 Good afternoon, good evening, everyone. Saan manpanig po ng daig ding kayo naraon? Welcome to our 91st episode of the Stop COVID Deaths webinar series brought to you by the University of the Philippines. Thank you for being part of our credible online community. And to all those who have just discovered us today, welcome po. We usually refer to waves or surges of COVID-19. Somehow, there are periods po where transmission increases. Meron din naman pong times where in the number of infections ay bungaba ba. So definitely, vaccination has contributed to our current status where we are more confident po with regards to opening up the community, returning to work, returning to school. Sa kabalang banda lamang po, COVID-19 has brought with it a rising tide of psychosocial problems na hindi po nga nagtagwawain katulad po ng infection. So may mga healthcare workers po tayo, mga kapatid sa front line, who suffer from those kinds of conditions po. And obviously, those may put their family members po at risk. So they also see how the lockdowns have affected yung kaili lang mga kamag anak, mga kaibigan, mga pa-senior citizen po ito, kaili lang mga anak, mga kaibigan ng kaili lang mga batang anak at young children po. So for today's webinar, we will discussing the rising tide, mental health outcomes of the pandemic. So if you want the latest science based and evidence based information from a panel of distinguished experts, keep it right here. I'm Dr. Raymond Francis Sarmiento, Director of National Telehealth Center, National Institutes of Health at University of Philippines Manila. Always a pleasure to be with all of you during a regular Friday lunch date. Obviously, very happy po ako to share hosting duties with our adjunct research faculty National Telehealth Center and also my mentor and special envoy of the President for Global Health Initiatives, Dr. Susy Pineda Mercado. Dr. Susy. Hi. Good afternoon Raymond. Magandang hapon pusingan lahat. Great to have everyone here again. Nagkapasalamat kami nanan dito kayo. Dahil po hindi po sa inyo, wala po kami rito. Alam mo Raymond talagang, sa bingan ang mga international colleagues natin that this is the second, it's the second pandemic. And I think what we are seeing in the literature is that about 20% of people who develop COVID within three months have some kind of a mental health problem, no? Now for frontliners, health workers, tayo, those of us who are here in this community. Nandiyon umpa, simulat sa po le, hindi kayong mga uisa pamilya kasi naiisip nyo baka mahawa nyo sila. O kaya nagkakovid kayo, you get COVID yourself and it's very stressful or you hear about somebody who got COVID na nakasama nyo. So there are so many reasons for health frontliners to have anxiety, no? And sometimes it becomes really debilitating, hindi na makapagdrabaho, marami nag-quit, marami nang umales sa pag-denercing o kayo sa pag-doctor, no? So sa araw na to, we have really very good guests, we're going to talk about how do we stem this rising tide of mental health issues and problems. And no? Parang pag meron tayong mga paciente, how do you know kung kailangan nyo nang i-refer? Or siguro kung kayo mismo merong nararamdaman, lumalapit baka kayo sa iba para magpatulong? Ito yung mga tanong natin, no? So samaan nyo kami, maganda pang pag-usapan natin, we will talk about mental health. I know this is one of your favorite topics. So tuloy-tuloy lang tayo and we're all looking forward to a great lineup of guests. So go ahead, Dreamer. Thank you, Dr. Suzy, for those who are joining us for the very first time, we usually put out interview video po na, just to put our discussion into context, antao po natin dito, a person on the street video. Para sa ating person on the street video for today, ang tanong po na ating pinos sa ating interviewees paano na apektuhan ng COVID-19, pandemic, ang inyong mental health. Mayroon po ba kayong nabalitaan na nagkaroon na problema sa pagko? Ano-ano ang mga pwedeeng gawin para maalwa, maalwanan ang inyong mga stressors, mayroon malalip pwantagalog. Please watch this. Na-apektuhan siya because of my personality because I'm a very extrovert person tapos because of pandemic, I am not able to go out and be with the people na, you know, nakapag cheer up saka, encourage saka, and so hindi ko selam meat physically. Hindi pa din ako nakakapag-adjust talaga ng tuluhan dito sa, again, itong setup, pero in terms of kung paano ako nahirapan, si tingin ko kasi nasanay ako sa pagpapasaka ko na school namin na ikita kong iba ang kakraso ko at isang akapag-usap kami, saba'y-saba'y kami, saba'y-saba'y kami nagealal, saba'y-saba'y kami kong makain. Aming mga kakilala ko na struggling sila sa pandemic dahil sa situation ng mental health nila. Aming mga ilang nakong mga kakilalan na diagnosed talagang ngayon wala akong connection with them dahil nagputol o nga isila sa amin. I have been diagnosed with major depressive disorder since 2016. So when the pandemic hit in 2020, I was actually in a neuropsychiatric ward. When the pandemic hit and I was discharged from the neuropsychiatric ward, nothing really changed kasi yun nga na prepare na ako inside the ward for a life in isolation. That was what I thought. Isasaguro na na feel ko din sa mental health ko was when I experienced death na within the family, I saw that iba yun na papanood mo lang, iba yun na hikita mo lang na cases na mga namamat ay and iba na siya pag you experience it to your own family or like personally. I started hurting myself in many ways, in many ways. So I admit it's not a healthy way of hoping but that's what I did. I stopped taking my medications and I started isolating myself even more. So eventually, problems arose. So marami naman, marami na akong dini deal with stressors and triggers and I didn't know what to do. Ang mga pwede nga gawin para kaya pa paano ay mabawasan yung mga stressors, ay siguro para sakin na pinakag-gurt ay yung time management talaga. Gagawin, kailangan kong iset na yung mind ko kung ano yung kailangan kong gawin ngayon pero in a way na hindi siya masyadong sunod-sunod para makakaran para na ko na ora sa serili ko. I'm trying to make it normal. I'm trying to get back to my normal routine unlike before. I try to go out as much as possible with, siyempe, C-3 precautions. I try to go out and like do biking or walking around. I have a partner na diagnosed with a mental health illness and kung baga yung pag-unawa dun sa kalagayang niya, ay isang malaking bagay para makatulong sa kanya, sa kanyang pinagdadaanan at kung paano siya makakakook with the situation lalo na natin ang pandemi. Everything that develops mindfulness, yun dun talaga ako nag-focus as a method of pooping. So when you adopt a healthy mindset, a mindful mindset kung baga, mas makikreate tayo ng better relationships. Okay thank you so much TVUP. I'm always blown away by how you're able to get our persons on the street. But these are real, yun know, hindi naman po re-enactment to ang mga in-interview po ng TVUP at alam po natin na maraming kapataan talagang meron silang mga nararamdaman, meron silang mga iniinda. And I think, you know, well what we want to do now is to understand it and to know what we can do, what we can do to help. Kasi this is still part of COVID, doesn't mean na dahil, yun know, nag-alert level one na itapos na hindi mo kang medyo tulit-tulito na. So tulit-tuloy yung mental health problems. So okay, so I think coping is going to be one of the topics we're going to discuss and how to get to overcome stigma. Kasi kait na nang sabihin natin, ayaw natin yung medyo markado tayo na, ay papatingin sa psychiatrist no, ganon. So you know, we have to talk about this openly because definitely our frontliners are very much affected and the families of our frontliners. Okay, Raymond sabihin mo 91 episodes na tayo. 91 episodes, Dr. Suzy, yes. I just can't believe it. Okay, so we've done 91 episodes and we are fast approaching our second year anniversary. So for our second year anniversary, we would just like to remind everyone, and we did this last year no, nagkarun tayo ng COVID-19 Heroes Memorial. And I think it was a very touching moment for all of us and I think even this second year is going to be the same. So we would like to ask you if you have friends, family, who have passed away and have sacrificed their life in the service of others for COVID-19, please send us your photos and a little bit of a caption. High resolution portrait photo at least 300 dpi. Ano ba in dpi? Raymond, pixel na. Something per inch. Sorry, I mean, dpi. Oh, parang magpukunwa. Hindi ko alam ko nyo. Full name, date of birth, date of death, and what is the occupation? So we want to remember, I think we want to remember, we do not want to forget the ultimate sacrifice na ginawa na ating mga kasamahan. And this is our small way of doing it. Hoping na hindi maggagantu ulit, hindi tayo magkaranang yun ang ito ulit. Okay, Raymond, over to you. Thank you, Dr. Suzie. So fast approaching na po yan, and March na po, at malapit na po, well next month we will be celebrating our two years na po ng ating stop COVID-19 webinar series and we hope to be able to get, well we are accepting po stories also, just very, very brief stories if you could share that with us but it will be a little bit more interactive in that sense po if we would be able to share with us photos of your kaibigan or kamag-anak po as mentioned as part of our COVID-19 memorial. Right now we have 800 and plus attendees in the Zoom webinar but we can accommodate up to a maximum of 3,000 participants. So please join us in Zoom so you can fully experience this interactive program. If you are watching in YouTube and Facebook, do not fret, dahil kayo pa rin po ay makakapag-join sa ating webinar for today although it will be better kung sa Zoom po kayo to be able to fully experience ang ating online community. Please input into the chat box dun po sa mga na sa Zoom at sa comment section po dun po sa YouTube at Facebook na konsan po kami naglalive stream ng episode po nito so that we'll be able to pick out the questions from our audience. For those who are asking, we have been able to distribute all 90, well partially na 90, all 89 episodes na certificates po. But for, I think for webinar 90 we are still pa huling buhos pa po ng mga indidistribute po natin mga certificates and only those who have watched at least 50% of the webinar duration will be receiving certificates of attendance. Those who are not in the Zoom, eto po yung pinakiihintay, please open your browsers and enter www.menti.com and din pagdating po ninyo doon, pag dinan ang po kayo ng code, input po ninyo ang 41152662, that's 41152662 so you'd be able to participate in our fun poll. Today's webinar will be using the standard panel discussion format where in the speakers will give their talks followed by a reaction and then will be doing Q&A sessions po wherein will be entertaining questions kung saan man po. You Zoom, YouTube, or Facebook po. Without further ado, Dr. Susie will introduce our opening remarks speaker. Okay, bago yun Raymond, sabi ni Renato Jose, saan ba yun? Ang ibig sabihin daw ng DPI at dots per inch. Oh, meron tayo bago na tutunom yan. Okay, thank you po. Thank you for looking that up. When I thought about it, I said how could you have 300 dots in one inch? Kamalit lang yan, parang 300. That's ibig sabihin, high resolution. I think so, I think so, yes. Thank you very much, Renato, for giving us that. Okay, so let's go to our opening remarks. Well, we have somebody who's very well known in the mental health community. Siya po ay director ng ating UP Diliman Psychosocial Services. She's a well known advocate and really, she's like a burst of sunshine. She's a life code. She sees patients also and she's a psychotherapist and a clinical psychologist. We'd like to welcome to the webinar Dr. Violet Bollet, Bautista Bollet. Welcome. Hi, Dr. Susie. Why thank you for such a warm introduction. I feel very much at home in your webinar series. Magandang tangali po sa ating lahat, good noon to everyone. Nakakapraod naman po ang sipag ng University of the Philippines and National Telehealth Center together with Philippine General Hospital in addressing mental health issues resulting from the pandemic sa inyong stop COVID deaths, webinar series. Nakikinig ako sa kwentuhan yung dalawad o Cremont at Sacadok Susie at tuntua ako na malaman that this is your 91st webinar offering and that you are soon to be moving into your second year anniversary. Achimpre dahil nasa field of psychology ako, I very much appreciate your decision to focus your special edition webinar. Anong kaya sabihin ang special edition webinar? Siguro mami akit kwento nyo sa amin on mental health outcomes of the pandemic. Syempre, we know that even before the pandemic, hangga, Bollet nag-freeze ka or ako lang ba yung ribbon? No, parayaw tayo Dr. Susie. Okay. So, Dr. Bollet, we lost like a minute. Oh, okay. We've lost you, Bollet. We've lost you again. We lost about a minute. A minute of what you said. Cremont, wala talaga nang. Medyo na puputul. I think it's where it's based on her location. There's a delay. Okay, Dr. Bollet. Bollet. Bollet. Maka, you can move your position muna. Move your location. We can't hear you. Yes, yes. Sayang ang ating. Okay. Let's do this. Let's try to get Dr. Bollet back so we can hear her message. And in the meantime, why don't we go to our fund quiz muna, Raymond? Okay, kasi ang Dr. Bollet is still here. Pero kasi if we don't have Dr. Bollet's video, we don't really experience her full persona. Kasi that's the entire package. We hope to get her na may video sana. Well, I think we have to proceed, Raymond. Let's proceed with the... And let's just bring Bollet back once her connection is done. Okay. Okay. Sige pa. So, thank you. Dr. Bautista, we'll get back to you mama while once your connection is a little bit improved kung baga po... Oh, Bollet, let me know. Okay, move to another place muna. Okay, Raymond, let's go. Okay. Thank you so much. We have two questions for today as part of our fund quiz. Flash on the screen po ang ating dalawang katanungan. They are in Filipino. The first question reads, alin ang maaring senyales na depression. Option one, walang gana sa dating ginagigiliwan. Option two, walang gana kumain. Option three, hindi makatulog. Option four, walang pakiramdam. And option five, mainit ang ulo. Hig magalaw pala ang kulay sa... It's like a rainbow. We hope yung pung ating mga attendees at least in Zoom which are numbering almost 900 na po. Makasali po dito sa ating fund quiz. At hamang sinasagotan po yun, gusto ko namin batihin ang mga nag-jojoin from the Bataan St. Joseph Hospital and Medical Center in Balanga, Bataan, Rogashano, Meghmercado, Memorial Hospital in Santa Maria, Bulacam, the Department of Social Welfare and Development, Haven for the elderly in Tanay Rizal, Eastern Visayas Regional Medical Center in Takloban, Leyte, and WCT Health Office in Pakibato District, Davao Del Sur, and finally Amay Pak Pak, Medical Center in Marawi in Lano, Del Sur. For our second question naman po, alin ang maaring senyalist ng anxiety. Okay, medyo mahirap yung ataitagalog ang anxiety. Nevertheless, the options are as follows. Number one, nervios. Number two, hindi makakali or restless. Number three, hindi makakoncentri. Number four, nakakaramdam ng panic. And number five, natitens. Natitens po siya. So please feel free and we encourage you to join our fund quiz po. Alalo na po yung pung mga nasa, labas po ng bansa internationally from Manama, Bahrain, Banda Arceli, Bagawan, Brunei, Bintaro, Indonesia, Bukit Murtajam in Malaysia, Bangkok, Thailand, Ho Chi Minh, Vietnam, German Embassy in Singapore, Maca, Saudi Arabia, Lunici Alley University of Bleeda II in Algeria, University of Fiji in Laotoka, Vacaville, California, Lexington, Virginia, Edmonton, Alberta, Canada, Surrey, British Columbia in Canada, and St. Eustaceous, Auxiliary Home Foundation in the Netherlands, Antilles. So maraming, maraming salab po sa inyo. Hindi po namin muna ito, isasara ang ating fund quiz. Alam po namin, marami po po ang gustong sumagot sa ating fund quiz. But we will go on to Dr. Bollet. Back to Dr. Bollet po. Are you back? Mam, Bollet? Bukang hindi atang makapasok si Bollet. Raymond, we'll go ahead na. So we'll keep that open. You can continue to answer the questions. Actually, ako, I really like the fund quiz. Oh, maraming po ang gusto na. It's something that reminds me of, ado ba ang tungkol dito sa webinar na ito? Parang anong pinakayimportante, di ba? Mingsin ka-center, may pinagayusapan. Okay, let's go to our main presentation. So I am very happy to introduce to you our first presenter. She is the chair of the Department of Psychiatry and Behavioral Medicine at the UP College of Medicine, Philippine General Hospital, and we're very fortunate to have her for the first time. Dr. Evangeline Delafuente, or Dr. Sandy. Sandy, welcome to the webinar. Hi, Dr. Susie, Dr. Raymond. Thank you for having me here. Okay, go ahead, Sandy, with your presentation. Alright, sharing my screen now. Okay, so today's presentation has been entitled The Rising Time, Mental Health Outcomes in the Pandemic. And I was instructed to prepare a pre-test and let's go over this now. So let's say, you know, someone named Jake, who has been feeling unusually sad and downhearted for most of the day, almost every day for two weeks. He does not feel like eating and has lost weight. He cannot keep his mind on his work and his work performance has dropped. He has put off making decisions and feels that even his day-to-day tasks are too much for him. To him, life seems meaningless and he doesn't feel like he's worth much as a person. What would you recommend that Jake do? Talk with family and our friends, talk with an advisor, talk with a mental health professional, all of the above or nothing. It is okay to be not okay in this pandemic. The second question is, a person who has exactly the same symptoms as Jake, but that person is you. If that person were you, what would you do? And same choices, talk with family and our friends, talk with an advisor, a mental health professional, all of the above or nothing because it is okay to not be okay in a pandemic. So moving along, let me walk you through the learning outcomes for the next 20 minutes. We would like to describe the toll taken by COVID-19 on mental health in general among health workers and on an individual level. And we would like to explore ways of enhancing resilience by using cognitive behavior techniques to promote emotional regulation, self-compassion, and appropriate help-seeking behavior. So we are still in a pandemic. The pandemic has taken a toll on many lives the world over. COVID-19 has taken hundreds of thousands of lives, infected millions of people, upended the global economy, and cast a shadow across our future. Much of society has been upended in unprecedented ways. The measures adopted to mitigate the public health crisis such as travel restrictions and lockdowns have affected physical movement and social interactions integral to the promotion and maintenance of mental health. Okay, just to give you a benchmarker on how disruptive COVID was on an individual level. A study in the U.S. noted an average decline of from 10,000 to 4,600 steps per day. So hindi ko alam po nakakakat 10,000 steps kayo per day pre-COVID pero kung hindi man, surely nitong pandemic nabawasan pa yan. For the study participants, there was an increase in sleep hours from 25 to 30 minutes per night because they would wake up later. Then time spent socializing decline by over half, so naging less than 30 minutes. And then yung screen time sa gadgets nagdouble. Now the proportion of participants who became at risk for clinical depression went up by 90%. So undoubtedly, the pandemic has been very stressful for all of us. So to review the stress response is an adaptive response. When we are, for example, crossing the street at masasagasaan tayo, yung stress response is what saves us. Yung amigdala natin turns on stress hormones para we can fight or flee whatever the stressor is. So ito yung magpatakbo sayo para hindi ka masagasaan. So ang stress response is meant to be short-term. Pero pang ikaw ay chronically stress nagiging chronic stress siya. At sobrang delicado ang chronic stress. It leads to high blood pressure, lowered fertility, it weakens immune system, gives rise to heart problems, stomach problems. So of course we don't want chronic stress. Despite our own challenges as healthcare workers during this pandemic, the nature of our profession calls upon us to keep taking care of the needs of many people who rely on our expertise and compassion for the restoration and maintenance of their health and well-being, often at great expense to our own. So maraming nasi stress tayo rin ay nasi stress, of course, pero patuloy ang paninilbahan. Okay, so the chronic stress has been documented to have adverse effects on the quality of life and mental health of healthcare workers. A local study done in 2020 showed that majority of healthcare workers had been affected psychologically. More commonly with anxiety symptoms and depressive symptoms, tulad ng nasa fun quiz natin. So ito na ang sagot. Anong nga ba ang anxiety at depressive symptoms? Sa depression ang hinahanap natin yan ay depressed mood, low mood. At ang isa pang hinahanap natin yan ay kawalan ng interest sa datin mga kinagigiliwang bagay. So yung mga habis mo hindi na nagpapaligaya sa iyo. So may rindun changes in appetites, sleep disturbance, mainiti ng ulo, madaling mapagod, hindi makakoncentrate. Paano naman kung anxiety? Meron tayong nagsabi sa chat box ang wabatagalog ng anxiety. Pwede ng nervios, agam-agam. So pagkagan yan, ikaw ay mapagalala. Iba po yung maalalahanin sa mapagalala. So may ronding fatigue, masakit ang kasukasuhan ang buong katawan, hindi makakoncentrate irritable. So ang hallmark nito ay ninynerbios. Yung isa naman, yung depression ay kalungkutan. Okay, sa mga health workers, balik tayo. Ayong sa isang study, anong main sources of anxiety reported by healthcare workers? Primarily it was fear of becoming infected. And unknowingly infecting others. There's huge concern of course for the welfare of loved ones. And uncertainty about the availability of support. And then the health information was a source of dissatisfaction. Kasi it was evolving pabago-bago siyempre. Okay, now what we want to do is be resilient. Ano ba yung resilient? Nakalagay dito, an ability to recover from or adjust easily to misfortune or change. At ang recommendation pa is be like the bamboo, bend but do not break. So siyempre in the face of such challenges, we want to be resilient. Okay, and thankfully merong resilience training that can change the brain. Kasi pagka ikaw palaging stress, na chichangin yung brain mo, mas nagiging active ang amigdala mo. Certain parts make you more prone to getting stressed. But we can reverse this intentionally by working on the other areas of the brain that dampen the effect of the amigdala. And let me explain to you how. So basically to enhance your resilience. Pagsinabi natin resilience physical, mental, emotional. Pero ang target natin ngayon mental health. Pero hindi po eding mental health lang ang patutukoya natin. It is necessary to pay attention to factors that improve physical health. Particularly sleep, exercise and diet. Factors that enhance social connectivity. And factors that enhance mindfulness and a balanced outlook. Binanggit ito ng mga na-interview kanina. Okay, so kailangan sa patang tulo. Kahit sinasabing 7 to 8 hours every night, iba-iba ang bawat tao. Average lang po ang 7 to 8 hours. Some need more, some are okay with less. But adequately per person is necessary for our recovery and healing from daily stress. Okay, so pag kayo po ay kulang ng tulog. Lalo kayong sensitives and stress. Magkakarung kayo ng tinatawag na emotional dysregulation. Magiging emotionally reactive kayo, susungit kayo and nobody wants that. So on the screen this can easily be downloaded from the internet. Our recommendations for sleep hygiene. Hindi naman kailangan na laging gamot po ang babalingan natin kapag katayoy hindi nakakatulog. Mayro mga natural means. Bawal uminom ng caffeine, magpatugtug ng relaxing music. So mayroong relaxing activities tayo pag malapit ang bedtime and so on. Okay, how else can we boost physical health? Syempre, hindi mawawala ang exercise. At anoong klasing exercise ang nirekomenda? Aerobic exercise, okay? Yan ang mas nakakapagpatibayraw sa atin against stress. So pwede yung walking, running, biking. Okay, ay nabanggit kanina ng isang in-interview. Mindfulness, ano ba yung mindfulness? Mindfulness is being in the present moment. And on the screen is an exercise that you can do to help you be more mindful of the present. When we are unmindful, inisip natin yung kahapon, yung bukas, ang dami natin inintindi. Pero ang gusto ng mindfulness ay being attuned to the present. And we can hone our mindfulness by exercising our five senses, okay? So wherever you are now, try to do this. Look around you. Find five things you can see. Titing nalang po, hindi hahawakan, okay? So, milimang bagay, kahit malayos ay nyo, identify nyo. Four things you can touch. So touch, touch, touch. As you touch, please identify. And then three things you can hear. Pwede yung gan nyo, syempre ako naririnig nyo, ako ano yung nasa paligid nyo, baka yung gadget nyo naririnig nyo rin. Then two things you can smell. Yung iba challenge dito, pero malamang yung shampoo nyo, or yung soot ninyo, or yung lunch ninyo. And one thing you can taste. So nagkape bakay nyo, nagmentos bakay nyo, or kumakain bakay nyo kayo? So this is exercising our senses and being in the present moment. This is a simple mindfulness exercise. Okay, ngayon medyo maglilevel up tayo ng exercise. Ang tanong, kamusta ka? How do you feel? Bakit sinabi kung level up dito? Chances are kasi ang mga sagut ninyo pag tinanong kayo. Kamusta ka? Ang sagut ninyo okay lang, medyo okay, mas okay ngayon. Okay, are you really okay? As health workers, we face a lot of challenges. And it is kind of hard to really be okay. More often than not, the conduct of our profession discourages the expression of emotion. So kahit ikaw ay nalungkot, naapektuhan, hindi mo yung usually ito pinapakita, kapag na sa workplace ka kasi dapat professional ka. Okay, so when work requires expression of an emotion that is at odds with your true emotion, we call that emotional suppression. So effort yan, kasi minararam damang kay, pero hindi mo siya pinapansin. This can lead to emotional exhaustion and may impact on work performance. Unfortunately, if you do it often enough, you're not aware that you do it. You automatically suppress your emotion. It is part of being resilient or self-care of improving mental health to be able to express how you feel authentically. If there's anything particularly distrustful, create a narrative in your mind. At bang nararam damang kung ayon bakit? Either write it down or better yet, verbally share it with a trusted person. Hindi po kwedeng, it sa walang bahala na lang ito. Merely saying, I feel anxious, naninervyo ako. I feel sad na lulung ko tako. Just acknowledging it may dampen the very feelings that you are experiencing. Okay? The simple act of labeling an emotional experience can reduce stress. Okay? Hindi tayo na uoverwhelm or nadadala ng emotion. Kapag ka, meron tayong magandang emotional regulation. At isang buhay pagandahin is identifying how we feel. So, if you can't do it now because likely you're at work, set aside time before the day ends to reflect on how you are feeling. Ayan po, mikodiko sa screen. It's an emotion wheel. As best as you are able, acknowledge and validate how you are feeling. Anong nararamdaman mo at bakit? Meron ka bang inaalala sa ngayon? Sa tutulang, napakadami po ng choices na alalahanin sa daigdig na ginagalawa natin. Pero ano ang pinakarelevant na inaalala mo? Okay. So, then you practice self-compassion once you identify how you feel and why. What can you say to validate your own feelings? What can you do to make yourself feel calm and safe? What can you do to take care of your emotional needs? Okay? So, these are important steps. So, to reiterate verbally sharing your thoughts and feelings about personally meaningful experiences can improve well-being. Pag-uwi sa bahay, masarap na mai-quento mo anong nag-anap sa araw mo, mag-quentuhan kayo ng family. It will ensure appropriate emotion regulation and encourage family members or friends to share their own experiences as well. Social connectedness is positively correlated with enhanced emotional regulation. So, as I said, take time to connect with loved ones and friends. It can increase health-promoting behaviors, improve mood, and reduce distress responses. Now, it's particularly important to close meaningful relationships rather than a large network of casual friends. It's not how many Facebook or Instagram followers you have or telegram friends. Ilan yung close mo doon? Okay? Another way to enhance resilience is to be thankful. Expressing gratitude can have lasting effects. On emotion regulation and can boost psychological well-being. You can say just thank you for the blessings you have. You can write it in your diary. Or better yet, think of someone to say thank you too. Gagaan ng loob mo, gagaan din ng loob nung pasasalamatan mo. Okay. Let me review, let's sure given by Dr. Anselmo Tronco before on mental health and mindfulness. It was said there that most of the emotional reactions to this pandemic are healthy responses to an abnormal, uncertain situation. Ang nakalagi dito ay most, hindi all. So, yes, it's okay to not be okay. Pero may degree rin ang pagkanat okay that is acceptable. And we would like to highlight that it is inherent in our values as a Filipino to be family-centered and have the bayanihan spirit. So, dapat, agamitin natin ito by sharing with our family and friends how we are feeling. Kahit mild lang yung iyong nararamdamang lungkot o pag-alala, wag na natin hintay yung lumalapa. So, may study that showed what are the preferred sources of support. Karamihan ng tao, gusto siyempre sa kaibigan o sa pamilya. May iba, sure, na meron silang mentor o teacher na close nila o spiritual advisors. Hindi priority na pumunta sa mental health professional na banggit na may pangkas, may stigma o minsan hindi lang alam pa ano ba ito pumunta. Okay, but ang gusto lang natin, sino man ang pupuntaan mo, kung kailangan mo ng tulong, basta pumunta ka, makipag-usap ka. Notice on your screen now is a dark slide and it says help seeking behavior. There's a dark site to help seeking behavior and what is that? My study has shown that given a psychological problem, needing professional attention, there is a greater likelihood of seeking help for another than for oneself, despite knowing that help is needed. So, ibig sabihin, mas madali para sa mga tao mag-isip tumulong sa iba. Ang tanong lagi, paano ba ako mag-refer? Pero yung sarili mo, nabibisita mo ba? Okay, kapag ang problema ka na mild, ay hindi biniging atensyon. Pwede ito maging moderate to severe. Pwede tayong magkaroon ng clinical depression and anxiety disorder and we can have suicidal thoughts. Suicide is a very real concern. Among the mental health concerns, ito ay irreversible. Therefore, I urge you to a check up of yourself and if you need help, whoever you prefer to consult with, please do so. Ask for help if you are struggling to cope. If stress gets in the way of your daily activities in a row, if you feel you may be misusing alcohol or drugs, even prescription drugs, if you have thoughts of harming yourself or other people or if you are already being treated for mental health condition and you experience new or worsening symptoms, please ask for help. If you're not comfortable seeing a professional, start with a friend or an advisor, just to talk with someone. Here's an option. You can set an appointment at PGH. Alright, na yung marami na po na bakunahan and we are gearing up for the tail end and we hope the end of the pandemic. Will the tide wane, do you think? As we prepare for a post-COVID world after two years of social distancing and losses suffered, we will need to adjust to yet another normal. Ang tagal bago tayo nakajas dun sa tinawag nilang new normal and some of us succeeded, some of us not so, but now we are called upon to adjust yet again. As COVID subsides, a tide of mental health concerns may yet rise. The outcomes are not yet conclusive and may continue to evolve. How do we stem the tide? Let me ask you, how do you feel? We start with ourselves even as we check on those around us. Let's talk about feelings as part of self-care. Self-care does not mean me only. It means me too. Taking care of yourself is an essential prerequisite for taking care of others. So to recap, COVID brought challenges to our mental health. The end of the pandemic is not to be done. Let's begin with ourselves so we can be better prepared to serve others. These are my references and I go back to the questions posed at the beginning. Ano ang tamang sagot dito sa tanong nato? What should we ask Jake to do? Sino ang dapat kausapin niya? Okay? And if you are feeling exactly the same symptoms, there should be no discrepancy in the answer to the first and the second. Unfortunately, many people think of referring another person but not looking out for themselves. So I hope with what I have shared with you today, you will take better care of yourselves so that you can take better care of other people as well. Thank you so much. That's Dr. Sandy de La Fuente of the Department of Psychiatry and Behavioral Science at the University of the Philippines PGH and College of Medicine. Ang ganda no? Parang ano ay sabi ko nalamig ng bosses ni Sandy kaya parang parang terapisa kanya. Parang tumuslund ako sa mga exercise. I'm sure Sandy you'll see how our audience and I'm sure there will be questions. So those of you who have questions, please go to the Q&A box tsaka sinasagot nila yung post test, a pretest and post test. Thank you so much Sandy, na pakausay na pahaganda. Okay, Kariman, ikaw naman. Thank you Dr. Susie. Malamig ngayong bosses ni Dr. Sandy. It's as if just telling a fairytale story na. So thank you po Dr. Sandy and we hope you'll be able to join us. Mamaya po sa Q&A session later on. We will move on to our next speaker who is an obstetrician and gynecologist by practice po but as a UP Manila official she is the director of the Office of Student Affairs University of the Philippines Manila. Please welcome to your screens Jill Suzette Mantaring, Dr. Obles. Good afternoon. Magandang hapun po sa inyong lahat. Good afternoon mam. Before I start my talk I would like to have a declaration of interest that I even if I'm a faculty of UP College of Medicine and department of anatomy I have no commercial or financial interest in any of the contents of my lecture and my only interest is the care of the UP Manila students. So this is a present scenario that many of our students are facing today. Mam bless can you make it a little bit bigger say we see your desktop. Wait, I'll stop sharing first. Okay mam. Is this better? Yes mam, perfect. Thank you mam. I'm sure that you're facing today because of online classes. So they sit the whole day staring at their gadgets while they're doing their online classes during the past two years. There is no time constraints na ka-aral sila any day of the week kasama na doon sa Saturday and Sunday they can study any time of the day and sometimes even midnight just to have a good internet connection. Aside from this multi-tasking is present. Aside from studying and social interaction with family and friends is limited to social media most of the time. So the UP Manila through the programs of the Office of Student Affairs would want to transcend or improve this scenario in adapting to this new circumstances wellness should be integral to the daily lives of our students. I would like now to talk about how UP Manila can improve our students. During pre-pandemic we had what we call the Psychosocial Wellness Network or PSWN program to address the emotional needs of our students because even before pre-pandemic we already saw increasing mental health concerns of our constituents and with this PSWN it will widen the reach of mental health care originally offered only at the college department of psychiatry and behavioral medicine. Now this PSWN is a collaborative work of seven of the nine colleges of UP Manila to foster a healthy and responsive campus climate. It is headed by the OSSA director and we have several members. It will include college student relations officer from each college who is also a faculty member all our OSSA guidance counselors of the university student council and representatives from the department of psychiatry and behavioral medicine. This is usually attended by the chair of the department of psychiatry. We meet regularly for updates as well as discuss methods and strategies to promote mental health and share best practices related to student support. We follow the multi-tiered public health approach which is recommended by the WHO at mental health in the community. We also want to prevent or minimize health and behavioral disorders among at-risk members and treatment or intervention for those identified with mental health challenges. Hence we meet all the needs of our constituents all those who are healthy mentally those who are at risk and those who will need help for their mental health challenges. Now in the middle of the pandemic a crisis management and foresight planning workshop which was hosted by the ecosystem was done and it was agreed that there should be a constitution of what we call a subcommittee on students in distress in each constituent university. With this establishment of subcommittee the PSWN was incorporated into this subcommittee and of two colleges the NTTC, HP and our extension campus a school of health sciences which is based in Baler, Coronadal, Palo and now Tarlac. This is now headed by the vice chancellor for academic affairs. This is a very important step for the UP system because we now give the UP system now gives emphasis to the mental health of all our students. We also have to fill up a periodic health exam form and submit this to the health service. Once they fill up this part they also have to fill up what we call the patient health questionnaire or PHQ-9 which is a medical examination at the end of the pandemic at the end of the pandemic at the end of the pandemic at page Q-9 which is a tool to screen, to diagnose and monitor the severity of depression of our students. This page Q-9 is the score is added up and depending upon the score we can see here in the table but students with a score of 5-9 diagnosis mild depression 11 to 15 to the Department of Family Medicine and Adolescent Pediatrics and greater than 15 will be referred now to the Department of Psychiatry. So we already have our limited face-to-face classes in some of the colleges and from the interval of July to September 2021, we had a total of 953 students who had or will undergo face-to-face. They underwent the annual physical examination and through the page Q9, 8.7% of these students or 83 students were referred to the concerned offices as seen from the table. Due to the social isolation experienced by our students, our guidance counselors had an audio and visual technology to have a wider reach of our students who have mental health concerns. These services are offered daily during office hours. Individual counseling services were given through these various modalities such as emails. We have our mobile app called the Lift app, which is an online chat platform between students and counselors. We also have audio or video calls using the Google Meets or Zoom or we can the student call or do an SNS to our guidance counselors. We also have group counseling with a tagline using usapang babohay, buuhay na usapan. This is given to the undergraduate colleges of Tutu Manila and the students voice out their concerns for the possible face-to-face classes that they're going to have. Now this is the Lift app. It's a mobile application. It's a live chat between our guidance counselors and students with anonymity on both sides. Meaning, hindi alam na students kung sino ang guidance counselors ang kina-kausap nila, or in guidance counselor hindi rin kilala kung sino student ako anong college ng galing astu jante. Therefore, this anonymity provides a platform for the open discussion of mental health and counseling for mental health problems in a safe, inclusive, non-threatening and non-stigmatizing environment. So the students can choose from the person they would want to consult. You can see here that there are no names. They can either choose an usap guidance counselor or they can choose a peer facilitator. Peer facilitators are student volunteers who trade under the Office of Student Affairs. Unfortunately, we presently have no peer facilitators available since the start of the pandemic. From this graph, you can see that there are many reasons why students use the lift-up from interpersonal reasons such as they feel stressed or anxious to family problems, to psychopathology situations and academic performances. OSSA also has an online mental health survey that was started last 2020 to assess the emotional state and resiliency of our students. We only had the soft opening so we only opened this for freshmen. And we used the following scales to measure the emotional state of our students. We used the DAS 21, the Depression, Anxiety and Stress Scale, which measures the emotional state of depression, anxiety and stress. And we also have what we call the brief resilience scale to assess the perceived ability of the student to bounce back or recover from stress. The data that we gathered from this can be accessed by the student-relation officers of each college. And from the data, there is a difference in the DAS and resilience scale of freshmen from the colleges in our main campus and from SHS, which is in Baler, Coronadal and Parlac. So from this data, we can see here that the DAS rating scale of students in the colleges of UP Manila showed and SHS will show mild depression. Both will also show moderate anxiety. But for the UP Manila campus, main campus, there will be mild depression, mild stress. But for students in SHS, there are normal stress levels. The resilience scale for both UPM and UPM SHS are in the normal levels. Now for the academic year 2021-2022, UP Manila showed mild depression while SHS has normal scale for depression. Then for anxiety, both main campus will still show moderate anxiety. And then for stress, UP Manila campus, students will show mild stress while normal stress for SHS students. Resilience is still the same. Normal resilience for both. Now this is probably understandable to have a moderate level of anxiety because of the uncertainties experienced by our students during this pandemic. But you can also see that the depression and anxiety levels did not progress to the severe form because of normal levels of resilience of our students. All students will also need to fill up what we call the UP Manila Bayaniha na employee symptoms tracking system or what we call BESTS. It is a web-based application designed to help monitor and keep track of the health status of all employees and students. They are required to log in their temperature and any self-assessed symptoms. These reports will be generated and emailed to the head of offices and the focal person of each college. For example, as head of the Office of Student Affairs, I can monitor my staff's condition when I will show the temperature, the symptoms, the BESTS and possible exposure to COVID of my staff. There is a flow process that UP Manila will follow. This uses a guide on how to deal with faculty, admin staff and students with possible COVID-19 exposure or infection. There is also a focal person identified per college to assist employees and our students who show symptoms of COVID-19 infection. The BESTS app alerts the focal person or supervisor of their condition. UP Manila also has undergone several steps in order to prepare for face-to-face classes. Such as all students who are now undergoing limited face-to-face should all be registered with field health or unequivalent medical insurance. There are also retrofitting of the classrooms and laboratory rooms. The traffic flow of students in campus is also ensured so there are arrows to show the students where to pass during ingress and egress out of the buildings. Students and faculties are required to have complete vaccination. For example, in the College of Medicine we have to access a QR code for daily symptom monitoring and our temperatures are checked at each point of entry. The subcommittee of students in distress also had two recorded videos given by two nurses from the College of Nursing and from the Philippine General Hospital and this and the topic was strengthening self-care and coping through stressful times. This will be given to all the colleges and the SROs are expected to show these videos to all of their constituents. There is also an ongoing telehealth and wellness program which is sponsored by the College of Alley Medical Profession wherein there will be regular group exercise sessions to start a more physically active lifestyle for all constituents of Philippine Manila. The program aims to improve health, the physical fitness and wellness of our constituents through exercises and healthful health education led by a team of physical therapists and physical therapy interns. But before you can enroll into this program you have to undergo a quick screening procedure in order to ensure safety prior to participation. And after a period of more or less eight weeks the progress of the participants will be checked again. The subcommittee on students in distress also did a survey. It was answered by both faculty and students. In the survey answered by faculty the faculty were asked questions to determine their perception on how their students experience distress and how they responded to this distress. And in the survey answered by the students almost similar questions they were asked their personal experience of distress. And the results of these two short surveys will be used by the subcommittee on students in distress to develop intentional and context-focused psychosocial intervention for our students. Now for the next few slides that I will present this shows the responses of both the faculty on their perception on a student's distress which is called a pink in the table. And the student's own perception on distress which is called a blue. In the majority of the questions you will notice also the faculty's perception of how the students respond to distress is almost consistently exceeds the actual perception of the students. So in this question on effects of distress to students changes in eating habits will have the nearest response rate for both faculty and students on the question how does distress affect you. Now for the question which of the following concerns at home can possibly distress both students and faculty will have the top most answer which is unclear boundaries between schoolwork and household chores which is what I mentioned earlier in my slide there is really multitasking of the students. They are expected to do their schoolwork at home but they are also expected to contribute to help in doing the household chores. So here for the students there are conflicting priorities they don't know what to do first will they study first or will they help at home. Now which of the following can cause you distress when you lack any of this answer for both faculty and students. But for the students the absence of leisure and recreation and socialization have severely affected them. Is a COVID-19 pandemic a significant stressor to you personally both faculty and students agreed that it is a significant stressor for students. And how have you been coping with distress? For both faculty and students the most common answer here will be browsing on social media such as Facebook, Tik Tok and listening to music but an additional answer coming from students will be sleeping and resting and connecting with friends online. As a summary I have presented the various programs of the Office of Student Affairs as well as UP Manila to address the well-being of our students. Surveys and online assessments will help our office and the university to develop programs and mechanisms to meet all the health needs not only of the students who have mental health concerns but all of our students. Thank you for your kind attention. Okay, thank you very much. That's Dr. Blazmantari ang ganda rin ang presentation nya puro data that kind of analysis really helps us understand from the point of view students. Ano ba yung mga stress or nila? Saka paano natin silang matutulungan and ako I was taken aback by the multitasking thing na parang kala natin siguro mas madali para sa mga student and di sila pang mapasok pero actually nang ang stress din yung sa bahay sila. Anyway, we are now in our room and we are going to ask Bless and Sandy to open their cameras. I think we don't have Dr. Ballet but we'll proceed but prior to that Raymond has an announcement. Go ahead Raymond. Very, very quick announcement lang po before we go into the Q&A session we have I think the first of a new set of public service announcements for today. Take it away, TV UP. Stay safe and stay well. Mga bata, magpasama na sa Vakuna Center. Okay, thank you so much TV UP the COVID communication public service announcement is one of the many creative announcements that we are going to do at the end of the year. Thank you so much TV UP the COVID communication public service announcement is one of the many creative announcements that we are going to do at the end of this announcement is one of the many creative outputs of the stop COVID deaths team to push for pediatric vaccination for children ages 5 to 18 years old. Oh di ba na extra pa tayo don't Raymond. Puna pa lang po yun. It's a set pa lang po. I think you can naman po yun datin na now we're really promoting the vaccination of adults particularly seniors kaya mga di ito na para tuloy-tuloy lang yung pagbabakuna. So Raymond, let's start our panel discussion. Actually I saw several questions in the Q&A and we'll take them in a moment but I had a question both for Sandy and for Bless. Yung health workers natin I would say would you say to begin with the resilient kasi para maging health worker kaya nakita ka nang may sakit, nakita ka nang sinaksak nakita ka nang nang nang mamatay so there is some level of resilience among the health workers. Do you think na there is additional training that's needed for frontliners? And in the case of Bless's presentation, our students of medicine, our students of nursing, do we have to do more in terms of training? Kasi the pandemic was a completely different kind of stress and if we do what do we need to do? So ano mo na, Sandy ano tingin mo dyan? The answer I think would be yes. I agree with you that health care workers become resilient over time. They may not have started out resilient but when they chose to go into this field with experience they do become more resilient. However yes I would agree with further targeted training kasi na now that we have experienced this pandemic but even prior to the pandemic there were disasters and we need to address yung emotional concerns na kasi usually hindi na naman yun naging target natin when we are trained to be health care workers nandon tayo sa competence pero kailangan din napagusapan ang feelings natin at pano ba ito e-manage tapos ang feelings rin ng bakit kailangan ng training kasi na minsan wala kang oras pano ba ito ginagawa na mabilis na mabilis kasi hindi naman pwedein kawasap mo paciente ma-tutugonan mo So I think the training will be there. In our college this is being addressed already. Anyway that's my answer maybe Bless what are your thoughts on that? Well I agree Even students should have training in preparation for facing patients especially medicine facing patients during their rotation as interns kasi interns tayo na nag-face-to-face but I know that there are orientations given to interns to help them the do's and the don'ts on what to do when they are in the hospital or what you have to wear the PPEs but I also see the appreciation of interns when they do face-to-face because I have a son and you really appreciate the face-to-face interaction that he has because nothing can replace face-to-face particularly for this kind of work and he's really very appreciative of all the orientations and all the do's and don'ts that he's giving to them also the College of Medicine has their own Office of Resilience which really tries to help all students in the college to overcome any anxiety and stress although sometimes it's really hard to reach out to all the students because sometimes the students really don't want to be helped they really need an open mind at hospitals and that's it one more question before we go to the questions for the audience and this percent because someone was asking me this and I wasn't very sure how to answer it can you explain to us from a psychological point of view how come we were all looking forward to going out no more lockdown and so on people are still anxious no, parang gusto pa rin magpates kaya nilang kailangan how do you explain this so parang we were looking forward to something and then now that it came people feel the same they still feel na parang, ay nako hindi pato ganoan explain that Sandi what is your explanation to that Doc Susi it took time for us to get used to the pandemic we were told to get used to the new normal so unti-unti we learned new ways of dealing with the situation of being in isolation so it took time and finally we learned magpapatest ka how to distance ka sa tao and now after two years we were supposed to be going back to how it was before but we know it is not as it was before the pandemic is not yet completely cleared therefore yung kabam mo parang reality based dahil yung virus nag-evolve siya so mahirap maging campante hintay ka muna ng sinyalis na talagang safe na so the excitement will remain but the action will have to wait until we all feel really safe and that will not be coming very soon okay Sige Raymond we've got some questions some very interesting questions in the Q&A okay doctors you see I'll be picking one from the chat actually from jovenia selo who says that she is the chair of the scholarship committee of the UP Alumni Association in America they've been doing some fundraising to help UP bagyo students with their psychosocial problems so aside from psychosocial problems those students also are financially challenged and so her question is any other constituent universities other than UP Manila that can offer help and is there anything else that the UP College of Medicine or UP Manila in general can provide in terms of services for students within the system but from other CEUs I'll pose it to Doctor Amantaring all the directors of the office of student affairs and meetings that will be under the UP system so we meet regularly and we discuss the problems of our universities and from this we have come up with certain steps for example helping the students financially through the GIP program of the university we also have the Kaagapay program that helps also financially need these students in need of gadgets for example but dahil nga sa dami ng sujati nangangailangan the system really cannot answer all the needs of our students so we really have to classify the students based on their income level so those who are classified as really in the poverty line then they get for example a gadget and a monthly internet connection for one academic year and then the next level will only get internet connection so it really depends on the income of the parents also the system is so conscious about the mental health of our students that we already have come up with a program that will give financial aid to the students who have mental health concerns to help them for example in their expenses to buy their medicines or for example in order to consult a psychologist or a psychiatrist so this is still undergoing study but I think by the next academic year may establish na rin itong program na ito thank you bless I think we're doing that in UP do we know what's happening in other institutions outside of UP? I'm also a member of SMEC which is the south manila educational consortium the SMEC and we also have a group of the office of student affairs and we also meet regularly and I think all schools well in SMEC are helping their students through mental health support and this is also being talked about by other universities Good to know, good to know Sige, Prima mayan pa yan Question naman po I'll pass it on to Doctora Sandi coming in from Professor Emeritus for Psychiatry si Mamlulu Ignacio So what does it mean when normal resilience result so yun po yung kanyang katanungan mam Sandi I'm first stressed I'm sharing my feelings and sharing my own advice when Doctor Ignacio I'm really reduced to studenthood So yung normal resilience result I can only define what resilience is which is like the ability to adapt or to bounce back So it is our aspiration to resilient So that is the only way I can define resilience I cannot say if there's abnormal resilience I think all resilience should be normal and that is the aspired result I hope Doctor Ignacio is happy You might want to talk No, I think that's a great question I mean I guess if I were to rephrase that it would be like how do I know that I'm resilient and that I'm coping well Right? If I'm a health worker and I'm super stressed out I have older parents I'm taking care of yung How do you know that Doctor Lulu you might want to join Doctor Sandi na high resilience result and low resilience result in aspectrum ba Is that a thing? Ang naisip ko na term is high functioning, low functioning or sakto lang we're going to go to issues of normality Ano ba ang normal? Mayan kasing optimal yung functioning na malamang superhero sila pero ilan lang ang ganon So parang we aspire to be basic human beings we struggle every day pagtulog mo na gawang mo ba lahat ng kaya mo nga gawin and you are grounded in your capacity May I phone a friend I see on the screen Doctor Ignacio I will be quiet now and turn the floor over to ma'am I was just struck by Doctor Amantaring's survey result as normal resilience So it struck me as in a survey result That's it lang So for our audience that's Doctor Doctor Ignacio who is a professor emeritus of the U.P. College of Medicine and PGH in psychiatry Lulu, you want to talk about why it struck you? Actually Sandy has answered it Resilience is part of us We are basically resilience So why are you what is that thing in the skill na normal You should have resilience as a human being You bounce back we cope and then we cope but then the first step is resilience anywhere disaster problems of daily living but I was struck by the survey result on students normal resilience So I'm asking Doctor Amantaring ano ang source lang result na yan because I think it's very confusing Ma'am what we used was the brief resilience scale I think and that was answered by the students and based on the scoring there was with normal limits ang resilience we interpreted it as the ability to be able to bounce back if there is any stress in their lives because these resilience scales are really to be contextualized That's all I have I was really struck by that Okay, I mean I like this discussion ano a say we can't take everything at face value sometimes when we hear things ano bang what exactly does that mean ya So I think blessed answer the question So did Sandy So let's go to some questions Thank you very much Thank you ma'am Lulu and thank you Doctor Amantaring The question naman po I'll just choose from our most upvoted What is high function depression is it healthy as a coping mechanism that coming in from Nora Villanueva po Ma'am Sandy When we say depression the term depression mayang regular everyday depression mayang clinical depression kapag sinabi mo clinical depression mayang effects of functioning at ang functioning ay personal social occupational So kapag ito ay functioning depression ang inisip ko ang tinutukoy dito ay nararamdaman natin kalungkutan dahil party yan nararamdaman ng tao So What is the question kung healthy coping ba ito Yes ma'am Is it a healthy coping mechanism Ano sabi Raymond The term used po is high functioning depression so At least for the question Kung healthy coping ba ito If in the face of regular run of the mill sadness you can still function then you must be drawing upon good psychosocial resources Bale, you're just grounded na it's natural to be sad sometimes So that would be my answer to what I understand the question to be I have a follow up question to that Sandy because some people who have depression their experience is not sad nese is that they don't feel anything ang sinabi natin kanina na yung datin nakakagilio ay hindi na nakagigiliwan na parang wala lang there's nothing So is that the same depression or it's something else So yung depression kasi marami siyang criteria pero ang top 2 na hinahanap mo nga yan ay depressed mood or loss of interest in usually pleasurable activity So yung sinabi mo kinukonsider nga sa criteria na may ibang tao na lulungkot pero may ibang tao nawawalan na lang ng gana ng pakiramdam So that can also be depression meron din tinatawag na agitated depression pero basically it is a negative low mood you don't feel your usual self So depression can present in that way Yeah okay Ramon meron ba tayong okay, it's a question Well there were 5 questions po kasi that were already answered by Dr. Sandy This one I'll pick one from Renato Joseph Although medyo nabangit na rin naman I'll just read it Can you share with us how PGH health services if may referral I guess in terms of handling cases as it relates to the mental health condition of the students Does it affect their standing as students in the university and then he has a recommendation He hopes that the program can be shared with other schools dahil kailang po ito ng ibang students sa ibang mga schools So I think it's much more of the coordination by OSSA, their findings especially if you have counselors paano po by if it requires referral You're on mute ma'am The last few slides that I've shown are just recent data So the sub-committee will have to work on this on the programs that will be needed particularly for students in distress Our guidance counselors has received several referrals not only from UP Manila but also from other schools and from other constituents other UP constituents So it's really open Even the Department of Psychiatry is not only for PGH but to all kaya kaya kaya kira preng ng residents ng psychiatry to help not only our constituents but also to help the outside people to help in their mental health concerns Well, we are naman willing to I've been invited to several talks already on how to help with their students and I've introduced already some of the programs and I hope some of the universities that I have talked to can pick up on this Rima, do you have a question for Sandino? One of the things that we've noticed or we've heard about is that we have many residents and even nurses who are quitting Sandi, would you like to talk about what's happening there? What's going on with people that they're hoping is to quit? May I will make two comments. I want to follow through on what Bless said earlier that the Department of Psychiatry is accepting referrals from all UP units at binanggit niya na nahihirapan ang residentirin namin Related to that one of our projects that I'm hoping to get off the ground soon is capacity building The WHO is promoting inter-professional collaboration so that people will not only expect to see psychiatrists meron din naman kasing psychologist meron din naman social worker maraming mental health professionals hindi lang psychiatrist gusto natin may enhance ang capacity at ang awareness para ma-address ang mental health concerns so that is we are starting on this project now it's one of my academic improvement programs and we hope to update you on that in the near future. Number one. Number two residents who eventually quit I'm happy to share that the numbers have been improving no pandemic there were a lot like last year last last year nurses and also nurses na maraming hindi na they just quit kasi may hindi ko alam yung hard data so this is just like my opinion no pandemic survival mode ng tao hindi resilience ang pinagtatalunan noong simula buhay so hindi ka magugulat na many people decided to withdraw there are many people who may be young and able at baka hindi naman sila hindi sila delicado for COVID but they live with family members who are elderly so I would think that was also an important factor the people they live with and their fear for the physical safety kasi I have interacted with actually consultants who actually left their posts positions they quit and they're coming back now and that was the reason they gave to protect their family members now on a personal level naman talaga naman kakaibang pandemic so kaya gano ka katibay pwede ito na yung katapat mo so it's multifactorial the residents and the nurses it's a multitude of reasons foremost would be the reasons I hear love for family, concern about welfare katulad nung shinoko na slide fear of infection uncertainty about what's going on so that would be my answer to that question thank you very much Raymond meron ka pa? thank you doctor Sandy well meron po dito palagdag lang palagdag lang po palagdag lang palagdag lang po I'll choose one coming in from Matthew Ivan, Kurt so he's curious to know what coping mechanisms have been most prevalent po based on consultations et cetera during the pandemic so yun po yung his question with regards to that most common coping is connecting with people which is a good way of coping depending na lang na itong pandemic kung gano kakakreative at resourceful kasi bawal yung face to face bawal yung naglalapit so pwede yung telepono pwede yung viber, messenger zoom what have you so I think that's a good way to cope a not good way to cope is shopping at dumami yung delivery people yung economy medyo na challenge pero nagbomang shopping online services so sinair ko lang yung ng coping bahala kayo mag-judge kung good ba yun kasi depends pwede ba yeah there's an interesting question here is bullying or verbal abuse in the home a manifestation of depression so we've heard a lot of stories about child abuse and domestic violence at home during the lockdowns are those signs of depression or is that something else maybe a very cryptic answer would be hurt people hurt people somebody, a bully hurt other people this person is probably hurting for some reason we can't categorically say na depression ito for sure it could be many things but depression is probably hurting inside too Dilman, do you have another question? these are actually I'll just aggregate po they're asking about peer support programs on mental health concerns et cetera my question so I'll just input my question how does so Dr. Mantaring mention kanina na the directors of the office of students over the system do you have an interface with let's say psych serve or other universities that may have their own local programs not necessarily out of osa pero yung po ba ay napago usapan at mayroon po bang pagkakilan lang at intention to work together, integrate et cetera that's going to be hard because the first app started from psych serve so it was developed from psych serve and then UP Manila added its own needs kaya naging UP Manila but it's really going to be hard to integrate all the UP Manila universities to talk in one app kusino ang tataw doon that's our problem rene because now the people maning the lift up in UP Manila our guidance counselors and we should also respect their mental health so they can only man that up during office hours so our problem is after office hours who is going to man that lift up wala sa ngayon and then the weekends wala rin sa sa good sa lift up so that means it needs additional finances to get more people to man that mobile app and then to think of it in a wider scope to include all the constituents of UP for example that's even a harder task because that needs malaking trabao yan it's a very big project that we have not really talked about because we're just talking now about what each constituent is doing on their own campus okay thank you po mam bless we have been for the most part talking about students the youth et cetera po but this question comes in from Francis Therese Marie and I'll pose it to Doctor Sandy pano naman po yung mental health ng mga elderly if they experience loss of interest or some other mental health symptoms po because of loss of friends by death tapos dahil po social distancing po coupled by the fact na hindi po sila techie tapos hindi rin po sila pwede ng luwabas how often do you see those kinds of patients and ano po ba ang advice that usually given to them so I would say that the elderly have been among the hardest hit by the pandemic kasi one patient comes to mind ang kaligayahan niya dati ay manuod ng cine ay mag-zumba sa mga kaibigan niya ok so nung nagkaroon ng pandemic meron siya mag-anak naman na maroon techie kung ikawa elderly at hindi ka techie for sure meron kang mag-anak na bata na techie pero iba pa rin siyempre hindi pareho ang zumba na virtual at zumba na kasama so talagang ang usual na payo yung mobilize family members and friends parang gagawa ka ng Monday group, Tuesday group parang dapat meron silang kina ka-excitan sa araw-araw I would recommend routine kasi kailangan niyo mental health ng mga kamag-anakan alalayan mo re hindi naman ang iisipin di ba so come up with a routine so let's say every Monday ito yung ka-usap niya Tuesday is a spread mo tapos you form a social network kasi marami naman elderly in the same boat so why not start a club for them with whatever resources are available kasi nga di ba marami rin ang mga viber yung mga messenger mas madali yun matutunan for some kesa yung zoom meron pang doxy dyan so basically ang gusto may paraan ang ayao may dahilan so yun lang ang iaano ko resourcefulness which is very Filipino okay there's a good question Reymond from Parie Elena de Guzman is avoidance a good coping mechanism from toxic environments and toxic people okay avoidance is necessary at times okay kasi hindi ko naman sa sabihin sa nyo na sugod sugod okay pero hindi pwede ang avoidance mo dapat ang gusto kasi natin harapin ang problema pero you don't you don't like do it unprepared avoidance is a temporary respite kumit sobrang toxic na tao medyo bumuelo ka okay so my answer is there are times when avoidance is necessary but it cannot be your go-to indefinitely you need to develop other skills hindi pwede nga ang skill set mo mo arpa okay thank you Reymond anything else before we start doing our closing remarks I think that should be it Dr. Suzy okay so thank you very much we're gonna give our our speakers a minute or two to just formulate their closing remarks for our audience this has really been very informative and I think our audience has been very much engaged in thinking about what was discussed now so we're going to do the oh you wanna answer the questions first Reymond let's answer the questions po okay let's answer the questions thank you okay can we have the mentee on the screen as well okay so the two questions that we have alin ang maaring senyalis ng depression so hindi po ibig sabihin nito one answer lang po you could choose multiple answers among these we have one two three four five five options the top most at least for zoom is wala nga na sa datin kinagigiliwan at 84% that's followed by hindi makatulog at 72% and then wala nga na kumahin at 66% for our second question alin ang maaring senyalis ng anxiety again multiple choice multiple answers din po ang pwede dito number one hindi mapakali or restless was chosen as the top most answer at 78% that's followed by nervios at 69% and then closely followed hindi makakoncentrate at 68% so before we before we shift to the final messages po from our panelists we'd like obviously we know that everyone is medyo busy po at nakakarumpu sila ng kanilang mga kanya-kanya pung ways of skimming especially YouTube especially those who would want to look at our channel at TVUP is at YouTube.com we'd like to remind you that we have very very short snippets po that we fondly call our SED shorts ito po ay mga Mikey lang po na mga video clips very very important points mentioned just short videos po coming in from our webinar so please do visit youtube.com forward slash TVUPPH for you to be able to look and be able to view our SED shorts po and then lastly we'll go into our evaluation poll for akas ilagito pa natin yung questions yes we did all of the above lahat po yes po yes po ok akas is going to say Raymond before you're going to that you're mentioning the shorts after this webinar this whole recording would be available on YouTube so I know you I saw it in the chat that you found Dr. Sandy very therapeutic so you can go back and watch it again and I think there's really a lot that we can learn from this particular episode ok go ahead Raymond thank you Dr. Susie before we ask our panelists for their final messages we'd like to show on the screen the evaluation poll just a quick reminder again that we are not distributing any separate evaluation polls po ok and we have it on the screen unless we are having problems again with the evaluation poll it's a four point like for each of the five questions that we have right now ok we're just waiting for the poll question to appear po ok there we go um so questions are as follows the panelists demonstrated thorough knowledge of the topic the panelists were well prepared and organized the panelists spoke clearly and audibly the panelists used appropriate language with technical medical jargons adequately explained and finally the panelists contributed to new perspectives and knowledge on managing virus kicovid-19 health issues uliting ko lang po wala po kaming nilalabas na hiwali na evaluation poll ito na po iyon so we hope that you'd be able especially if those umabot po tayo na almost 1200 kanina sa zoom at least so you'd be able to join and input your feedback dito po sa ating webinar for today we will not be closing our evaluation poll as we move on to final messages from our resource speakers okay we'll go first to bless your parting words for our audience um I did not mention this in my presentation but we ask the students if they know about the programs of FUP Manila and OSAN and it was disappointing because a little less than half didn't know about our programs and I think the main trust now of students in distress and also particularly is to really broadcast all the projects all the programs that we are offering to the students because it is only with the knowledge of the students it's only when the students know that there is help being offered to them that we can really help all our constituents yeah thank you very much bless mantarin who's handling this service support services for the students okay Sandy na siyempre ang parting words go have to do with caring for yourself so as you would care for another do care for yourself as well you have only one you and no one can do you better than you take good care of you you matter we all do bow thank you very much Sandy and we're seeing here in the chat some of our participants are saying we have to do more sessions like this non-mental help so we're we're going to respond to that okay so for our closing remarks and our synthesis we've got the deputy director of the Philippine General Hospital Dr. Stella Legaspi Jose Stella the floor is yours thank you very much for this enlightening webinar from Dr. Bless bless he also set mantarin and Dr. Evangilin de la Puente we all learned a lot from your talk and it is greatly appreciated by all of us in TV UP the talk of Dr. Sandy on the stress response she said that the amigdala of the brain is turned on when there is a stressful situation and chronic stress happens when what you are doing and what you feel you should be doing are different so it causes a stress in you and this is documented to affect you psychologically she differentiated between depressed mood and anxiety she said when depressed mood the person is of course she has a low mood there's lack of interest in the things that she usually like to do and there is sleep is hard she has a hard time sleeping and also eating so in Tagalog this is kalungkutan while anxiety in Tagalog is din inervious so there is easy fatigue and painful joints and all these symptoms now the sources of depression can be for the healthcare worker it is the fear of being infected or infecting others now she mentioned about resiliency now being resilient is when it is the ability to bounce back the ability to recover or adjust to a certain misfortune so tayo daw we should enhance our resiliency how do we enhance what are the factors that enhance resiliency ang sabi ni sandi number one is your health so dapat daw lahat tayo may sleep hygiene so there are you know you have to sleep like 7 to 8 hours a day ako niyan offense ko yan kasi I sleep less than 7 to 8 hours so you should do aerobic exercises yun important din yun and sinabi niya mindfulness what is mindfulness that means that you are attuned to the moment so there are five things daw for mindfulness five things you can see four things you can touch three things you can hear two things you can smell and one thing you can taste so these are the concepts in mindfulness now there is also what we call emotional suppression what you are doing is not what you feel you should be doing so dapat daw tayo we should express how we feel for example you do not agree to what the nurses for example you do not agree to what the doctor has advised your admitting physician you should talk to them and say daw bakit kaya ganito ang ating dinawa so you have to express your feelings so ang sinasabi din niya yung emotional regulation you should verbally share your thoughts and feelings i think that is a very important message because when you keep it yourself the more it becomes a big big problem another concept is social connection so how do you do that you express gratitude show your appreciation share with your family and friends what you are feeling now we should also have the help seeking behavior psychological problem it is easier daw to help others than yourself we should help ourselves first when does a person ask for help when should you ask for help when first you are struggling to cope when the stress gets in the way of your work or you are thinking of self harm yung nga yung mga may or previously you had a mental health issue and presently the mental health issue came back or it is in a different form ok so marami tayong natutunan kaya sandy and i suggest you go back to the recording because it will be all on every live now let's go to the talk of Dr. Blessile Mancari listening to her talk ang dami nilang programs ang dami nilang programs and it is all directed for student welfare so i hope our students appreciate this so yung sinasabi niyang tiered psychological concept yung first yung pinakabase ng tiramid is to promote mental health and then yung second yung targeted is to prevent depression and anxiety and third yung intensive yung nga yung nirerefer sa psychologist sa psychiatrist now, meron din siyang sinasabi na scoring for patient health health quality yung sinasabi niya na depende ko ane yung symptom doon natin e-refer so for example kung mal-symptom sa student e-refer mo na sa psychologist or doon sa mga student volunteers and as you go deeper and deeper then yung refer to the psychiatrist now in UP in the student of office student affairs they have counseling so counseling can be done by e-mail and they have the lift up app it is a mobile app and where there is open discussion of certain issues now they also have audio and video call the mobile phone for direct direct communication and for the first year students they have the online mental health survey and in this survey the first year student is asked they classify if they use the DAS 21 or DAS S21 which stands for depression anxiety and stress scale so in this they now know the category of the patient and there is an action for each of these students and they also have the brief resilience scale so there are many tools that they use and also the use of the BEST BEST stands for bayanihana employee symptoms tracking tracking na system so both physical and psychological issues are addressed in this BEST okay so I think that is all for this today's webinar I hope you all go back to the recording and so you can learn more thank you very much thank you very much that's Doctor Stella Legaspi Jose who is the Deputy Director of the Philippine General Hospital for the participants Renato Josef may sinabi dito na because sometimes you want to pick up what our participants are saying he said integrating spirituality in handling the psychosocial psychological issues of the pandemic is vital nice na so thank you Renato and thank you to DPI DPI that's for linear inch for inch okay thank you very much alright next week we have a very nice topic again so we are going to talk about safe na balumabas ang mga senior na hindi vacunado alam mo pinoprobleman namin dito na marami pa rin senior ay magpabakuna so ngayon question is safe balumabas ang mga senior na hindi vacunado so we are going to have of course Shelly de la Vega who is one of your favorites at the Philippine society of geriatrics and gerontology so join us next week this is going to be another very interesting and very informative session over to you Raymond thank you Dr. Susi and thank you for the synthesis and closing remarks from the deputy director for health operations at the Philippine general hospital Dr. Stella Legas P. Jose before we conclude our program let us first acknowledge the very hard working team behind the stop COVID-19 webinar series without each and every one of you we won't be able to churn out our quality content week in and week out and finally po meron po tayong channel as mentioned po all stop COVID-19 webinars are archived for viewing at the tvup youtube channel just type in youtube.com forward slash tvupph and you'll be able to see all 90 webinars and then pagataspo ni to 91 webinars na po pagpapansin nyo po mental health po as a topic marami po talaga and hopefully will be able to put out more webinars on the same topic in the future po so this formally closes our webinar for this week next week po lalo na po do sa ating mga seniors sana po ay mas makanood po sila na episode po natin next week para po sa kanila po iyon as mentioned by Dr. Susi geriatricians and also experts from the institute of aging will also be having one expert po from vaccine expert panel so please stay tuned we are showing on the screen the results po of our evaluation po with more than 90% po in consistent po with our previous webinars choosing the strongly agree for each of the five questions so maraming-maraming salamat po at we hope to be able to see you again next week from 12 noon to 2pm every friday it's a date together we can stop covid deaths so keep safe, keep healthy and see you online at we hope to see you again next week at we hope to see you again next week at we hope to see you again next week next week at we hope to see you again next week next week at we hope to see you again next week