 halipo sa lahat. Good morning, good afternoon, good evening everyone, nasanman po kayo, party ng mundo. Maraming-maraming salamat po and welcome to the 73rd installment of the Stop COVID-19 webinar series brought to you by the University of the Philippines. Thank you for being a part of our credible online community and to all those who have just discovered us for today, welcome po. This month is Mental Health Awareness Month. We have a very timely topic for today. As global studies point to the serious vulnerability of the youth, particularly students who are experiencing extreme stress because of the COVID-19 pandemic, we try to explore what are the things that we could help out in terms of their mental health and what are the assistance that we could provide in that regard. Local practitioners are reporting an increase in young patients who are depressed, anxious, and maybe even suicidal. So paano po ba ang mga youth po natin sa Pilipinas? How are they coping? What are the things that our frontline healthcare workers can do when faced with young people who are manifesting these signs and symptoms of psychosocial stress? If you want to get the answer straight from the most credible experts, please stay tuned. We really have an excellent panel of speakers for today as always and we hope you'll be able to take away very important nuggets of wisdom from today's webinar. I'm Dr. Raymond Francis Sarmiento, director of the National Telehealth Center, National Institutes of Health University of Philippines Manila. Always a pleasure to be with all of you during our regular Friday lunch date. I always look forward to Fridays because I get to share my hosting duties with a beloved mentor, my partner in crime, and the special envoy of the President for Global Health Initiatives. She is also our adjunct research faculty at the National Telehealth Center. Dr. Susie Pineda Mercado. Dr. Susie? Hi Raymond, good afternoon. Kamusta po sa inyong lahat. Everyone who's watching, we'd like to welcome you to the webinar. From all over the country and from different parts of the world later Raymond will share with us our international participants. But anyway, I'd just like to start by saying that I know that again, I always say I know that you're having a difficult time and we all have family members who've been affected by COVID. Maybe some of you are actually recovering from COVID now. Just hang in there, no? We know it's not easy. It's tough for us and it's tough for our families, but we have hope. And today we're going to talk about mental health in young people. It's an opportunity to understand how we can reach out to young people who are going through severe stress, but we'll also have insights about ourselves, right? How we can take care of ourselves so that we are resilient and we come out of this better persons and better frontliners. So welcome to the webinar and Raymond did you say 73? Yes, 73. Tama, Dr. Susie. Yes, that's correct. Okay, so 73rd episode and we have a great lineup of speakers. So stay there. I think earlier there were some problems with entering Zoom, no? So if you have friends who cannot enter, just tell them to go to YouTube nalang kung nahihirapan sila kasi mo kong may problema kanina yung Zoom. Okay, so Raymond over to you. Go ahead. Thank you, Dr. Susie. So for those who are joining us sa YouTube channel and TV UP where we are live stream, as well as our Facebook accounts, University of the Philippines, stop COVID-19 and TV UP, please let us know if you are doing this sort of watch parties, so we could greet you while you are watching this episode. For today, we'd like to discuss the issue of mental health and well-being, particularly in the youth. So ano po ba yung sinasabi nilang youth na category? So pasok papuba tayo doon sa youth category. Okay, Raymond, anong ba? Raymond, talaga nag-ambition, kapawog na, tapos ka na dyan, tapos ka na. So according to the National Youth Commission, the youth identifies yung pung mga between ages of 15 to 30 years old. So today, we will be taking a closer look at COVID-19 and the mental health of the youth, most specifically po, those who are students, maybe who are early career in terms of teaching, working in the front lines, yun po ang ating tututukan for today. And as always, putting our discussion into context, TV UP has prepared a person on the street video. Take it away, TV UP. Sa akin, feeling ko wala na mong hindi at-pictado ng lockdown dahil sa pandemic. No one ever heard kong onyong community quarantine ever. So siguro na off-guard ang lahat po ang naman ngayari and very uncertain. The health situation po actually is very personal sa ating. I am actually diagnosed with my polar one. Ayah, ma, medyo familiar po siya sa akin concept. Tapos, I've been diagnosed ko last year nung nag-hit yung pandemic. Po, apictado ko kami. Pero po sa ibang angal siya ditingan, yun di po siya kasing bigot compared sa karanasan yung iba. So kapag nagsyapdown po ko usually it last a week. Ang pinakamatagal po nangyari sa akin is three weeks na parang nagkukulungpo ako, tapos hindi ako kumakain, tapos ayin. Parang nasa space ka lang na hindi mo alam ko ano talaga yung gagawin. Nasa very, very dark days. Actually may mga suicide attempts, kanyun po. Personally, I'm not diagnosed with any mental health condition. I know I do have friends who have. Ayit na hangitit ko ako. Masasabi ko na pangit mo po yung lagay ng mental health ko. At na-fifil ko sa sarili kung declining na siya. Of times po, meron ako anxiety or stress but hindi siya, I mean hindi po ako nagpapakonsult. Ang hirap na magpush ng sarili kahit, para kung hilos kahit lang sa mga kasi yun nga, going back to the fact na wala naman ako in diagnosis. Inisip ko sa sarili ko, like is it valid for me to feel anxiety when I'm not clinically anxious or clinically depressed? Sometimes, iiyaka na lang, you can handle yung mga pressure and yung stress na meron ka. Nung hindi pa po ako diagnosed, siyempre yung mga prejudice sa mental health, siyung mga may mental health situation na value ganun. Parang natakot po ako na makategorize sa ganun. Kaya sobrang difficult po sa akin yung acceptance stage. Ang tinkle po sa mga tao ko na, tumanggap po sa akin. Ayit na may mga ganun po ko na nararamdaman. Ang pinaka-importante po at atalaga yung batanggap mo sa puso mo na may ganun kang kalagayan. So let ako ng spoken poetry or tula, or kanta. Ang sa akin kasi halas lahat tayo dito. We are dealing with our own problems in life. And panang nakakahiyak for me na mag-bother sa ibang tao. Feeling ko madali talagang madishartin ngayon, especially yung laya sa mga naihita natin sa news, parang andaming bad news. The way that we should be looking forward is that palagi naman may bagong nalalaman itong ko sa pandemic. Hindi naman tayo nagiging backwards. Kahit na anong mangyari, matatapos-matatapos talagay ang pandemic. Thank you very much, TVU. It's always good to start with that person on the street interview. And for the people who joined that interview, thank you so much for sharing your thoughts. It's really easy to share what you're feeling, what you're experiencing. And we're just very thankful that you gave us time and you shared your feelings, your ideas. And I think this is a source of inspiration for everyone that we can actually talk about these things and not just keep it under covers or hide it because it's very real and it can be very debilitating especially. So thank you to all of those who participated in the app person on the street interview. So Reymond, over to you. Thank you, Dr. Susi. So for those who are joining us, specifically for today's webinar, just wanted to reiterate that we may be talking a bit more of sensitive issues related to mental health. Something that bakal ang po that there are certain emotions that may be evoked para lang po hindi po magulat ang ating ngamang attendee especially for those who are joining us for the very first time sa ating webinar po. Anyway, our webinar is able to accommodate 3,000 participants. So please join us as a Zoom. We notice that we have 2,049 registrants if I'm not mistaken for this webinar alone. We are now numbering almost 50% of that in the Zoom webinar sa mga sumusubay-bay po sa ating through YouTube and Facebook. Maraming salamat po. Pero sana po ay makasali rin po kayo sa Zoom so that you could get the full experience of the online community. Dun po sa ating mga first-timers na sa salalip po, we often have this fun quiz sa Zoom. And for those who are outside of the Zoom pa dito parin po kayong sumali if you go to www.menti.com. Today's code is 73519422 that's 73519422 yun po ang inyong e-enter na code so that you'd be able to join our fun quiz. And for those who are asking, we are still trying to churn out the certificates of attendance and trying to review all of the requests for attendance for the previous 72 webinars. Kayo po na nasaipun natin kung ano po yung nilagay po ninyo sa inyong registration, yun po ang mag-appear sa inyong e-certificate and only those who have watched at least 50% of the webinar duration will be able to receive a certificate. We continue to work in disseminating all of the certificates for the previous 72 webinars. So thank you po sa inyong patience and understanding. For those who have attended any of those webinars outside of the Zoom, please let us know so we'd be able to create and check our records and create the necessary certificates po. Over to you, Dr. Susie. Yeah, thank you very much, Raymond. So Raymond was saying that, okay, we are hearing of and actually experiencing restlessness, a lot of stress among young people. Some are even experiencing anxiety, depression and even hurting themselves or committing, trying to take your lives, not committing suicide. The question is, what can we do? As frontline workers, okay, this is something nakikita nyo sa paligit nyo, nababalitaan nyo. Ano ba dapat ang gawin natin? Or how do we respond? So let's say, merong pumunta sa inyong kaibigan nyo na sinasabi ng kukulong ang anak sa kwarto. Anong gagawin natin? Anong mga sinyalis na mukhang kailangan na natin i-referito sa emergency room or sa mga specialist? So we will talk about all of these things. We've got a great, we always have a great line of speakers. We're so happy that they give us the time of day to share with you because you are very important, our audience, you are very important. Kung hindi po sinyo, wala po kami dito. So today, we are really going to zero in and focus on mental health issues of young people. We have talked about mental health before. It's not the first time we're talking about mental health. We've tackled mental health many times. It's probably our third episode on mental health. So we've done it before, but this time we want to talk about young people and as you saw on the persons on the street interview, e talagang malalim at mabigat. Hindi na dahanan ng mga ang mga kabataan ngayon. So today, we're going to learn more about that and we have very good speakers. Raymond, am I going to go straight na into the end? Are you going to talk about the format? Okay, okay. So again, ang ating format and structure for this webinar, we have a standard panel discussion format having our main speaker give like floor representation on the topic and then we will hear talks from our set of reactors followed by Q&A session. You will notice, lalo na po dito ko sa ating zoom na we are almost numbering 1100, may mga sometimes one of the organizers or host or co-host will be reaching out to you to ask you to be promoted sa panelist section po. Wag po kayo may iya. Wag po kayong kakabahan. Dahil po na pili po kayo dahil po sa inyong katanungan. Yung katanungan po ninyo will be what you will be asking any of our resource speakers for today live. Directly, we want it to be able to promote you to panelist po para you'd be able to open your camera and your mic and be able to converse very, very naturally. So we notice po kasi in previous webinars that there are a bit more of those who are declining in the past. And we hope those who will be asked to join the panel will be more than happy to join us. So maraming-maraming salamat po para doon. Okay, Suzy. Okay, thanks Raymond. Yung baka siya na hiyari, mani ko naman. Thank you. Okay, let's go to our opening. We've got a very distinguished opening remarks speaker who is associate professor of psychology, college of social sciences and philosophy at the University of the Philippines. So former chairman of chairperson of the department of psychology let's welcome Dr. Michelle. Michelle, welcome. Magan na umaga po Dr. Suzy and Dr. Raymond. Magandang araw po sa lahat. It is my privilege to welcome you all to this webinar on COVID-19 and the mental health of youth. A topic which is quite apt given that October is mental health month. Given that we have been living under the threat of a pandemic for over a year now under various degrees of lockdown it is about time we ask about how the pandemic is taking a toll on the mental health of young people who strive to live to study, make a living and take care of themselves and others under very challenging circumstances. From a developmental perspective, youth is considered a time of great and rapid changes and learning. Young people are getting to understand themselves and their place in the world through education and work opportunities where they gain knowledge, skills, friendships and important life experiences. It's expected to be a tough time but also an exciting time one that we adults may be remember with some fondness and one which we have gained a lot of lessons from the young people who fall into our care. We freely give love advice and career advice. We mentor our young colleagues. We tell them which people to avoid which paths to try, which adventures to actively seek. But from 2020 the extreme changes in school and work settings created social, psychological and even financial challenges that have an impact on young people's development There are many who have lost loved ones, friends and colleagues have been unable to continue with school or feel that they have no job prospects. None of us have prior experience of living through a pandemic and so we are here today to figure out together how we can better help our young people and promote and protect their mental health. If they cannot benefit from our past experience we hope they can benefit from our capacity to learn and capacity to care. As a faculty member of the UP Dileman Department of Psychology and as a mother to a teenager I encountered many stories and you probably have heard them too of adolescents and young people being overwhelmed by the difficulties of remote learning, taking care of sick family members sila na lang yung natiti rana hindi infected or pwedeng lumabas ng bahay dealing with financial difficulties because parents lost jobs or worse, grieving the loss of loved ones to COVID and fearing getting infected by COVID themselves. I have colleagues who are young people too who are teachers while they are students who must take care of many others while they also struggle with their own anxieties, feelings of isolation and meaninglessness and the stress brought about by job insecurity, health problems and juggling papers they need to submit and papers to check. As a volunteer of the UP Pahinungod Program so some of you may have heard of the volunteer service program of the University of the Philippines I participated in an initiative to provide psychosocial support to our students, faculty, staff and alumni of UP Dileman. This initiative was in response to the pandemic that appended our lives in 2020. UPD Pahinungod identified the need for more peer-based psychological support to complement the more specialized professional services offered by PsychServe which offers free psychotherapy and this is headed by its director Dr. Bollet Bautista and our University Health Service which offers free consultations with our resident psychiatrist Dr. Dina Nadera. So we began as a small team offering training to interested individuals on PFA and wellness skills based on the community resilience model and eventually recruited from this pool volunteers who would provide email-based psychosocial support to our community. We have now trained over 80 people and that includes faculty, staff and also alumni, students also and offered support to over 100 individuals and are now preparing to establish volunteer run peer support groups in interested colleges and institutes this academic year. The hope is that our efforts at Pahinungod combined with the work of PsychServe the University Health Service the Office of the Vice Chancellor of Student Affairs student town sales and administrative teams of the various colleges and institutes creates a community of care in UPD Liman that young people and even not so young people like me and even our families can benefit from. So like everyone I aim to learn from our esteem presenter and our reactors I'm looking forward to today's conversation and really hope that for myself and for all our health professionals out there listening that this is just the beginning of many more conversations that later lead to actions to create more communities of care for the benefit and well-being of our youth Malipo, welcome at Magandang Arao sa ating lahat. Okay, thank you very much. That's Dr. Michelle Ong from UPD Liman Department of Psychology. Okay, Raymond, we have our fan quiz. Let's go. Thank you, Dr. Susie and thank you to the former psychology chair po Dr. Mitch Ong, Dr. Mitch marami-marami salamat po. Hope you'll be able to still join us ating panel discussion. We are now posting in Entitled Opinion poll po. We have two questions for today and this is exactly what you will be seeing sa ating Mentimeter. We try to give something very, very new in terms of visually appealing stuff as part of our webinar. For our question number one, alin sa mga sumusunod ang red flags or signalis na pagkakaroon ng mental health problems ating mga kabataan. Medyo marami po ang ating choices, pero please feel free to select yung para po tingin po ninyo na tamang sagot ang options po natin ay hindi makatulog. Option two, sobra naman sa tulog. Option three, walangan ng kumain. Option four, overeating. Option five, cannot take care of oneself. Option six, cannot take care of others. Option seven, kado ang pag-iiba ng ugali. So marked behavior changes po. Next option, disinterested in things they use to be passionate about. Next option ayong makipag-usap and our final option sinasaktan ang sarili. So please take your time. We are seeing pagkonti-konti po ang sumasali but we hope that you'd be able to join because a little over 1200 attendees in the Zoom. So hopefully maray po sa inyo ang makasali po sa ating fun quiz. Before we go on to our second question, as mentioned we are being viewed both locally and internationally. So I'd like to greet those who are joining us all the way from Marivellas Mental Wellness and General Hospital in Marivellas Bataan, the National Center for Geriatric Health in San Miguel, Manila, the province of Negros Occidental, Department of Health Eastern Visayas Regional Office, Dr. Arturo P. Pingoy Medical Center in Coronadal, South Kotabato. Internationally from Oman College of Health Sciences Ministry of Health, Muscat Oman, Mentary, Intercultural School, Indonesia, Nguyen Thayhok Clinic from Kanto, Vietnam, Penang Malaysia, Nongphant Cambodia, Shinshu, City, Taiwan, Maharashtra, India, Dubai, UAE, Jeddah, Saudi Arabia, Lunichi Ali University of Lida II, Algeria, University of Fiji, Laotoka, and Health Education Australia Limited very first time all the way from Melbourne, Australia. So maraming-maraming salamat po and hopefully maray po kayong makuwa sa ating webinar for today. Second question reads, if you do not know what to do about someone with suicidal thoughts, what should you do? Ano pung kailangan yung pung gawin pag merong po kayong kailala or naing counter na may suicidal ideations? Option A, prescribe an antidepressant. Option B, tell the parents to watch the child closely. And option C, send to appropriate center like a clinic or emergency room. We are seeing that a little over 700 have joined. We will not be closing our fund poll. Please participate po. And we hope that you will be able to get of the pulse po of our audience and be able to contribute for our valuable discussion for today. We will not be closing this as we move on to our webinar proper. Over to you, Dr. Suzie. O na katuwari mo ang gagaling na ating audience yos masagut pa sila sa chat. Yes, yes. This is really very stimulating kasi red flag, dapat alam natin and also I am really very happy to see people participating, putting their answers even in the chat, in the Zoom and in the Mentimeter. Okay, let's go to the meet. Sige, na batatagaling to kasi magaling po talagang ating susodada speaker. So for our main presenter for this webinar when we talk about child psychiatry in the Philippines there is one name that stands out and we are all very privileged to have known him, to have been his students and to have also experienced the help that he has given to our families, to our older brothers and sisters. So many children have benefited from his wise council and some refer to him as the father of child psychiatry in the Philippines. So let us welcome Professor Emeritus of Psychiatry at the University of the Philippines, Philippine General Hospital Dr. Cornelio Gibana Junior Dr. B. Welcome to the webinar. Thank you, Susie. Thank you very much, Raymond. Good afternoon to the thousands of people who are attending and I'm very happy to be here. It's indeed a privilege especially to talk to our frontliners. Our frontliners have always been an area of concern for me. They are our new heroes and yet they seem to be forgotten heroes, neglected heroes and sorry to say but they are doing a great job and today we're going to be talking about the mental health of young people what is the impact of this pandemic. We're now moving into the third year of the pandemic. We're ending the first one and a half years very soon and it will be third year and we will see what the continuing impact is on the life of the young people. Next, please. I want to start with the mantra of the World Health Organization that there is no health without mental health. I think more than any other time this is the time when we realize how true this is. Next slide, please. And yet, long before the pandemic year 2013 WHO released fact sheets calling our attention to an emerging mental health crisis. The alarming global increase in mental health problems WHO in fact focus on the young people and estimated that anywhere from 10 to 20% of children and adolescents in this world suffer from various forms of mental disorders and that most mental disorders in adults 50% in fact begin at age 14 but remain unrecognized or did not get any appropriate help until the problem has become very complex and the risk of suicide is highest in ages 15 to 24. What happened is a very good question but that may be for another lecture because today I want to focus on the impact of the pandemic on the youth mental health. Next, please. But this is a survey the Global School Based Student Health Survey which is done in collaboration with WHO and some private groups like the CDC Center for Disease Control and Prevention and of 2015 results the 2019, I don't know I have not seen it the pandemic had intervened but these are results long before the pandemic 17% of the students surveyed said yes they attempted suicide at least once in the past 12 months when they were asked about suicide 12% admitted that they seriously considered attempting suicide in the past 12 months and 11% have made plans on how they would commit suicide. Alarming figures and very young people there is also an allusion, a mention for social media envy as a moderate significant predictor of symptoms of depression among the Filipino students surveyed and we can understand what's going on with WHO, I mean with the Facebook right now and there's also allusion to an emerging mental health crisis saying that we have very limited facilities to meet the needs and we are now facing the mental health crisis of supply and demand the demand is increasing geometrically lahat kami na mga health worker mental health workers punong-puno at mahaba ang mga waiting line and yet there are not that many of us, psychologists psychiatrists, social workers so this is heading for some kind of a crisis next please and then the coronavirus descended upon us we all know by now how difficult this time is that none of us have ever had to deal with we have an invisible enemy that we can see only in counting the number of people na nang kasakit, na matay kaya madalas, nakaglute tayo sa TV, sa radio adding to the burden of mental health where forever getting a lot of negative news and how did we respond the simplest response was avoid getting infected wash your hands, put on your mask and now also the face shield and keep social distancing stay away from crowds and the ECQ now called alert 1, 2, 3, 4 was implemented next please and we observe following this an elevation in the levels of stress and anxiety and how stress is normal at times like this we are going to be stressed and it's normal to feel sad it's normal to get nervous at times like this but our anxiety have gone beyond the boundary of normal so that now we are going through a lot of people are experiencing toxic anxiety marked by constantly worrying problem in sleep problems and this regulation of emotion next please there are so many factors that we can impute as a reason for this rise elevation of mental health problems but we can summarize this in two words uncertainty and isolation uncertainty there are so many good questions with no good answers we don't even know how this all started and we don't know when this is going to end there are young children asking mommy kailan ako babalik sa school kailan ako pwede makipaglaro and young teenagers languishing in their bedrooms wishing to meet with their friends but cannot because of this pandemic we don't know when this is going to end when we step out of the house we don't know whether we are going to be hit by this virus and if we do get hit what's going to happen are we going to be hospitalized we don't know how long our savings will last because we don't know when this pandemic is going to end so much uncertainty makes our lives feel like we are not in control and isolation isolation is something horrible for Filipinos we know that we love to be connected and this isolation that brought a lot of loneliness and grief next please and now we are made to live a new normal whatever that new normal is this constantly shifting normal and there are certain features in this new normal that can be a major source for stress next please when number one this school migrated to home and distance learning this was a sudden event we are all unprepared and specially our children and the parents this changed the context of school for both parents and their children and presented unique challenges and this has been one of the major sources of the stress of young people next slide when work went home and people are working from home parents specially mothers became confronted with a very tight balancing act of managing multiple responsibilities that work their social lives their family the household will have to be okay cleaning the household making sure that there is food on the table multiple roles so much stress on the parents next slide please and this common conversation masakit na ang mata ko ang likod ko masakit na sa kaw dito sa little corner but I don't have any choice I don't have my own room this is the lament of people who live in small spaces which is a vast majority of our people pa wala ng load the way the things are being done is just rust we need more time to prepare and one of my patients had said this school has just become a matter of compliance now it's not about learning I keep working on my reports I managed to submit them many times late I get very anxious but I comply but I don't think I'm learning next slide and this pandemic altered the experience of loss grief and bereavement we're familiar with this when a member of the family gets sick and needs to be hospitalized we're not allowed to be with them at the time when they need us and we need to be with them that is not allowed and when we lose them to the COVID we can't even exercise the normal grief that we go through so the experience of loss grief and bereavement depression, anxiety post-traumatic stress disorder and there is so much complicated grief floating around next please the focus have moved to the children, the young people because they were evidently being very stressed among the first studies were the ones done in U1 China Hubei China 403 children admitted to depressive symptoms 20.6% 18 close to 19% of the student survey admitted anxiety symptoms next slide please and in Italy and Spain the same findings parents were asked what they observed about their children ages 3 to 18 about 86% of parents said yes, we know emotional state and behaviors in our children they showed difficulty concentrating boredom, irritability restless, nervous feelings of loneliness and easiness and a lot of worries next slide please study after study will show that there are many countries that you can search and the same findings and in the Philippines what is the impact this is something very recent this came out just August 2021 Philippine One Health University Network in collaboration with Southeast Asia One Health University Network study the impact of the pandemic on our students in terms of stress, depression, anxiety and the impact of the event itself our students from the national capital region showed high levels of problems dealing with stress 19% 22% admitted to depressive symptoms 36% admitted to anxiety and close to 26% admitted having a terrible time trying to cope with the impact of this pandemic when compared with other students the numbers did not change much but when compared to non-students the numbers dropped by about 50% showing that the students are the most stressed group in this population next slide please and this is what is interesting when compared to members of the general population housewives, people who are employed people who are unemployed farmers those who are retired when they measure the impact of the event of the pandemic on the mental health the students still remain top the highest group that is stressed next please and the young people took actions you are aware that we have the Y4MH youth for mental health a group of young people organized themselves in an effort to help push back the stress that is beginning to envelope our young people and then there is this other group student solidarity network to survive COVID-19 2020 wrote a petition for the issuance of a memorandum order to implement other measures to address issues of accessibility financial, physical mental stress and the COVID-19 pandemic please do not just measure our academic performance please look at the context in which we are trying to learn look at the poor internet connection the unavailability of devices the non conduciveness of learning in this digital the COVID-19 effect on students and families the struggle of coping with online requirements physical, mental financial stress next this is a slide that shows us how to be watchful it is normal to feel sad under these circumstances and nervous and angry and inattentive but when did the sadness the normal sadness become a depression which is an illness that needs to be treated when did nervousness become an anxiety disorder and anger became a manic rage punching the wall, threatening people hurting oneself there is an imaginary line in the center and there are certain warning signs that would show us that we are moving towards that red line and in fact maybe have crossed the red line and these are the warning signs we need to notice that we have been drawn for more than two weeks seriously trying to harm oneself or making plans to do so sudden overwhelming fear so intense worries or fears suggesting depression anxiety changes in the behavior normally quiet now getting involved in many fights and decide to hurt others severe out of control behavior that can hurt oneself next please not eating throwing up increasing use of cigarettes alcohol drugs severe mood swings that cause problems in relationship drastic changes in the students behavior or personality next line school difficulties may in fact be assigned of emerging or unrecognized mental illness poor attendance for vague physical reasons that have no organic explanations difficulties of relating responding to the demands and the threat to the underlying mental health needs difficulties with the academic work social integration adjustment to school cries for help on social media young people are so engaged in social media and there are cries for help that goes around one of my patients got very alarmed because his friend texted him and said baka ito na yung huling text ko sayo ha and that's very frightening next please what are the risk factors for depression environment school is always number one as a source of stress social media facebook we understand what's going on with facebook now twitter instagram there are some individual risk factors like cognitive distortions what do we mean the child the individual the young person begins to be supported in the way they look at things there's no hope there's always problem and I'm not good at this negative thoughts personal global attribution like nobody likes me in my school they all hate me that's a global attribution that will make him feel depressed next slide please other factors of course family and stable environment serious family fights and conflicts abusive, unpredictable behavior of parents alienation from family members or friends multiple losses one of my patients lost his grandfather his favorite person and then lost friends who are going abroad because they're going to study abroad and became very depressed exposure and experience of suicidal behavior actual suicide in the family or a close friend one or more attempts at suicide by the person himself other mental health conditions like anxiety ADHD conduct disorders next slide warning signs for suicide there are some behavioral clues drawing pictures, writing stories plays or doing other artwork about death or suicide I recall a mother who was so worried about her son high school who keeps to himself and she checked the notebook there was nothing written in the notebook except drawing of people hanging giving away their favorite things parang nagpapamanan nat pinamamanan nanyang kanyang mga favorite things changes in their behavior from being quiet to becoming aggressive there are certain situational clues of course the death of a loved one especially if by suicide or accident the loss of important relationship next please there are direct verbal cues I've decided to kill myself I wish I were dead I'm going to end it all sometimes it can be indirect like what's the point of going on soon you won't hear you don't have to worry about me any longer you would be happier better off without me talking, writing about death or texting a friend this may be the last time you'll hear from me next line now this is alarming this is the latest the state of the world's children 2021 by UNICEF I want to thank doctora bernie madrid for sharing this very timely that suicide is the fourth leading cause of death right now among 15 to 19 year olds in the world every year almost 46,000 children ages 10 to 19 and their own lives that is one every 11 minutes that's scary alarming and very very sad next slide please there are certain means about suicide that we have to know people who talk about suicide to do it they just want attention don't ever say a mother saying tigil na yung pag-inarti mo adami kong problema minimizing the problem making the individual feel guilty that will push this person to jump out of the house talking about suicide can be interpreted as encouragement we're afraid to talk about it the truth is when the individual where some suicidal thought is able to talk to someone there is a relief it is as though a deep secret has been shared only people with mental disorders are suicidal that's not true most suicides happen suddenly no it takes a long time suicide is a very ambivalent act someone who is suicidal is determined to die but suicide is always true but suicide is a very ambivalent act it takes them a long time before they decide to end it all and those who survived they say they regretted it they were sorry that they even tried once someone is suicidal always suicidal no that's not true suicide only happen to certain kinds of people that's absolutely not true suicide does not respect any particular group of people it can happen even to members of our own families next please so a very important step when you suspect there's suicide and depression is to screen screening for depression can prevent deeper mental health problems and suicide it can help us especially the frontliners to make the proper connection make a diagnosis implement some measures and refer quickly so next slide please there are certain measures that are designed not for psychiatrists and psychologists only but even the primary care workers can use this screening for suicide and depression patient health questionnaire or PHQ-9 what we use for screening for depression and if positive for suicide then we go to another tool called colombia suicide severity rating scale CSSRS these are all on public domain you can search this and download them and study them and you can use them PHQ-9 is self-administered the CSSRS is administered by clinician and as we will see later the self-administered patient health care questionnaire is if positive and 11 points is positive then we move to CSSRS next slide this is the PHQ-9 modified for adolescents modified only in modifying some words for example number 7 instead of reading we added watching TV because reading newspaper original at PHQ-9 but these are the symptoms we see in depressed individual feeling down, depressed irritable, hopeless little interest in pleasure in doing things trouble falling asleep, poor appetite feeling tired, feeling bad about oneself trouble concentrating on things moving or speaking so slowly that they become noticeable to others or the opposite they become fidgety and restless or entertain thoughts that they were better of dead or hurting oneself and there are four columns to fill one for several days two for more days than half the days nearly every day and if they take this column then you add and if the total score is 11 or more or answered 1, 2 or 3 on question number 1 take column 1 or 2 or 3 then go to suicide screening because there is a possible suicide intent suicide plan next slide and this is the CSSRS this is 6 item questionnaire this is the gold standard in suicide assessment ask number 1 and number 2 number 1 have you wish you were dead or wish you could go to sleep and not wake up passive suicidal thoughts have you ever had any actual thoughts of killing yourself the scoring here is not number but color yellow is moderate yellow is low risk these are just thoughts then we move if this number 1 and number 2 are answered with yes color it yellow and move to 2, 3, 4, 5 and 6 if number 1 and number 2 is no you go to number 6 as a double check what's number 2 suicidal thoughts have you had any actual thoughts of killing yourself thinking about how you might do this number 4 have you had thoughts and had some intents of acting on those thoughts number 5 have you started to work or work out the details of how to kill yourself do you intend to carry out this plan increasingly becoming serious and number 6 have you ever done anything to end your life if yes within the next 3 months color those red next slide please and this is the summary of your work on DCSSR if most of it is yellow that's mild and the intervention will follow accordingly do some safety planning will talk a bit about that that there may be some risk and you can opt not to refer at the moment but observe and continue counseling continue advising the parents to be mindful and be more attentive to the needs of their children if moderate do safety planning will see how to do that notify parents that there is a higher risk level and recommend removal of anything that the child can use to hurt himself if non-emergency refer to mental health professional number the level 3 the red one is severe safety planning notify the parents remove things that he can use then suggest maybe you need to bring him to the emergency room of a hospital PGA National Center for Mental Health in Manila National the Medical City the Philippine Children's Medical Center I'm sure in Ido Ido in Sibu in Davao we have those centers that they can go to next please the general approach to depress suicidal patient we need to interview the patient separate from the parents interview him with the parents and we need to be very careful in the manner in which we talk we have to show communicate sympathy and understanding we have to feel the sadness of this young person and the initial question should be open-ended and non-threatening like well it shows here I have some samples here next slide please ways to start a conversation I have noticed that you scored positive for depressive symptoms in our PHQ when did you begin feeling this way can you tell me more about what you have been feeling lately of course you promise confidentiality that this is between us but there is an exception if I believe that you are at risk for harming yourself or others then I will have to break the confidentiality I will have to tell your parents because I don't want you to ever attempt suicide the positions you then inform the parents and guardians and make them believe that the patient is at risk and even if it is against the patient's risk next slide pronouncement of suicidal thoughts should never be dismissed it's not we have to acknowledge the seriousness of their admitting that they have had some suicidal thoughts some empathetic statement will be very helpful like you must really be suffering deeply for you to even be thinking of hurting yourself mukhang napakabigat naman yung nararandaman mo para isipin mo na sakta ng sarili mo make sure that the individual feels that your health has been hurt maaring hindi kumaunawaan kung ano yung nararandaman mo ngayon pero narito ako gusto kong makatulong inform the patient the need to tell the family to facilitate a plan of treatment and you can say what you have informed me earlier that in case there is risk you have to break the confidentiality next slide now we do safety planning this is a systemic approach to maintaining safety of a suicidal patient we need the collaboration of the patient this may take anywhere from 20 to 40 minutes this will provide the patient some specific coping strategies and support sources once suicidal thoughts arise next slide please and this is how it looks like there are six items one, what are the thoughts mood, behavior or situations that you may associate with suicide the individual will say when I'm feeling very sad or when I start crying then you ask him to write that down what can you do on your own to cope when you are having suicidal thoughts maybe I can call my best friend or maybe I should go tell my mom make him write those things then who can you call or where can you go to distract you from suicidal thoughts I can go to my book bookshelves and I will start reading maybe I can just play my guitar please write them down so that you will be reminded and si no mga maari mong lapitan na mga suicidal thoughts maybe my mother maybe my father maybe my friend then ask for any professional person that you may contact and many teenagers many young people will say I don't know anyone maybe my family physician then write that down and if they don't know anyone you can give them some names and if you have the contact numbers that you know can be of help then you give the name reducing the potential little means how can you make sure that your environment is safe I will ask my mom to remove all the medicines in her medicine cabinet I will ask her to remove the knives and sharp objects in the kitchen I will surrender my blade I keep in my room but they have to write that down next slide please informing the family it's not always an easy task we try to remain calm and composed avoid overreacting or underreacting be aware of your own emotional reactions effectively communicate the seriousness of the situation reassuring the parent at the same time that treatment can be available and effective ensure safety at home emphasize the need to have a supportive person at home at all times and limit access to anything that the young person can use to harm himself next slide before I end this talk let me just share how do we manage our anxiety at this time of the pandemic all of us we are the service providers we are very good in helping others but we are hardly very good in helping ourselves I want to share this with you because you need to do this to yourself and you also need to share this to the young people that you will be talking to and ending up finding out that they are either depressed or suicidal very simple, nothing fancy be good to your body mental illness begins with physical wellness sleep is a sacred priority I say that but I also suffer from sleep deprivation because of a lot of things to do but we have to pay back our sleep we have to sleep at least 7-9 hours for young people that is asking too much because when they are in school they sleep less than 6 hours but neuroscience tells us that an individual young or old who sleeps only 5 hours or less every night you will be depressed even if you don't have any problem try to exercise, move every day find ways to move take a walk in the morning do online exercises dance, ride on your stationary bike or better still if you have the treadmill feed your body well healthy food options like vegetables fruits, minimize caffeine and alcohol next slide follow routine one of the first things that disappeared when the pandemic was imposed when the pandemic came and the ECQ alert were imposed the loss of routine we have to resume from our routine we know our body our brain rates on a 24 hour cycle daily lack of structure changes our sense of well-being when you wake up in the morning and you can't get up because what am I going to do I don't know what to do today well that's a challenge to our well-being lockdown has practically stripped us of our normal routine so we need to establish that exercise, bathing, house chores more or less on regular schedule next slide it is normal to feel sad to feel stressed, to feel anxious during times of crisis but the human mind is so powerful that it can be our best ally or our worst enemy do you realize that our mind produces at least 80,000 thoughts in any single day and many of them are negative thoughts we have no power to control those thoughts but we have the power in reacting to those thoughts feed our mind with inspiring happy thoughts you will notice there is so much floating of nice quotations avoid negative thoughts avoid information overload get the facts from credible sources do your social connection even by by the digital practice meditation there are so many apps online that we can use for meditation neuroscience shows us that meditation helps calm our mind and our anxieties practice gratitude notice things going right rather than dwell on what is going wrong or what is missing just waking up in the morning when I woke up this morning I expressed my gratitude knowing that in this world there are many who did not wake up this morning practice kindness and look for opportunities if you are going to mercury to get some medicine call your neighbor and say baka may kailangan kang kambiling gamot upunta ako sa mercury ngayon pwede kong bilin yan para sayo practice kindness kindness and look for opportunities kindness is probably one of the best things we do it makes people feel good the ones we help and it also makes us feel good when we help and with that I want to end next slide I want to end this and thank you very much for listening thank you very much that's Dr. Cornelia Banag Jr for a wonderful presentation as you can see Dr. B in the chat box people are appreciating your talk I'm sure there will be many questions but I think you really covered a lot in a very short period of time and I'm sure I am listening to it and feeling very enlightened about what you have just said and I think our audience feels the same way so thank you very much sir for entering the thank you go ahead Dr. Cornelia thank you so much sir for enough for really an excellent presentation you will note in the chat box many people are resonating with your presentation sharing their own personal experiences something lang po na to show na really it's a very personal topic for a lot of our members of the audience and really very grateful to have you as part of our line up of speakers for today Thank you so much Dr. Banag Thank you so much and I was given this opportunity okay thank you sir so let's go to our next speaker I said I'm introducing the speakers because I know them a little bit and our next speaker is a clinical psychologist who has done a lot of work in the field of trauma so alam po natin na if we experience something very distressing or very sudden like an accident or abuse there are many many cases of young women who are sexually assaulted or raped people who survive bombings fires our next speaker was head of the trauma center at the University of Santo Tomas and I've seen their work up close you know merong nangayaring very traumatizing at the scene of a bomb explosion or something and helping helping with the psychosocial needs of survivors so it's my honor and pleasure who has just feeling better now and I'm very grateful that she's joining us today so I would like to welcome Dr. Largesi Lou, welcome thank you Suzy you know indeed this topic is very personal so I can't say no to Dr. Suzy and I'm very glad I did I got to listen again to Dr. Banag now, hindi ko alam mo merong ko ba akong sasabihin ano bang irerea ko kay Dr. Banag when it's really very comprehensive and it's in a very short time parang lahat ya tanong napag-aralan ko ay na summarize niya in this very short time but akilaman siguro, I think what I can contribute to this is about trauma as Dr. Suzy was mentioning there's a lot but I would like to focus on the trauma that's brought about by the COVID so yun yung a for focus ko right so ang gabit talaga ngayong clients in patients habi ni Dr. Malag overflowing and very in demand tayong ngayon kaya mga frontliners lahat ng mental health workers no ko you have to brace yourself kasi talagang this is the next pandemic actually is I would want to say or use the term the trauma that this virus had brought upon us globally, universally nakudok ba na after your discussion parang kailangan kwayatang mag-collect tayo mag-collective breathing to relax a bit ourselves because this is a very personal sharing of topic for me ang gagawin ko is I'm going to put life into the signs and symptoms that was shared by Dr. Banag a few patients and even a personal note first of all personally we have a daughter she's our only daughter but she tried to kill herself now the thing is wow, di ba? di ba talagang umaw yun so sabi ko the rest of our family members actually went through therapy hindi po hindi because these individuals who try to do it have something going on in their mind now I have discovered through experience about 15 years working with people with trauma and suicidal who attempted and I'm very happy na wala pa naman saksid sa aking mga paciente either is a common thing they are driven into it because of the negative cognition or the negative self-belief that they developed because of the event because most of us focus on the emotions o anong narandaman mo anong ganito ban yan but we went deeper like okay because everything starts with the thought hindi po ba so bakit ganun yung naging emotion mo ano ba yung nasa isipan mo so when we conduct interviews regarding the trauma this is the very first thing that we try to discover so katulat nito ang mga kabataan nagkaroon ng COVID for their family members nagkakovid so one patient she was sexually abused when she was prettier but she never told anyone so dala dala niya yung so ang negative view na about herself is no, I'm dirty I'm worthless masura pa ako stuff like that and she didn't tell anyone so she tried to appeal herself many times I think two or three times already so nung maging patient ko siya ang susunod na nanyali sa kanya ay yung kanyang she had a retinal detachment pa so magkaroon ko siya na isapang problema another problem and so therefore on top of that yung mami niya nagkakovid did so sabi niya do I think when I sleep tonight I don't want to wake up anymore now when you have this patient right in front of you telling you that because everything is online you don't know face to face so it's really very overwhelming but of course we went through therapy and all that the commonality even all the others it's not the COVID per se that their parents are with it the other one the very recent one is 30 and both his parents died because they were not vaccinated and that was what he was so angry about like he's been telling them to get vaccinated but they didn't want it and it happened it was just two days apart so ang sinasabi niya tulungan po nyo ako di ko nabualang po nung tago nito so it cannot work kind of focus in life it doesn't know what to do so ang nabuuna isip niya I am not a good son because I was not able to persuade my parents too to get vaccinated so meron ding isang very young couple they had two sons and both of them got the COVID so they isolated themselves the complete protocol but then on the 9th they discovered that they were told that their two sons also were positive with COVID so ituna death sentence na yata ito death sentence na po yata ito when they were quarantined this is what I'd like to share with everyone yung mga nakakwarentin sila not because they had a COVID or some had a COVID but it's because of family members so long once had a COVID so ka-isolate lahat nang mga patientin na ito or clients na ito during the 14 days the only thing that they were focusing on were their breathing pero wala na rong talaga silang maisip kong binaririnig lang nila yung silence yung breathing nila and that is that caused them a lot of mental body and spiritual concerns so ang sabi nila na ito I try to summarize what they had experienced because I'm now trying to reach out to these people who are in quarantine because they're going through a lot so in terms of mind sabi nang nila na ito you know we were having flashbacks and daming nightmares to na nila everything that we had heard about was going on around nanagnan nightmare do sila and they can't control it so all their focus came out all their fears so that's why they developed anxiety depression and they really thought everything was out of control ito na ba talaga yung is this death for me so there's a lot of breathing that's going on and in terms of body of course we know what happens in terms of the body there's a lot of pains and aches that's what they're saying and of course problem with sleeping even eating and some actually had tried to do self harm the frontliners who are working with this category of group or group of patients are separated in a different area and they themselves the frontliners themselves are having difficult time trying to cope with it because they had to deal with the patient and have to deal with the family members and they're also overwhelmed about it but of course they're doing their best but I think the most serious thing that we can actually look into is what they develop in terms of the spirit never aware of the mind the body now it also affects the spirit because once they start already questioning bakit bakit pa ba ko mabubuhay they ask themselves things like this already what's the meaning of my life now my parents are dead my kids have COVID my job, I mean my husband does not have a job economically we can't afford if we get worse it is really sad so there is now the breaking of the spirit the hopelessness the helplessness and most of them already now start questioning about their faith bakit ka may bakit pa ko bakit pa ko now there is a lot of grieving going on with them and can you just imagine how many of these individuals you have to see and give therapy to or stabilize them what we need to do the best at we can now if you ask me so what happens then what happens to them now you know what they themselves also figured it out because there is hope there's really sadness around in grieving but I'm telling you there is hope now why you ask me when the common term that they told me whenever we were having the conversation and the therapy they said that don't bento pala yun e pagpala nag-surrender ka if you surrender meaning surrender in terms of not giving up but in terms of accepting the reality ok hindi anandito na ito na it's here it's at home it's with you it's with me it's alive the virus is in your body in my body once we surrender to that mindset then it gives a sense of calmness kailangan pala on surrender ka tangapin mo na so that this all of this negative thoughts and crest breaking of the spirit everything would come down and so because of the acceptance the grieving also stops so I'm also learning a lot from them and because I personally experienced the quarantine today is my 14th day the rest of my family we have the COVID it's here it's at home but of course it's just a good thing that we are able to cope and we have mild symptoms but what about these individuals who does not have that so these are the terms which they have in common told me we need to surrender because in surrendering they say they have accepted there's no need to be shameful about it there's no need to hide we can reconnect with friends we can tell them we have COVID and then start then the love, the support they start pouring in see so now they are overwhelmed now with these positive thoughts that indeed you know there's really no stigma if you have the COVID economics would actually solve itself because there's a lot of people that are willing to help out and so they start seeing the new them no ganong palayin do akong no parang now are overwhelmed kasi andami pala nagmamahal say and that spelled a big difference nakita nila yung mga strength of character nila nakita nila nami resilience pala sila despite and this is where I would say the wisdom from trauma is there is now hope and hope really is the best shall we say remedy once you have hope then you start become grateful great every day I'm thankful for being alive you know I'm 71 I'm diabetic and a recovering cancer patient so I said wow okay lord I've been praying I don't want to die because of COVID saan malang something meaningful pero dumating ito so I had to accept it face it do something about it and I guess and God had granted me an extension so that's why I'm here right in front of you now please, tama po si Doc Bannaan I'm very an advocate of those who are suicidal or suicidal ideation because did not only have my own doctor but this is the expertise that I really had focus on for the past almost 40 to 50 years because they had nowhere to go they don't know what to do kanin no kami pukunta sino mo maka-intindi sa amin ito kasi COVID na ito parang talaga na complicated grieving eh nila sexually abused and aming adverse childhood experiences so they have come up or develop a lot of negative self-beliefs in them which is destroying them along with these negative beliefs would be all these negative thoughts ang mahirap pa siya lalo na if it's really really traumatic it is stored do divided stored in our brain in a very special way sobrang sobrang sa loob siya hindi siya pwede makawasa usap ko sa kan ilangang talang iriproces mo ang mga negative thoughts na iya which is the challenge because you have to transform with something very negative into something positive at kung meron sila tumatak mo sa isipan nila yan then you have pressure in school or in academics you have pressure from the parents here you have pressure from friends aya talagang our immediate environment we need to do something also about that we need to understand them we need to reach out to these young people who are going through a lot and yung COVID kasi na pangyayari sa family nila o sa kanila is only like an an additional burden on them so that's why they are pretty much at-along whatever I'm trying to say is those of you who are listening here the parents or the young ones there is hope look at this webinar it's just 73rd and there's a lot of people who care all of those who are in here we all care for you and you can always reach out to any I know you Pia he's doing a lot at U.S. is doing a lot at say it's plastic can we do a lot in all of our oh sorry sorry in all of our in all of our online I'm involved with a lot of online organizations there's an outpour ang daming tawang ang dami-dami po but we still have to be thankful and grateful our mental health professionals or the frontliners that's all to you oh well this is the sharing that I would like to give to you a message of hope to everyone thank you very much thank you so much really ano po ha yung pung ating spontaneity in your talk Dr. Lu very very well appreciated following that well lecture and presentation from Dr. Banaag you will notice in the chat box a lot of well feel good messages po and release messages that resonate with your talk Dr. Medina so maraming-maraming salamat po oh well done thank you po thank you po finally we will have our last speaker for today we wanted to have someone who will be providing a perspective from an educator po especially since we have a lot of our members of the audience coming from the Department of Education a lot of them also parents very very much concerned so we are pleased to have for today's webinar the president and the co-founder of the Beacon International School Dina Lomongo-Paterno Mamdina who is all the way from the east coast ayun po hi good afternoon good evening po sa inyo mamdina whatever the other participants are joining from thank you yes po go ahead mam well I really I mean it's such an esteemed group of medical professionals and I'm definitely not one as I'm an educator I deal with young students young kids I also mentor high school college and graduate level students so I deal a lot with education and what even before COVID hit there was already a lot of anxiety among the youth because there's a lot of pressure that they deal with in the world we live in I mean we all know that and so I think COVID just exaggerated already a lot of what their anxieties were about their future about how they they can get good jobs or have careers and provide have a good future that's part of their anxiety already but COVID really exaggerated that and I think initially for our own experience in our small school it goes a lot of confusion but thankfully what helped us was we had teachers and the leadership team and the whole community with the parents with the teachers the academic staff even the non-academic staff of the school the custodians, the IT people with the Board of Trustees really came together and met repeatedly just to even prepare and try to understand how do we deal with a situation that no one has ever experienced before we were going into lockdown we had to prepare for some kind of online platform to continue the learning because that was our primary concern how do we keep the kids the students learning even in a situation where you're now stuck at home you're under lockdown and you can't do anything and many of our teachers were also parents and so they're having to deal with providing that continuing the education but also taking care of their own children and attending to their own children and how they're going to continue with their learning so there was a lot of confusion in the early days of COVID but thankfully like I said it took the community to come together everyone in the school community to understand their roles part of it was also learning to manage expectations for everyone we had parents initially were panicking because they thought why do we even need to pay the school because they're teaching their children and we had to hold seminars as well for our parents to let them know that no, you're not taking over the teaching that's too much for anyone to ask of parents but that you're there to give support and we had to be very specific on what kind of support at different levels that their children are at that they can provide also feeling overwhelmed on top of having to deal with their own work they also now have to take care of educating their children which was really not the point so the challenge for the young people during COVID was really how do you continue learning initially it was how do we keep them safe in a campus but then that was sort of answered because we were in lockdown and we couldn't even bring our kids to the classroom but having said that we had to continue with the skeletal staff in school to make sure the IT the IT became very important in the school because we were going online we had to make sure everyone in the school and people lived in different areas so you had to make sure every single one had access had access to technology if you needed to loan them the iPad or the computer needed to help them access connectivity because that was always an issue we needed to take care of all those things logistically initially just to be able to get everyone in some kind of even online platform where we can all access and have a classroom going on the other step to that though is it's not an automatic transfer it's very different when you're teaching in a classroom and then when you're teaching in on an online setting so we had to schedule synchronous sessions asynchronous sessions we had to have small online classes so we had to have online classes so we had to have asynchronous sessions we had to have small group sessions actually for the educators it was a whole lot you're all frontliners and I'm so privileged to be with you today but the other side of the frontliners as well are the educators the teachers who are actually trying to continue teaching the children because it has not been easy I mean I know our teachers have not had a break especially last year we had to learn we had to have training on how to transfer or how to actually translate their curriculum into an online platform that would work that would be effective and that would also be dynamic enough for the kids to continue to be engaged in but there was anxiety but it was helped by coming together we had sessions with the different stakeholders in the school community it was really trying to create the what everyone else was saying that we needed to come together and develop help giving skills right we needed to be aware of okay we have parents who are really confused and panicking about their role we need to really do them and help manage their expectations and what they're going to do we have older teachers who are not as tech savvy we needed to help them understand also how to use the technology because they're not as used to dealing with an online platform and as well just how do you translate your lesson onto a program or how do you even detect a classroom a student who's not participating or doesn't want to put on the camera and how do you even know how to reach out to that student so we had to develop also small group sessions that our teacher led just to check in on individual students that may be cost for concern so it became a different way of teaching but what the pandemic had allowed is really a pause I think I mean there's a lot that happened that is overwhelming that is sad and unfortunate but I think what it's also allowed for us in education it's allowed for us to step back and re-evaluate possibly even redesign some things and really get to the core of what is it that we want the students to learn sometimes you have to let go you require them because it's just too much they have too much work that they're doing and you have to acknowledge that that you need to give them some space to just switch off their computers because they're on their computers all the time trying to do the work so I think the great learning for me in my limited experience is that it has allowed for that pause that allowed us to then re-evaluate and see okay how do we help not just the students but also the parents because they're also having to deal with work from home situation and also our teachers who also are parents and even the non-academic staff who need to keep our school as well disinfected, sanitized for the skeletal staff that's there 80 people every single member of the community we needed to just really be mindfully and careful and thoughtful on how to support each one needed to provide the structure so that after a while, actually after that semester the following year everyone was much more calm when we started the school year after that initial confusion everyone was a lot calmer knew better how to proceed on this new platform so the big challenge for us is we don't know when we're actually going to be going back to the physical classroom and so what is the future of learning now, right? Again, it continues to challenge us because how do we keep our students learning now in an environment that is not as what we're used to it's going to be a combination of probably blended learning and then there are the logistical issues of when we open the campus how do we prepare the campus how do we keep it safe what do we do to make sure that we can track and make sure the kids are safe it's a challenge for the especially the public schools when they have 100 students in a classroom how do you socially distance or how do you even provide to be able to still learn but also be safe that creates a lot of anxiety for everyone but it is what it is the situation is what it is and so we try to just do it a step at a time if the issue is technology let's deal with that first and let's try to make that better and then we move on to the next challenge so that it's small increments it's like a step at a time and you're able to then help everyone in that school community understand that this is a new situation it's not going to be the same as before but we will continue with the learning because that is what you're here for that's our promise to you that you come to school we will give you that allows for creativity on our part there's an opportunity to innovate there's an opportunity to be creative it's a challenge but it's also an opportunity and I think that's what COVID provides so as much as there's anxiety I feel that there's also opportunity to rethink redesign and really just be more thoughtful about how we move forward with educating our children at the earlier conversation we have been talking about it's important for our kids to really be able to discern and be able to think critically and be able to see the situation have the language in the situation of COVID even have the language to be able to acknowledge what is it that they're going through because if they don't have the language for it they can't express themselves and if they're not going to be able to express themselves then it's difficult to even acknowledge what is going on so it's a lot of also giving permission for them to just say how they feel without judgment as a parent I'm a mother of three children and I also have children to deal with mental health issues I had to learn it took me a while to get it but I had to learn that when my children are saying something I don't necessarily have to prescribe a solution that's not what they're looking for what they want is that you just listen if they're dealing with something if someone's there to listen that's really all they need and they don't need for you to prescribe the solution because they will find the solution if they're able to unburden first so I think as educators information and educating racing awareness about mental health is so important especially these days for the youth because if you can imagine this is the future of our country the youth who are going through this unprecedented anxiety is our future and we really need to be able to do things to support them so that they can thrive in the future in spite of the pandemic so I think that to me is what this is about COVID is unfortunate it's difficult, it's challenging but it is an opportunity to reevaluate and rethink and redesign and be creative and be innovative but also stay safe so forums like this I think are great because frontliners like yourselves who really deal with this on the ground your work is admirable I have to say our commencement speaker last week was a frontliner because we acknowledge that but this is a real situation we have to deal with and we invited actually a doctor to speak on it just so the entire community can also get it from the perspective of a medical frontliner our past speakers have been from more maybe other industries but we thought it was appropriate to have somebody from the medical field talk about what is present and of concern to everybody at the moment I think my only contribution really is to say that education is so vital especially for the youth and there are ways to help them deal with the mental health but this is also an opportunity for us to help them and support them in ways so that they can thrive better so I think the pause allows us to do that so, thank you thank you very much that's Dina Lomonco-Paterno who's president and founding trustee of the Vegan International School in in the Philippines in Manila so okay, so we are very grateful to have all our speakers again as you can see in the chat Dina our audience is really great they are very responsive and they really share their thoughts and their responses to our speakers in a very candid way so thank you so much Dina okay, we're going to go to our panel discussion and we're going to ask all our speakers we're going to start with Mitch and Dr. B and Lou and Dina to open their cameras while they're doing that we are going to have a public service announcement from TVUP TVUP, please go ahead oh ako mukang malalim niyang iniesin mo ka wala ka magpasuk ngayon wala po may disinfection pa siya at grocery ah gan ba nating ka yung pasukahabong pa tinong yos ang araw sana makabalik na ako sa tarbaho oh siya siya dina muna ka tayo store buen ang mukang malalim yung iniesig mo look ano mga pabakuna na kayo tayo ah wala problema po malahan mo lang ako eh talaga dahil mahal ko kayo papabakuna ako Thank you TVUP The COVID Communications Public Service Announcement is one of the many outputs of the UP Research Entitled Communicating COVID-19 in Post-Quarantine Philippines and set it by our UP Vice President for Public Affairs Dr. Nene Pernia and funded by the DOH and the DOSTPCHRD under the AHEAD HSPR project Over to you Dr. Suzy Okay so unfortunately Raymond we are close to the top of the we may not be able to to have a discussion but maybe we can field one question Raymond from the Q&A box do you have something there because I saw something but you might have something So um our top most question comes from one of our avid followers po no Dr. Joseph Tortona he is asking would it be feasible if all the schools are required to have a psychiatry psychologist who will handle mental health needs of children and adolescents in any crisis any situation and perhaps maybe even accessible at any time um let's direct up to our last speaker po ma'am Dina since she's an educator po I would recommend it I mean in our school we actually have three counselors um you know to deal with and it's a very small school and we train them all the time and we have training sessions for parents as well we invite um professionals in the mental health profession to speak to our community because like I said it's all part of information and awareness and school counselors are you know they know the students if they're trained well they know the students and it's not it's not going to be a react it's not going to be a reactive thing to actually have them in school as part of your your support system because it's very important to have that um within the school yeah thanks Dina let's ask uh I'd like to hear also from Dr. Banag and Mitch and Lou your thoughts on that no because it's ideal right but I don't know Dr. B do we have enough psychologists like you know it's really ideal to see saan nga pwede pero reality tells us hindi man yayari there's not enough of us out in the field we're also like soldiers up front and there's really not just enough the next best thing we do actually Dina is collaboration we work very closely with uh the counselors the school counselors we have seminars with them just with them we have uh agreements with individual schools lasal as an example we provide even consultations even for the counselors if they encounter difficult cases they can call us and we provide consultations you know so we develop those programs of collaboration the only way to go is really through a collaborative framework thank you sir mitch did you have something to add to that you've been in mitch and also how you've been involved in the training of psychologists go ahead please I completely agree with Dr. Bana it's ideal there's not enough but building maybe networks at the local level regional or yung small localities where our schools are public and private can come together to build this network of experts who can support what initiatives there are within the schools themselves so being able also to equip counselors and teachers faculty advisors student leaders with some of the basic siguro that can help with the support of mental health of our students and even in the workplaces also we can do for now given urgency na makahalaga na matugunan pero alam natin na mayka ko hindi kaya ng lahat so ang mas maigis siguro how can we prevent or how can we reduce the need for professional services how can we kubaga arrest or how can we prevent the worsening of the mental health condition of our students and our young people okay, you did you want to say something? yeah I agree with both of them and also with Mamdina we have been actually doing that because I'm involved in three different universities and a lot of organizations so we are training actually the guidance counselors and all the others because they're not pretty much adept yet into all of the new, even the new stabilization techniques and new interventions so we are working with them and we are giving workshops for free some are not for free but those who can afford the pay but mostly for free now I'm just a bit worried maybe I can ask the rest do you think we can also already handle this opening face to face by depth and I'm pretty worried about this because we don't have enough even guidance counselors they're trying to circumvent it and use a different term but they're still guided by a licensed guidance counselor and now we're opening up the face to face I don't know, I think it's going to be a nightmare Dina, what do you think? It takes a lot of preparation and resources to be able to do it and again that's an ideal situation but I think, I don't know and maybe I'll direct this to Dr. Corny and the doctors because I don't know if first responders within the school like teachers can be trained to just detect because most of the times the teachers are the ones who are really at the front lines with the students and they're the ones who can see but sometimes when they don't know how to detect it they can actually make it worse so I think it may be because they're not enough counselors and psychologists teachers can be taught to be first responders and maybe even in some of the schools some of the PTA the parents can also be educated or at least raise their awareness I think if the community really can be, the awareness can be raised and just basic first response skills that they can learn so may there's some multiplier effect because we understand there's really a need to have more psychologists but there's not enough but I think if there are those frontliners like teachers and even parents who are in the school PTA who are active they can be trained just with basic skills and then learn how to refer them maybe if there's a list that they can be given so that they can be referred then at least there's that initially we help to create that support Dr. Bernan Yeah Well my concern goes beyond mental health I'm all worried about the spread of infection I'm afraid we're really not ready other countries have opened either partially or wholly because they're ready they have prepared some countries are 80% vaccinated we're only 10% vaccinated I'm not even sure how many teachers are really vaccinated and young people are not vaccinated not yet even though there is a drive to vaccinate the young people they may be willing but there is no vaccine available here so they're not ready and it may ogar a big spread of the COVID and the victims will be the students Thank you sir We have a question from someone in the audience Rima, let's take that Yes, go ahead Sophie please open your video and your mic and ask direct your question to any member of our panel Actually I'd like to direct my question to all of the panelists but before my question I think I have to say a backstory I was a public health nurse and I was a frontliner but because of exhaustion due to the nature of my work I was diagnosed with bipolar 1 and in this exhaustion and exasperation that I experienced it was very difficult for me so my question is for the frontliners now I was a fresh graduate for the frontliners now may be teachers or medical frontliners or even young parents that are new to whatever they're doing new parents, new frontliners how can we help them in their mental well-being and not have the opportunity to rest and do self-care because they're doing their job how can we help them cope when there is no really opportunity for them to pause and look back and see where they can actually better themselves with the burden that they're carrying as new frontliners the pilot ok, thank you very much Sofian, thank you for sharing that I think it's a lot to come out and say this so let's see is there anyone who wants to start with the response? Dr. B Dr. Banan these calls for a systemic approach and as the students were saying in their petition look at the environment look at us don't just focus on what we are doing there are many things around us help us deal with the many other problems we're dealing with so we need a systemic view of the situation we have good frontliners they're well-meaning they really sacrifice their lives they know what they're going into and they do it they feel very sad and we have lost some of them are my good friends so we need a whole systems approach in this it's not just the courage to do the work and that's it the other sectors need to provide the proper protection and be able to assist when there is problem starting with well-deserve Ayuda I celebrate this taxi driver who drives for free all frontliners because he said ito lang po ang paraan para pa kita ko ang pasasalamat ko sa mga ginagawa ninyo to make up for the lack of Ayuda coming from the government so Thank you Dr. Banan let's see alu si Luto Matawan Ayuda Ayuda I totally agree but then realistically I don't really know when this is going to come systemic is the answer but one and a half years until now there's no plan coming up to a systemic thing of addressing the need so I would suppose we have to do pretty good self-care talagang tayo na muna we have to take care of ourselves in this positive psychology thing which is relatively new here but it's very effective I think we should promote this maybe you can have a webinar on positive psychology and it helps a lot for self-care we have to take care of ourselves Sophie I don't know if it's any comfort for you but I also have a lot of nursing practicumers they attempt ilan sila na to hurt themselves habas nag-develop na din sila ng BP-1 dahil hindi nila kayo yung pressure being a nurse tapas na ka online meeting the mediamans of the doctors the hospital and all that it's really crazy I understand ok lunag-freeze ka ok so thank you so much Mitch do you want to say something about this? I'm happy that this question was asked and I think it brings home the point that our individual mental health is really connected to these larger systems as Dr. Banag said and while I agree that self-care is important I feel we at some point we need to recognize talaga na yung magagawa nung mas malawak mas organized na system ang ganda-ganda po nung binigay na lingbawa na experience ni naman di na lumongo pater dun sa kanilang school as a school they came together and created systems processes siguro policies whether formal or informal that took care of every single one no from teaching staff non-teaching staff to parents to the children to the students and that strengthened them that absolutely helped contribute to strengthening and protecting their mental health now if we can have something like that but at a larger level di ba yung mas malalaking systems not just individual schools private schools of public schools or hospitals or larger systems making that possible ang laking bagay pero dahil wala pa anong gagawin natin ngayon siguro wherever we are as individuals some of us maybe are in supervisory positions or other people under you you are an administrator you have certain you know other kubagamas may position o kapangyarihan make it possible to be kind ang laki-laki sakin nung impact nung sinabi ni Dr. Bana na yung being kind is one important way that we protect other people's mental health but also our own kung meron tayong ganong posibilidad para doon sa ating kinalalagyan sa ngayon then that might help tide us over that might help us while we are also working to change the systems improve the system so that they can better support our mental health Thank you very much Mitch we are at the top of the hour and unfortunately Chancellor Menchit Padilla needs to leave soon so I think we are going to Raymond we will switch around a little bit so that Menchit can do a bit of a summary then we will go back to the evaluation after okay so we would like to call on Chancellor Menchit Padilla to give a little bit of a summary before she goes and then Menchit will close the webinar for you go ahead Thank you very much So Dr. Michelle Ong opened the webinar and Dr. Ong said that adults usually recall their youth with fondness and this is the time when they are experiencing rapid changes and understanding their place in the world but with COVID adolescents and the young have different experiences to bring to their adult home so indeed COVID has changed this fondness of youth days to feelings of anxiety with remote learning job security and fear of COVID Now nobody has lived to a pandemic and all we can do is share the capacity to learn and to care and we're so happy to hear that you know in Yupidileman Siteserve and Udnai ng Pahinumod have organized volunteers to offer free services to make Yupidileman a community of care Our first speaker is Dr. Korn Banag and he starts with a mantra there is no health without mental health and he said that as early as 2013 WHO reheats the information that 10 to 20% of children and adolescents have various forms of mental disorder and most of the mental disorders in adults began at the age of 14 and that the risk of suicide is highest at ages 15 to 24 Dr. Banag shared several survey results and if you're interested I urge you to watch the replay So indeed COVID is an invisible enemy and we have to understand the factors causing the rise of mental health and this can be summed up in two words uncertainty and isolation Realizations and Filipino new normal are very important to understand Number one distance learning is a major source of stress Number two work from home that means balancing and managing responsibilities for the different roles at home has become a major factor for stress and the third is the altered experiences of loss grief and bereavement because now we're not you know if you've got a family member who has passed on you are not allowed to grieve in the same way that we did in the past You know I like this part when Dr. Banag said it is normal to be sad to be nervous angry inattentive and inattentive what we should worry about is that when sadness moves on to depression nervous becomes anxiety and anger becomes mania So I I recommend that we all watch the replay because Dr. Banag said he gave us the following the risk factors for depression the warning signs for suicide the myths on suicide safety planning with the patient in suicide and most importantly he gave us the steps on how to inform the family he ends his talk by addressing the frontliners he said we should know how to manage stress and anxiety in the time of pandemic number one be good to your body and this part is very difficult sleep at least seven to nine hours it's very difficult for all of us but he says what do exercises eat healthy food those are important things that we must do for ourselves number two is to follow a routine or a schedule and maybe the most important that we should really bring home today is we have to be kind to our mind we should feel our minds with happy thoughts avoid negative thoughts get facts from credible sources like stop COVID that's webinar and he gave us tips on the meditation as well as the last line being the practice of kindness our second speaker focused on trauma brought by COVID and Dr. Medina shared her experiences with dealing with patients with depression and attempts per suicide and she said that there is something common among our patients with depression and those attempts per suicide and in those cases and focusing on COVID it is not the COVID per se they are driven because of the negative self-belief of a bad experience in the past a lot of grieving to the past experiences will need a lot of processing because they lead to the breaking of the spirit a feeling of helplessness and for some even the questioning of faith so for those with COVID she had a very practical reminder there is a need to accept reality she said surrender surrender gives a feeling of kindness and as a result the negative thoughts and the breaking of spirit stops she ends by saying that there is wisdom from trauma there is hope the best remedy a realization of a feeling of resilience our last speaker is Dr. Paternal an educator who shared her experiences when when COVID happened and the lack then happened she said that even before COVID there was a lot of anxiety already about the youth you know worrying about the jobs about the good future it's just that COVID exaggerated it in the school setting they had to strategize on how to continue teaching at the beginning there was a lot of confusion the challenge for the young people is how to continue learning the challenges for the school which is very similar to what we have here in the Philippines they have to they have engaged the parents to give support at home number two they had to give support to the senior faculty who were not tech savvy they had to teach faculty to develop skills and identify students with concern and they had to keep the school safe for those who would go to school and make sure that IT was working so the message really is a whole of community and approach to make sure that we are able to continue teaching Dr. Paternal ends by saying that COVID allowed us to step back to rethink we evaluate redesign and check what students really need to learn so indeed COVID-19 has given us an opportunity to be creative Allow me to end with a mantra that Dr. Banna had shared there is no health without mental health we all have the responsibility to prepare the youth who are our future leaders and to all the frontliners let us remember to manage your stress and our anxiety in the time of the pandemic so stay healthy and do come back and join us again next week thank you very much Dr. Suzie and thank you for allowing me to give my summary before the closing of the webinar para misalamat po sa inyong lahat thank you very much that's Chancellor Menchit Padilla of UP Manila and thank you for that excellent summary Menchit alright so we are going to close very soon we're going to give our speakers a few moments to compose parting words so this is just a minute or less of what you'd like words you'd like to leave with our health workers very short very brief sort of parting words and while we're doing that we're going to flash the evaluation poll so we have an evaluation poll and I'm going to answer na lang para kasi malanatang time yes ma go ahead oh siya ikaw na sumagot Raymond no no it's okay it's okay you take the first question and I'll take the second question doctor so all of these are correct okay so all of these are correct we didn't give a choice na all of the above but all of them are correct okay Raymond go to the second one so for the second question it states po what should you do if you don't know what to do about some of its suicidal thoughts 59% of our attendees chose tell the parents to watch the child closely but there are yung when you go through that at that stage already it's very very important that they are seek the care as immediately as possible kung may ganoon na po silang suicidal ideations so thank you po sa ating 1,285 tama ba to 89% of our participants sorry 1,146 who were able to participate in our fun poll we will now be flashing our evaluation as and after this one we will go back to our panelists for their final messages to our audience there are five questions it's a likered scale and the five questions will really be part of the overall assessment for this webinar first question the panelists demonstrated thorough knowledge of the topic second question the panelists were well prepared at organized number three the panelists spoke clearly number four the panelists used appropriate language with technical medical jargons adequately explained and number five the panelists contributed to new perspectives and knowledge on managing virus key COVID-19 health issues we will not be closing the evaluation poll po and for those who are asking and even emailing us eto na po yung evaluation link hindi po siya link it's an evaluation poll so we hope that those who are in the webinar still will be able to answer our evaluation poll over to you Dr. Suzy thank you very much Raymond alright so far parting words we'll start with dina dina go ahead dina you're on mute dina you're on mute sorry thank you again for this opportunity to be part of this webinar and I think we've heard so many good ideas as well from different people and of course Dr. Banag and Dr. Lulu had very very good things and I wonder though if there is a way is there a place where these kinds of resources can be gathered so that people can have access to them I think that would be a good way to start this community collaboration maybe I mean my parting words are really that it's more a suggestion rather than words because I think that's what it is it needs to be systemic but perhaps this is a community that can start something on the collaboration of resources since you're able to gather them and that that people who may need them can draw you know can use so that's a suggestion okay thank you very much Dina for staying up so late to be with us really appreciate your sharing with us okay let's go to Dr. Medina Lulu go ahead okay so so all our dear frontliners may you be inspired by this most of the patients you know what they said about you you are the angels that we see every day so you are angels to your patients okay so you give hope that's my message for them so keep it up thank you thank you Lulu okay Dr. B well I think this pandemic is giving us really a long pause two chains we cannot go back to what was normal there's got to be some changes and the message that's very strong coming from TV UP is together we can do it collaborative work is what we need we cannot go in our individual separate ways we have to think in terms of systems and no one person will be able to do systems we need to collaborate with one another and maybe our department of education to start with will have to review some of the changes that we really need to do are we giving our students our young people who are really the backbone of every society are we giving them the right knowledge information skills that they will carry with them to lead this country so good questions and finally I want to reiterate what Lulu said my deepest deepest gratitude to the frontliners you are the angels in the lives of many people you bring hope despite the risks that you take you bring a lot of hope so thank you very much for giving me this opportunity to be part of this program Thank you very much Dr. Banag Is Mitch still here Reymond? I think she had to go for a 2 o'clock Dr. Susie So Okay So Okay So I think that brings that brings us to our conclusion Thank you so much to all our speakers Next week Okay So another exciting topic next week Okay Next week we're going to talk about um travel in the time of COVID pa paano bang magiging safe yung transportation whether that is public transportation or I mean road land transportation ships airplanes how do we keep them safe so we're going to have actually the secretary of tourism secretary Bernadette Romulo is our main speaker next next week and so don't miss it because this is very important for everybody we are seeing a lot of infection that people are getting from moving around from going out and taking taking public transportation so don't miss it we're going to talk about that next week Okay, over to you Reymond Thank you so much Dr. Susie So yun po ang ating webinar for today really I'd just like to take this opportunity to thank our really esteem panel of speakers and also the hardworking thing behind the Stop COVID-Dets webinar series without each and every one of you we will not be able to bring about credible online content and for and then for the suggestion of Mamdina po all Stop COVID-Dets webinars are archived sa ating TVUP channel sa YouTube po www.youtube.com all 72 webinars including this webinar ating episode for today will be archived in there so if you would want to watch it in the playback maybe share it to your community to your networks to your students to your colleagues very very welcome po yun and you will be able to revisit all of the learnings for today's webinar this formally closes our webinar for this week and we look forward to your company next week again same time same channel Friday from 12 noon to 2pm it's a date together we can Stop COVID-Dets so keep safe keep healthy and see you online