Eleventh Hour: Mainstreaming post-disaster mental health interventions in the Philippines


Typhoon Frank, which struck our municipality in Iloilo in 2008, still lives vividly in my mind. I remember how the night before the flood, my sisters and I, one of whom is a differently abled person, were nonchalant about what was happening outside. The blackout did not bother us because that meant playing shadow puppets on the wall again. We did not know what was coming to us.

What came after was a rush of events no one woke up prepared for. Our neighbor shouted, “May baha!” Flood was coming. My parents rushed to pack our bags. Then the water started filling our house, engulfing what little we had.

Confused, I modeled the actions of the adults around me: panicking to carry whatever could be rescued from our house that was quickly going underwater. A few minutes later, I found myself drowning, catching my breath like a fish out of water. Thankfully, one of our neighbors rescued me. Not knowing what to do, I did what others were doing: I ran as fast as I could, with only one slipper, semi-naked, until where my breath could take me.

The evacuation center was full of confusion. Children and adults alike could be heard wailing, grieving for the lives lost and for an uncertain future. This was not only in our municipality. In less than an hour, according to Relief Web, around 80 percent of Iloilo Province went underwater, affecting 48,836 families and 244,090 persons.

Gone in just a few minutes. Typhoon victims try to rebuild their lives after years of hard work went down the drain. (Shutterstock / Climate Reality PH)

Healing in a drowning world

The magnitude of destruction after a typhoon and other climate-related disasters is usually beyond the victim’s expectation. Years of hard work, gone in just a few minutes—leaving the victims trying to rebuild their lives. This is hard for every adult, especially since there’s also almost no space to feel.

Surviving in disasters is, in itself, exhausting. It is physically draining. However, another aspect of dealing with disaster is its mental and emotional labor. According to the Center for the Study of Traumatic Stress, debriefing is an opportunity for education about responses to trauma such as emotional reactions to disaster, somatic reactions, violence, substance abuse, and family stress.

Growing amidst disasters

While disasters and post-disaster rehabilitation are challenging for heteronormative neurodivergent adults, they are incomprehensible for a child and unbearable for the differently abled—especially if these children are from low-income communities.

Children are among the most vulnerable in our communities and often the most affected in disaster scenarios. According to the Philippine Statistics Authority (PSA), as cited by the National Disaster Risk Reduction Management Council, (NDRRMC), there are more than 30 million Filipinos under 18 that are vulnerable and may be subject to the disproportionate effects of disasters.

Children who experienced climate-related disasters life-long trauma without post-disaster debriefing and rehabilitation efforts. (Shutterstock / Climate Reality PH)

This highlights how prevalent mental health issues are, particularly on children that experienced climate-related disasters.

Children have a higher susceptibility to harm and suffering. They have limited coping and adaptive capacities, according to Carolyn Kousley, who studied the impacts of disasters on children. In addition, she identified that children tend to experience somatic concerns ranging from headaches, sleep problems, academic difficulty anxiety, and depression post-disaster.

Studies show that significant distress on the children due to the disruption of social networks during and after disasters is pivotal to their development. In particular, without access to mental health services, they are more likely to engage in delinquent behavior such as alcohol and substance abuse once they reach adolescence.

Absence of post-disaster debriefing, along with other rehabilitation efforts, enables a breeding ground for life-long trauma which will affect children in their adulthood.

Bridging frameworks into action

Mainstreaming mental health interventions post-disaster is where Republic Act No. 11036, or the Mental Health Act of 2017, intersects with Republic Act No. 10121 or the Philippine Disaster Risk Reduction and Management Act of 2010.

However, Republic Act No. 10121—the main legal framework in preventing, responding, and rehabilitating communities after disasters—does not fully incorporate mental health. Health is used as an umbrella terminology in the law and mainstreaming debriefing and other mental health interventions is not nuanced. This vagueness can be used as a loophole for local governments to view psycho-social services post-disaster as a prerogative rather than a priority for implementation.

The Philippines is the fourth most affected country by weather-related events from 2000-2019, according to Germanwatch’s 2021 Global Climate Risk Index. (Shutterstock / Climate Reality PH)

Streamlining the role of the government and agencies in formulating, developing, and implementing programs that ensure the provision of psychosocial support services to communities is an urgent matter as climate-related disasters are expected to intensify amid the worsening climate crisis.

As the fourth most affected country by weather-related events from 2000-2019 according to Germanwatch’s 2021 Global Climate Risk Index, we have no time to spare. With the recent Typhoon Odette leaving unprecedented destruction, we must expedite the mainstreaming of psychosocial services into our current disaster risk reduction and management plans.

We can’t let our next generation live with disaster-related trauma. Filipinos, especially the youth, should not be burdened by the fear, anxiety, depression, and other mental health problems that are aggravated by our volatile climate. That is unjust.

Thus, aside from integrating psychosocial services in post-disaster response, we must continue to demand climate justice from the culprits that brought the country into this situation: the Global North, corporations that are doing business-as-usual, and government leaders who have the power to act decisively and sufficiently to address the prevailing climate crisis but betrayed our rights for a livable future.


About the author

Ruzzel Morales is a Climate Reality Leader and Mentor trained by US Vice President Al Gore in 2016. She is a graduate of the University of the Philippines-Visayas in 2019 with a degree of B.A. (Political Science-Community Development). She is also an alumni of the Young Southeast Asian Leaders Initiative (YSEALI) Academic Fellow at the University of Montana, US under the Maureen and Mike Mansfield Center as part of the Global Environmental Issues and Natural Resource Management for Fall 2019.