There is nothing crazy about seeing a psychiatrist

The subject of mental illness figured prominently in the news recently. Worried over the possible stigmatization of psychiatric referrals, consultations, confinements and reports, 13 concerned past presidents of the Philippine Psychiatric Association, Inc. (namely Dr. Lourdes Ladrido-Ignacio, Dr. Cornelio Banaag Jr., Dr. Vicente Cabuquit, Dr. A. Efren Reyes, Dr. Dante Abcede, Dr. Cynthia Ramos-Leynes, Dr. Venus Serra-Arain, Dr. Jocelyn Nieva Yatco-Bautista, Dr. Sonia Castro-Rodriguez, Dr. Imelda Morales Martin, Dr. Felicitas Soriano, Dr. Ma. Imelda Batar and Dr. Norieta Calma-Balderrama) met last May 4 with me. They came up with the following statement:

“Recent political events focused on Psychiatric reports, which affect how the public perceives the field of Psychiatry which is an integral part of the practice of Medicine. We would like to state the following about psychiatric consults and psychiatric disorders.  

“Psychiatric consults do not necessarily indicate debilitating psychological conditions.

“It is expected that people who experience stress, whether on a day-to-day basis or as a result of more extreme experiences like disasters, domestic violence, accidents, separations, abuse, losses, medical illnesses will have psychological reactions that may range from normal to more serious reactions. Every medical illness carries with it an emotional component that if not treated in some cases may lead to psychiatric disorders that can be debilitating. Therefore, any individual or family may seek psychiatric consult for any of the above conditions, including among other things, developmental and behavioral problems among children. 

“Due to a wide variety of stressors in the environment, it is important to make clear to the public that psychiatric treatment can spell the difference between transient and long-lasting effects. Currently, depression is considered the   fourth in terms of health burden worldwide and predicted to be the second in terms of morbidity in the next few years. Recognizing mental health problems and seeking psychiatric treatment is very important in ensuring that one does not suffer from any kind of mental illness. 

“Perpetuating the misconceptions about Psychiatry prevents people from seeking consult for psychological sufferings. Early psychiatric consultation may prevent or arrest the development of debilitating emotional states.

“We call on everyone not to allow stigma, misconception and negative prejudice to rule over science and reason.  

“Let us advocate for a country that is cognizant of the importance of mental health in nation building.  

“Every Filipino has a right to a better mental health!”

The above statement indeed emphasizes that not all people who go to a psychiatrist are mentally insane; that depression may be transient or short-lived; can happen to normal individuals in abnormal or difficult day-to-day life situations. Going to a shrink may shorten the course of an emotional problem, resolve an emotional crisis and abate the development of additional symptoms. 

In fact, there is a long list of reasons why people consult a psychiatrist and request for a report on their mental status. Let me cite some of them:

1. Appointed government officials to high administrative positions require psychiatric clearance.

2. Couples legally adopting a child also need to submit to the court handling the adoption proceedings.

3. Persons securing license to carry firearms also need to show their mental competence.

4. Whenever there is question or doubt on one’s competence to handle one’s estate or funds, a psychiatrist may even need to appear in court to testify to the accuracy of the psychiatric report submitted in court.

5. In cases of organ donation, there is a need to show that the organ donor is not mentally unstable and is donating one of his kidneys for example, for the right reason and that his decision is made without coercion from anyone.

6. In filing for the petition for the declaration of the nullity of marriage, the court requires a psychiatric report from a qualified psychiatrist (diplomate of the Philippine Board of Psychiatry), psychological report from a clinical psychologist to understand the psychodynamics of the failed marriage and to determine who has a psychological incapacity to fulfill the duties and responsibilities in the marriage.

7. School referrals for children with special needs, with disruptive behavior or decline in the academic performance are also quite frequent. Here, the child psychiatrist or clinical psychologist recommends and/or assists the school in creating specific programs for the specific needs of the child.

8. The psychiatrist also plays an important role in the realm of plastic and reconstructive surgery. Sex change surgeries, for example, require psychiatric clearances from three qualified psychiatrists since such surgeries will result to permanent alterations in the patients’ bodies.

9. Some insurance companies require psychiatric reports of workers who sustained disabling injuries at the workplace in order to aid them in estimating the amount of money needed for the worker to undergo psychotherapy to help this worker cope better in accepting his/her disability.

10. Workers who filed sick leaves for emotional or psychological reasons require a psychiatric clearance stating that they are already fit to resume work.

11. Visa applicants with prior diagnosis of a mental disorder will also require a psychiatric report and clearance that they are mentally stable to travel.

12. Foreigners applying for investor’s visa also need a psychiatric clearance.

13. Infants born with ambiguous genitalia is actually a medical emergency. A medical team consisting of the pediatric genetic specialist, pediatric surgeon, obstetrician-gynecologist and child psychiatrist will need to explain to the parents the diagnosis, the need for the series of reconstructive surgeries for the child depending on the chromosomal and anatomical sex of the child and the necessity of psychological support throughout the growing years of the child.

14. Couples about to end their failed marriage likewise bring their children for psychological support to help them understand this phase of life circumstance.

15. In times of disasters due to natural calamities, psychiatrists and psychologists play an important role in the psychosocial rehabilitation of the disaster survivors.

I certainly hope that this article has helped in the destigmatization of the practice of psychiatry and psychology.

(E-mail me at nina.halilijao@gmail.com)