More than 150 years ago, Karl Marx and Friedrich Engels already criticized the capitalist system for damaging not just the wages and living condition of the working class but also their physical and mental well-being. The inherent features of capitalism were described by Engels in the book “Conditions of the Working Class in England” as alienation from work—workers separated from the product of their labor which becomes a capitalist commodity—social isolation, and despair. These are marked by brutal indifference and the unfeeling of isolation of each in the worker’s private interest that brings down social solidarity and adds to psycho-social distress.
Come the 21st century, when social order worsens and capitalism reaching its peak of self-destruction, the conditions of people’s mental health around the world also gets worse. Imperialism is already in full-blown offensive against humanity to keep it passive, uncritical, divided, and distracted.
Later, the imposition of neoliberal policies—deregulation, privatization, and liberalization—facilitated by fast-developing technology, popularized and promoted through various traditional mainstream and social media platforms aggravated the already prevailing mental health concerns. Individualism and commercialism have become the key narratives. It is not surprising thus, for the World Health Organization to say that worldwide statistics in 2023 showed one of eight people suffer from mental illness.
In the Philippines, a study conducted by the House of Representatives, also in 2023, cited that mental illness is at 11.3 to 11.6 percent and the number increases by two percent yearly. Compare this to the number of mental health practitioners in the country according to the Philippine Psychiatric Association: 651 psychiatrists, 516 psychiatric nurses, and 133 psychologists. The Philippines has only two psychiatrists per 100,000 people, far below the WHO’s 10 psychiatrists per 100,000 people.
Mental health manual for revolutionaries
Recognizing this situation and that its members are no exception from the rest of the population, the Communist Party of the Philippines drafted a manual on mental health for its members, cadres, and Filipino revolutionaries in general to guide them through mental health concerns and ensure that these are properly handled.
The manual comes amid rising fascist attacks against the masses, activists, and revolutionaries and a bankrupt economy that degrades basic social services, including the overall health situation of the country. Factors such as nutrition, access to health care, number of health workers and attending physicians, national budget allotted for health care—all in dire condition—reflects the inability of the reactionary government to recognize, much less respond, to mental health problems of the people. Most hospitals are not equipped to admit the increasing number of mental health patients, especially emergency cases.
Although there are natural factors in mental illness—such as a hereditary predisposition, the effects of a dysfunctional family; the impact of other physical illnesses; or the consequences of severe disasters—it cannot be denied that the extraordinary increase in morbidity and mortality from mental disorders worldwide has been driven by the deepening, widespread crisis in economic, political, and cultural conditions caused by imperialism.
Along this line, the manual identified the most common stressors poor Filipinos experience are caused by the exploitation of the ruling class—the hunger, job insecurity, landlessness, among others. The manual also clarified that while these stressors exist, people handle stress differently. Thus, the need to further understand their condition to address these correctly, especially in times of crisis and worsening attacks on people’s democratic rights.
The Mental Health Manual takes off from the Basic Course on Health released by the Party in the 1980’s. The section on mental health at that time was written for medical officers of NPA units in the countryside where there are no psychiatrists. In 2000, the CPP took the cue to produce this current manual for mental health when the number of cases among comrades increased. The Party made sure the manual is reader-friendly and adaptable to many local languages. It is now on its second edition. The Party’s National Health Bureau however, stressed that the manual is a work-in-progress as more information and practical experience on its use from the Regions are gathered; and, as new medical researches and practice continue to evolve and develop.
Facing mental health concerns among comrades
The Mental Health Manual recognizes that just like the physical body, the mind is also vulnerable to illness and fatigue. While they have different functions, they are integrated thus needing adequate care such as proper nutrition, exercise, and rest.
Stress isn’t always negative. It is a way for humans to finish tasks and develop more functions. Yet, the manual identified responses and symptoms of persons that may already indicate mental illness or mental health problem. It cautioned however, that there should be careful and thorough differentiation between behaviors that are symptoms of mental health problems and those that may stem from ideological problems.
The national democratic movement is in
a position to address mental health problems primarily because of its world outlook and understanding of society,
the scientific method it uses in
crafting solutions to change the world, and its available organizational mechanisms
such as its collectives.
There are pointers in the manual on how to handle comrades with difficulty managing stress, anxiety, trauma or similar concerns. On circumstances that the collective is not able to handle this, they are advised to reach out to a psychiatrist or a doctor. Yet, even with professional consultations, the collective must take on responsibility in managing the mental health of a patient especially those who have traumatic experiences.
There was once a case of a patient in a remote indigenous community. When a psychiatrist comrade visited that community, the patient’s relatives sought the doctor’s help. The patient was diagnosed with schizophrenia and depression, and knowing that the patient will not have enough money and supply to buy prescription medicine, the psychiatrist not only taught the patient but also his whole support system on how to manage his condition. The support system will have to make sure the patient gets the right amount of exercise, eat fruits and vegetables and sleep not less than eight hours a day and when the situation permits, a check-up with health care professionals.
This highlights the key difference between mainstream treatment and people-centered approach. Most western trained psychiatrists would readily prescribe medication to patients facing mental health issues. While pharmaceutical companies undoubtedly benefit from this, patients may become heavily reliant on the increasing doses of medicines just to function day-to-day. In contrast, the revolutionary movement’s approach offers a more complete treatment. It seeks to address the problem by getting into its roots and leveraging available resources in the community to find solutions. This approach integrates counseling, alternative medicine such as herbal medicine, acupuncture, medicinal drug (if necessary), and organizational methods into a comprehensive treatment plan.
The revolutionary movement’s significant position to address mental health
The national democratic movement is in a position to address mental health problems primarily because of its world outlook and understanding of society, the scientific method it uses in crafting solutions to change the world, and its available organizational mechanisms such as its collectives.
Embracing the principles of Marxism-Leninism-Maoism (MLM), a scientific ideology, teaches one to study the concrete conditions of one’s realities, both as individual in a society and the society as a whole. It teaches one to confront situations scientifically which minimizes speculation, anxiety, and the fear of the unknown that are usual the stressors. More importantly, MLM guides revolutionaries in their life’s purpose to persevere in the struggle to end all forms of exploitation and oppression against the working class. Revolutionaries acquire a deeper sense of meaning in life which gives them strength to brave through hardships, sacrifices, and face dangers at the enemy’s front.
To an unenlightened worker, the inhumane conditions at work, the meager salary, the high prices of basic needs bring hopelessness and desperation and look at these as individual failure. But Marxists would not stop here. They would go beyond and see the need and urgency to change these conditions, the need to organize and strengthen their ranks and fight for change.
The revolutionary movement’s approach offers a more complete treatment–getting into the roots and leveraging available resources in the community e.g. counseling, herbal medicine, acupuncture, medicinal drug (if necessary), and organizational methods into a comprehensive treatment plan.
Revolutionaries also have collectives. It serves as their support system while engaging in revolutionary work and even in their personal lives. Having a collective life helps members develop revolutionary attitudes in performing work and in dealing with comrades and masses. The collectives are mechanisms to resolve any conflict and challenges with objectivity and away from subjectivism. With the culture of care and understanding in the collectives, problems are not individualized but shared. Together, they untangle knots and identify causes of problems.
With concerns such as mental health, the collective is the first line of defense. It serves as first responder for comrades in navigating stress or difficult situations. The collective listens and objectively analyzes the issue at hand. Together, they establish concrete steps and recommendations to resolve the individual and collective concerns, while also monitoring the implementation of these solutions.
Overall, the ideological, political, and organizational work sharpens the mind of the revolutionaries. It is not just to make revolutionaries think clearly but to use the acquired tools of analysis in their daily lives—in addressing their individual concerns, in fighting the enemy, and in advancing the revolution. With the constant social investigation and class analysis, regular planning and assessments, comrades are able to understand the causes of wins and losses and to push further for victory.
The new edition of the mental health manual has been issued in recognition for the need to comprehensively address the mental health challenges among comrades and the people they serve. The vast force of revolutionaries are not only dedicated but also healthy, sharp, and steadfast for this protracted people’s war to win. (Mia Andres) ###
