditions, neurological and substance use disorders. Among the most prevalent conditions are major depressive disorder (affecting more than 1.1 million people); bipolar disorder (520,000 people); and schizophrenia (more than 213,000 people).

Behind all these numbers is the long line right now, with me sitting on a worn out chair in the waiting area. Someone is constantly checking the clock. Someone is wondering if the doctor will see him before the day ends. And someone is trying not to give up in this dreadful wait.

I had the privilege to take a leave at work to prioritize my consultation. But an average Filipino worker does not have this privilege, especially minimum wage earners and the contractual workers trapped in a no-work-no-pay system.

It’s already 3:00 pm. The two bottles of water and three pieces of bread are gone. The cellphone battery is running low.

A first-time outpatient tells another that it took her a long time to finally bring herself here. “Because of shame,” she said.

Behind her, a woman in her 50s told her, “You shouldn’t be ashamed. We are all survivors.” Sitting in the waiting area for half a day, most of us heard several stories of survival.

We pretended not to listen. But we heard such stories. This explains why the waiting area is difficult to forget. I spent more hours here than in my consultations. Most of my conversations with the doctor took only 15 to 30 minutes.

It’s 4:00 pm now, almost nine hours of waiting. I am already next in line. I may not be a doctor and I may be struggling but it is clear that the public healthcare system is dying from decay. (RTS, DAA)

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