1

CHAPTER I

THE PROBLEM

Introduction

Mental health refers to your overall psychological well-being. It can include

the way you feel about yourself, the quality of your relationships and your ability

to manage your feelings and deal with difficulties. Mental health and physical

health are very closely connected. Mental health plays a major role in your ability

to maintain good physical health. Mental illness, such as depression and anxiety,

affect your ability to participate in treatment and recovery. Issues with mental

health can have many different symptoms, just like issues in physical health.

Questions can be asked and tests can be done to help assess mental health, the

same as with physical health. For physical problems, most people go to the doctor

and get check-up. They have their blood pressure, temperature, and weight

measured. They have blood drawn to check for issues with cholesterol, blood

sugars, thyroid, iron levels, electrolytes, and other measures. However, most

people do not go to a mental health professional for a mental health exam. In many

cases, people only seek out a mental professional after a crisis has occurred. Are

you one of those people? And if you are, why take care of one part of your body

and not the other?

A clear difference is often made between mind and body. But when

considering physical health and mental health, the two should not be thought as

separate. Poor physical health can lead to an increased risk of developing mental
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health problems. Similarly, poor mental health can negatively impact on physical

health, leading to an increased risk of some conditions.

According to (Kisley and Goldberg 1997), physical health status affects the

ongoing mental health and wellbeing of people with mental illness. Furthermore,

mental illness has been shown to completely physical health status. A large study

from Western Australia by (Coghlan et al 2001b), revealed that death from all

main causes were higher for people with mental illness and the overall death rate

was 2.5 higher than the general population of Western Australia.

People who have experienced mental illness can have compromised

physical health for a number of reasons. They are less likely to receive appropriate

health care compared with those without mental illness, and it is an indictment of

out mental health care system that people who have been involved in mental

health services have often had their physical health needs overlooked.

Furthermore, behavioral factors such as smoking, harmful alcohol, and other drug

use, obesity, poor diet, inadequate living situations (such as homelessness), and

poor self-care as a consequences of illness symptoms, can make people with

mental illness vulnerable to physical health problems.

In contrast, being in good physical health, sleeping well, eating well,

exercising, and avoiding harmful alcohol, and other drug use are important for

maintaining wellbeing. In the consultations, many consumers mentioned the

importance of “getting the basics rights” to prevent relapse, by which they meant

the fundamental sources of well being in terms of sleep, nutrition, physical fitness,
 3

and access to physical health care. These are things that are fundamental to the

wellbeing of all people, but assume greater significance for people who are more

vulnerable to mental health problems because they have previously experienced an

episode of mental illness. Notably, good sleep patterns are very important for

wellbeing, and disruption to sleep is often one of the first signs of relapse

(Birchwood et al 2000).

This project focused on the study of finding out the assessment of physical

and mental health of the students in Batangas State University-Lipa Campus. We

will find out their physical and mental health condition. We will ask them how

they take care of their physical and mental health. This study is also conducted to

raise awareness among the readers the important of taking care both of our

physical and mental health. Taking care of your mental health is just as important

to long healthy life as taking care of your physical health.

Statement of the Problem

The main purpose of this study is to know the assessment on the physical

and mental health among Batangas State University-Lipa Campus Students.

Specifically, the study sought to answer the questions:

1. What is the profile of the respondents in terms of

1.1 sex;

1.2 age;

1.3 year level; and

1.4 program?
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2. How may the mental health of the research samples be assessed?

3. Is there a significant difference on the mental health of the research samples

when they are grouped according to dependent variables?

4. What activities can be done on the results/findings of the study?

Scope and Limitations of the Study

The study focused on the assessment of physical and mental health among

the students in Batangas State University-Lipa Campus.

The study considered the profile of respondents in term of sex, age,

educational level, and college department.

Significance of the Study

This research study, together with its generalization, would be beneficial to the

following:

To the students. This study could help them to understand the important of taking

care of our mental and physical health

To the parents. This study would help parents to know what to do with their

children to prevent in having mental or physical illness.

To the field of Psychology. This study would be an additional reference for

research in the field of psychology about the physical and mental health.

To the future Researchers. This study may serve as resource material for future

researchers who will be needed related studies in the future.

To the Researchers. This will greatly help the researchers in understanding the

real relationship between physical and mental health of students.

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To the Community. This study will greatly help the community in order to lessen

the inflating rate of physical problems caused by mental illnesses. This will also

educate the community on how to take care of their mind and body.
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CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter presents the review of related literature and studies considered

important by the researchers to widen their idea about the study. The researchers

gathered information from the several books, unpublished thesis and some

publications that will help them to add some application for the development of

their research study. This also includes the conceptual framework, synthesis,

definition of terms, and hypothesis of the study as well as the definition of terms.

Conceptual Literature

This part of the study presents the review of related literature that gave the

researchers with background and concepts that help to complete the study.

Mental Health

Mental health is defined by the National Institute of Mental Health as the

way one thinks, feels, and acts when coping with life and involves continued

forward movement in abilities to perform daily physical tasks and challenges

(National Institute of Mental Health, 2007). The Surgeon General describes mental

health as a “state of successful performance of mental function, resulting in

productive activities, fulfilling relationships with other people, and the ability to

adapt to change and to cope with adversity” (USDHHS, 1999, p. 4). Mental illness

10refers to all diagnosable mental disorders: “health conditions that are

characterized by alternations in thinking, mood, or behavior associated with

distress and/or impaired functioning” (USDHHS, 1999, p. 4). Mental health is

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further defined by the World Health Organization as one of the core elements of

wellness, along with physical and social well-being (1964). Mental health is not

only the absence of illness, but the capability to respond positively to stressors in

life. College is a stressful time of challenges and transitions. College students are

balancing many demands between classroom expectations, work, extracurricular

activities, social life, and more (Thome & Espelage, 2004). The risk for mental

health issues is increased for college students facing a great deal of stress (Kadison

& DiGeronimo, 2004.)

Mental health is defined as a state of well-being in which every individual

realizes his or her own potential, can cope with the normal stresses of life, can

work productively and fruitfully, and is able to make a contribution to her or his

community. The positive dimension of mental health is stressed in WHO's

definition of health as contained in its constitution: "Health is a state of complete

physical, mental and social well-being and not merely the absence of disease or

infirmity." This fact file highlights the important aspects of mental health and

disorders. The images include pictures drawn by children who participated in the

WHO Global School Contest of Mental Health in 2001. (World Health

Organization, 2014)

College Students, Depression and Anxiety

Rates of depression and anxiety in college students are salient issues to

explore. The National Mental Health Association [NMHA] (2005) reported the
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following statistics on depression and anxiety in college students: Depression

affects over 19 million American adults annually, including college students. At

colleges nationwide, large percentages of college students are feeling so depressed

that they are unable to function. Ten percent of college students have been

diagnosed with depression, including 13% of all college women (NMHA, 2005).

Anxiety disorders affect over 19 million American adults every year, and anxiety

levels among college students have been rising since the 1950s. In 2000, almost

seven percent of college students reported experiencing anxiety disorders within

the previous year. Women are five times as likely as men to have anxiety disorders

(NMHA, 2005).In 2009, the American College Health Association [ACHA]

indicated that depression and anxiety continue to be two of the most common

health problems that university students experience, and are often experienced

concurrently. The National Co-Morbidity Survey indicated that anxiety is the third

most prevalent mental illness in the US, following depression and alcoholism

(Kessler et al. 2005). The National Institute of Mental Health (2011) reported

18.1% of individuals in the United States suffer from Generalized Anxiety

Disorder, and 6.7% suffer from Major Depressive Disorder. Anxiety and other

comorbid conditions increase the lifetime occurrence of suicide ideation and

suicide attempts (Lepine & Lellouch, 1995). Eighty-five percent of people with

anxiety disorders experience academic or occupational difficulties due to their

inability to meet demands in maintaining relationships or employment (Bruce &

Saeed, 1999). In 2005, 17.0% and 13.2% of students who completed the American
 9

College Health Association’s National College Health Assessment (N= 80,121)

reported that they had experienced depression and anxiety, respectively. Students

who completed this survey also indicated that depression and anxiety frequently

interfered with their academic performance. The American Psychiatric

Association (2000) reported that half of all college students reported feeling so

anxious and depressed during their college experience that they had difficulty

functioning. According to Reavley and Jorm (2010), “The age at which most

young people are in higher education is also the age of peak onset for mental and

substance use disorders, with these having their first onset before age 24 in 75% of

cases. In most developed countries, over 50% of 12 young people are in higher

education” (p.134). “Face-to-face, cognitive–behavioral/skill-based interventions”

(p.132) resulted in the most effective strategies to prevent or intervene early with

depression or anxiety in college students (Reavley & Jorm, 2010). The number of

university students who are coming to campus with complicated mental health

care needs is growing on all campuses across the nation (Benton, Robertson,

Tseng, Newton, & Benton, 2003). For example, the proportion of students over a

13-year period (N= 13,257) who received counseling center treatment for

depression, anxiety, or suicide almost doubled from 21.1% to 40.7%, 36.3% to

62.9%, and 4.8% to 8.9%, respectively. University counseling centers report

increases not only in the use of student services, but also in the length of service

utilization. In a survey, 60% of university counseling center directors reported

record numbers of students using their services for extended periods of time
 10

(National Survey of College Counseling Center Directors, 2005.) This survey

reported that approximately 30% of college students see a counselor during their

first four years of college, with numbers increasing each year. Students seek help

at a counseling center at their college campus for a number of different reasons.

Below is a chart depicting the number of Midwestern campus’ students who came

to the counseling center for issues of depression, social, and generalized anxiety,

compared to the national average of college students(Center for the Study of

Collegiate Mental Health, 2010).The national sample was taken from 19,193

college students who sought services at 52 different institutions of higher

education for counseling services during the fall semester of 2009(Center for the

Study of Collegiate Mental Health, 2010). Age ranged from 18 – 63.3 years, with

a mean age of 22.6 years. The sample consisted of 64.2% females, and 35.4%

male. Race was self-reported as 72.6% of the sample as White/Caucasian, 7% as

Black/African American, 6% as Asian/Asian American, 4.9% as Hispanic/Latino,

3.1% as Multiracial, 2.7% Preferred not to answer, 2.5% as other, .05% as Native

American, and .03% as Native Hawaiian or Pacific Islander. First year students

consisted of 18.1% of the sample, 19.7% were sophomores, 22.1% were juniors,

22.8% were seniors and 14.9% were graduate students (Center for the Study of

Collegiate Mental Health, 2010).

College Students and Stress

Stress may also be the culprit for producing anxiety and depression in

college students. Anxiety and depression are often a result of stress. When stress is
 11

perceived negatively or if a student experiences too much stress, physical or

psychological impairment may occur (Misra, McKean & West, 2000). Researchers

reported that some of the most common reactions to stress in students include

emotional reactions, such as worry, fear, guilt, anxiety, anger, grief, and

depression. Students who experience higher levels of stress are known to have a

higher likelihood to engage in unhealthy behaviors such as drinking alcohol,

eating nutrient-lacking food, or not getting enough sleep.

Ross, Niebling, and Heckert (1999) examined the major sources of stress in

college students. In their study, 100 undergraduate students at a Midwestern

university were given the Student Stress Survey, which is a combination of the

Student Stress Scale and the Taylor Manifest Anxiety Scale. The results attributed

81.1 % of all stress sources to daily pressures and hassles. They conclude that

students need to develop the skills and resistance to handle these stresses, so the

stress does not develop into depression and/or anxiety.

In 2009, the Center for the Study of College Student Retention surveyed

more than 2,200 college students across 40 colleges and universities and found

that stress was greatly affecting students’ performances and that they were not

seeking help for their stress or other problems. They also reported that there is a

waitlist at many Universities for students to get in to see a counselor.

The Center for the Study of College Student Retention reported that eighty five

percent of students felt stressed on a daily basis, their academic concerns such as

grades scored at 77 % of all students. Furthermore, six out of 10 students reported

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having felt so stressed they could not complete their schoolwork on one or more

occasions and since starting college, over 70% of students did not consider talking

to a counselor to help them deal with stress or any other emotional or mental

health issues.

Misra and McKean (2000) studied the difference in stress levels between males

and females in college. Compared to males, females reported higher levels of

stress. A study by Hudd et al. (2000) revealed that in a survey of 145

undergraduate students, 63.8% of women reported feeling stressed often,

compared to only 36.3% of males.

Towbes and Cohen (1996) created the College Chronic Life Stress Survey.

They found that first-year students scored higher than other students in chronic

stress. Misra and McKean (2000) also found that emotional, behavioral, and

physiological reactions to stress were higher among freshman than any other

group of students.

A possible explanation for freshman experiencing more stress than upper

class students is the fact that they have not yet established a strong social support

system. Allen and Hiebert (1991) indicated that freshmen and sophomores lack

social support networks and have not developed coping mechanisms to deal with

stress that comes with the traditional college experience. According to a 2004

study by the National Alliance on Mental Illness, students are most likely to turn

to friends should they experience a serious emotional problem while at school.

Further results showed that 62 percent of students reported that they would turn to
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a friend, 46 percent would go to a parent, but only 30 percent would visit a campus

counseling facility. Joining a group exercise program may be a good opportunity

to help increase the social opportunities and support of students, and provide an

effective protective factor against stress.

Social support is very important to maintaining or adopting healthy

behaviors. Lau, Quadrel, and Hartman (1990) have shown that there is substantial

change in health behaviors during the first three years of college and that peers and

friends can have a strong effect on the types and amount of health changes.

Mental Health Stigma

In general, people with mental illness are discriminated more in developing

countries in Asia compared to Western countries. Unlike somatic symptoms,

psychological symptoms are seen as socially disadvantageous, affecting their work

and marriage.

Furthermore, people with mental illness are seen as dangerous and

aggressive. Disturbed behaviors manifested by people with severe mental

illness are more easily recognized; however, the public could not easily distinguish

this from the more common and milder form of disorders. This results in a

generalized view of mentally ill people as violent. In addition to the public, family

members of the mentally ill can also be a source of stigma.

It seems that there is a lack of proper information regarding mental illness

in developing countries. In some Asian cultures, there is a pervasive belief that

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supernatural forces are behind mental illness, and as such, religious and magical

approaches are utilized to treat people.

Several programs and initiatives are pursued in order to strengthen mental

health support and to lessen the stigma against mental illnesses and mentally ill

people in the Philippines. This includes studies conducted by both private and

government entities, laws on mental health, government health programs, and

mental health institutions. Mental illness, psychological disorder and emotional

dysfunction are widespread in the Philippines, due to a large poverty population

and the numerous out-of-school or out-of-work youths. These "psychotic

vagrants", as some would call them, are gravely misunderstood. They are

commonly called "taong grasa or "abnoy". This shows a generally simplistic

attitude towards issues concerning mental health. (Wikipedia, 2008).

Treatment Planning

Counselors adopt different theoretical orientations that they base their

therapeutic practice upon. Treatment goals, objectives, and interventions depend

upon what theory they conceptualize in order to assist the client. Treatment plans

are a necessary part of counseling. Treatment plans include mutually agreed upon

goals, objectives, and strategies to reach these goals (Seligman,2004; Sommers-

Flanagan & Sommers-Flanagan, R., 2003). Goals created in treatment may help

motivate the client to change, educate clients on positive outcomes, and provide a

way to evaluate interventions (Hackney & Cormier, 2005).

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When considering treatment plans, it is important for counselors to take a

holistic perspective and see the client’s issues through behavioral, emotional,

cognitive, biological, and social perspectives. More experienced counselors have

considered a broader scope of information when developing treatment plans than

the less experienced counselors (Falvey, Bray, & Hebert, 2005). Lazarus and

Lazarus (2005) and Seligman (2004) are three well-known individuals who

developed holistic models of assessment for treatment planning in counseling.

Exercise prescription may serve as valuable tool to be used in conjunction with a

treatment plan in counseling.

In some cases, exercise prescription may be the only tool needed for

certain clients. Adding exercise treatment may encourage positive social

interaction (if used in a group setting); decrease symptoms of mild to moderate

depression and anxiety; and increase an overall sense of well being. As a bonus, it

is likely to help maintain or improve physical health.

Current mental health services in the Philippines

Before possible predictors of mental health service underutilization can be

addressed, it is important to first discuss if there are sufficient mental health

professionals and services in the Philippines. In other words, underutilization of

mental health services could be a function of a lack of professionals and services

rather than a general reluctance to seek these ser-vices. In the Philippines, four

general professions are legally recognized to provide mental health services:

guidance and counseling practitioners (Guidance and Counseling Act of 2004);

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psychologists (Philippine Psychology Act of 2009); social workers (Republic Act

No. 4373 (1965)); and those within the umbrella of the medical profession. Under

the Guidance and Counseling Act, an average of 134 professionals was licensed to

practice yearly since 2008 to 2012 (Philippine Regulatory Commission, n.d.). At

the time of writing this paper, the licensure examination of psychologists and

psychometricians has not yet started. How-ever, according to the roster of

specialist psychologist of the Psychological Association of the Philippines (the

Philippine counterpart of the American Psychological Association), there are 98

assessment psychologists, 114 clinical psychologists, 82 counseling psychologists,

and 24 developmental psychologists that are presumed able to provide

psychological assessment and intervention. As a result of the nascent nature of the

licensure examination for both guidance and counseling and psychology laws, no

information is available on the ratio of these mental health professionals vis-à-vis

the Philippine population. No research is available on how these recent changes

have affected attitudes towards the utilization of mental health services. No

information is readily available for other mental health professionals, such as

addiction counselor sand pastoral counselors.

Better estimates are available for those within the ambit of the medical

profession. Re-search suggest that there are 0.40 psychiatrists, 0.40 psychiatric

nurses, 0.17 medical doctors not specialized psychiatry, 0.14 psychologists, 0.08

social workers, and 0.08 occupational therapists per 100,000 general population

(Jacob et al., 2007; WHO, 2006).

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As for inpatient units, WHO (2006) reports 19 community-based

psychiatric inpatient units, which accommodate 1.58 beds per 100,000, and 15

community residential facilities that have 0.61 beds/place per 100,000. Jacob and

colleagues (2007), however, report a much lower estimate of 0.09 mental health

beds per 100,000. As for outpatient units, there are 46 outpatient mental health

facilities which cater for 124.3 users per 100,000, and four day-treatment facilities

which treat 4.42 users per 100,000.

Are there sufficient mental health professionals and facilities? If the United

States Department of Health and Human Services’ (n.d.) criteria were to be used,

then the Philippines have a shortage of mental health professionals. According to

the criteria, an area should have at least (a) a core mental health professional to

population ratio of 16.67:100,000 and a psychiatrist to population ratio of

5:100,000, or (b) a core mental health professional to population ratio of

11.11:100,000, or (c) a psychiatrist to population ratio of 3.33:100,000. Making

matters worse is the current trend of mental health professionals leaving to work in

other countries (WHO, 2006). Facilities are also severely lacking, and available

only in urban centers (Conde, 2004; WHO, 2006). The largest government

psychiatric facility located in the capital city, The National Centre for Mental

Health, holds 67% of the psychiatric beds in the country, and the rest of the mental

health facilities are perpetually overcrowded, and effectively nonfunctional due to

manpower and budgetary constraints (Conde, 2004). Medical doctors (one for

every 80,000 Filipino) are also scarce compared to traditional healers (one for
 18

every 300 Filipinos), which could perpetuate the Filipino’s reliance on folk

medicine (WHO & DOH, 2012). As for school counselors, the reported

counselor–client ratio was 1:800–1000 (Villar, 2000).

Economic issues also need to be considered. For instance, the cost of

counseling in the Philippines ranges from 500 to 2000 Philippine pesos (Php), or

USD 12–USD 50 per session (Tuason, Galang-Fernandez, Catipon, Trivino-Dey,

& Arellano-Carandang, 2012). When juxtaposed with the minimum daily wage of

Php 456 or USD10 (National Wages and Productivity Commission, 2014), and

61% of the population living on or less than USD 2 a day (NSO, 2010), the cost of

seeking counseling from a trained mental health professional may be prohibitive.

Since alternative medicine is much cheaper (e.g., USD 0.44 for acupuncture), it is

understandable that 50% to 70% of the population use traditional and

complementary medicine (Lagaya, 2005; WHO & DOH, 2012).

The Cause of Illnesses

Hwang, Wei-Chin, Goto, and Sharon (2009) examined the possible causes

of mental illnesses stemming from their childhood up to the present. It focuses

mainly on bullying during the child’s formative years from either their parents, in

the form of abuse or neglect, or their peers, out casting them for differences

especially stereotypes. In the study they have found that most children with racial

differences tend to adopt anti socialistic or avoidant behaviours leading to

depression or sociopathy in extreme cases. With regards to physical or emotional

abuse by parents, all children have an equal chance of negative development as

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long at least one person in their family has a strong yet adverse impact upon them.

Blanco, Okuda, Wright, Hasin, Grant, Liu, and Olfson (2008) stated that “Almost

half of college-aged individuals had a psychiatric disorder in the past year. The

overall rate of psychiatric disorders was not different between college-attending

individuals and their non–college-attending peers. The unadjusted risk of alcohol

use disorders was significantly greater for college students than for their non–

college-attending peers.

College students were significantly less likely to have a diagnosis of drug

use disorder or nicotine dependence or to have used tobacco than their non–

college-attending peers. Bipolar disorder was less common. College students were

significantly less likely to receive past-year treatment than non-college attending

students”. This study entails that the common age group of college students, from

15-20 years of age, have an even chance of developing some form of illness

regardless of the social strata where they belong to. The only difference is the type

of disorder they tend to develop due to the circumstances and environment

surrounding them. Kadison, DiGeronimo, (2004) stated that it is due to stress

towards any and all that provide anxiety to which a college student has many.

Major Theories to Understanding Mental Health

There are a number of major or grand theories relating to understanding mental

health:

• Analytical/ Developmental theories: "Theories of development provide a

framework for thinking about human growth, development, and learning. If

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you have ever wondered about what motivates human thought and

behaviour, understanding these theories can provide useful insight into

individuals and society." (Cherry, 2014) Theorists: Freud, Jung, Eriksson,

Kohlberg.

• Behavioural theories: "Behavioural psychology, also known as

behaviourism, is a theory of learning based upon the idea that all

behaviours are acquired through conditioning. Advocated by famous

psychologists such as John B. Watson and B.F. Skinner, behavioral theories

dominated psychology during the early half of the twentieth century.

Today, behavioural techniques are still widely used in therapeutic settings

to help clients learn new skills and behaviours." (Cherry, 2014) Theorists:

Watson, Skinner, Pavlov

• Cognitive theories: Cognitive psychology is the branch of psychology that

studies mental processes including how people think, perceive, remember,

and learn. As part of the larger field of cognitive science, this branch of

psychology is related to other disciplines including neuroscience,

philosophy, and linguistics." (Cherry, 2014) Theorists: Tolman, Piaget,

Chomsky

• Social theories: "Social psychology looks at a wide range of social topics,

including group behavior, social perception, leadership, nonverbal

behaviour, conformity, aggression, and prejudice. It is important to note

that social psychology is not just about looking at social influences. Social
 21

perception and social interaction are also vital to understanding social

behaviour." (Cherry, 2014) Theorists: Bandura, Lewin, Festinger

Research Literature

Public and private stigma, hiya, and loss of face

The unique construal of mental illness or psychological difficulties could

lead to stigmatization, which subsequently discourages individuals from seeking

mental health services. Stigma and its detrimental effect on mental health help-

seeking behaviours has been documented in developed countries (Alvidrez,

Snowden, & Kaiser, 2008; Cooper, Corrigan, & Watson, 2003; Corrigan, 2004)

and among Asian cultures (Fogel & Ford, 2005; Miville & Constantine, 2007;

Shea & Yeh, 2008). Culture also plays a big role in shaping attitudes and social

interactions with individuals with mental illness, as well as in its treatment

(Abdullah & Brown, 2011). The public’s discriminatory response, also known as

public stigma (Corrigan & Kleinlein, 2005), is then internalized (private stigma),

resulting in diminished self-worth and self-efficacy, shame, low self-esteem, and

subsequent reluctance to seek treatment (Corrigan, 2004). Among Filipinos,

studies show that private stigma is negatively correlated with the intention to seek

professional help, and mediates the relationship between public stigma and

attitudes towards seeking professional help (Garabiles, Tuliao, & Velasquez, 2011;

Tuliao & Velasquez, in press). Although stigmatization and its effects on mental

health help-seeking behaviours are not unique to Filipinos (Abdullah & Brown,
 22

2011; Lauber & Rössler, 2007), hiya could be a potential barrier or a

compounding problem to seeking mental health services. Hiya has been loosely

translated by some scholars as ‘shame’. However, Pe-Pua and Protacio Marcelino

(2000) would argue that, depending on prefixes and suffixes, the meaning can

range from shy (mahiyain), embarrassment or awkwardness (napahiya), to a sense

of propriety (kahihiyan). For the purposes of this paper’s topic, the most apt

translation would be embarrassment and a sense of propriety. As an experience

beyond embarrassment, hiya is a painful emotion arising from real or imagined

transgressions of social norms or authority figures, and its avoidance is paramount

in social interactions (Bulatao, 1964). Hence, if having emotional distress or

psychological problems are frowned upon, then divulging these issues to the

public are to be avoided at all costs. Although the concrete role of hiya on mental

health help-seeking behaviour has not yet been studied, loss of face, an arguably

related construct, has been previously researched (Abe-Kim et al., 2004; David,

2010; Gong et al., 2003). Loss of face has been defined as the threat or loss of

one’s social integrity, especially as it relates to social relationships and one’s

social standing, and oftentimes measured using the Loss of Face Scale (Zane &

Yeh, 2002). Whereas some would consider face as a universal construct, others

assume that it is more salient among Asians (Lin & Yamaguchi, 2011). Results in

loss of face, however, are inconsistent, with some suggest that it is positively

associated with the intent to seek mental health treatment (Yakunina & Weigold,

2011), whereas others suggest the opposite (Leong, Wagner, & Kim, 1995). The
 23

discrepancy could be a product of the ethnic heterogeneity of the participants in

the study. Among Filipino Americans, research suggests that loss of face was

negatively associated with past utilization and propensity to seek help from mental

health professionals, positively associated with willingness to seek help from lay

networks, and not related to help seeking from general practitioners and folk

healers (David, 2010; Gong et al., 2003). However, among Filipinos, loss of face

was positively associated with intent to seek face-to-face and online counselling

(Bello et al., 2013). On the other hand, relationships between loss of face and help-

seeking-related variables are similar between Filipinos and Filipino Americans.

Studies suggest that loss of face was negatively associated with indifference to

stigma and psychological openness among Filipino Americans (David, 2010;

Gong et al., 2003). Among Filipinos, loss of face was negatively associated with

attitude towards counselling, and positively associated with perceived stigma for

seeking help and receiving psychological help (Bello et al., 2013). Qualitative

studies suggest that loss of face or shame may be implicated in the Filipinos’

reluctance to seek professional help. For Filipino women living in Australia,

Thompson and colleagues (2002) show that fear of being labelled as ‘crazy’ and to

avoid tarnishing the family’s reputation was a barrier to seeking professional help

(Thompson et al., 2002). In comparison to face-to-face counselling, some Filipinos

preferred online counselling because of the anonymity it provided which lessened

the effects of hiya (Hechanova et al., 2011).

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Other correlates of mental health help-seeking behaviour Apart from those

mentioned, prior studies also uncovered other variables that are associated with

mental health help-seeking behaviours. Problem severity and attitudes supportive

of counselling were associated with willingness to seek professional help among a

sample of Filipino college students (Bunagan et al., 2011; Gong et al., 2003;

Tuliao & Velasquez, in press). Ease in operating the system and the presence of

computers and access to internet was associated with higher intent to seek online

counselling among migrant workers, even after accounting for problem severity

(Hechanova et al., 2013). Gender’s effect on help-seeking behaviour has had

mixed results. Studies on Filipino Americans suggest no gender differences in

mental health help-seeking behaviour (Baello & Mori, 2007; Gong et al., 2003),

which contradicts studies suggesting that men are more reluctant to seek help than

women (Addis & Mahalik, 2003). Findings were similar for Filipinos, i.e., there

were no significant gender difference between attitudes towards professional help

seeking and intent to seek professional help (Bunagan et al., 2011). It is important

to emphasize though that both genders were equally reluctant to seek professional

help for psychological difficulties. Furthermore, the study by Bunagan et al.

(2011) was a bivariate correlational analysis. Hence, multivariate studies are

needed to fully clarify the role of gender. For seeking help from lay networks,

women are more likely to seek help from lay networks compared to men (Bunagan

et al., 2011), consistent with the results of Gong and colleagues (2003). Although

gender norms dictate that men should be strong and not show emotional
 25

vulnerability (Aguiling-Dalisay et al., 1995), these gender imperatives seem to

only influence help seeking from lay networks. It is plausible to posit that other

variables are more influential in predicting help seeking from professional mental

health professionals other than gender.

Synthesis

Most studies conducted on the mental health of students from preschool till

college or anywhere in between them are dominantly western. The three major

aspects of the proposed topic have been discussed upon by numerous students,

researchers, and scientists. Most focus on the different facets of mental health

namely suicide and depression and the proper treatment or interaction with the

afflicted like the work of Elkin, et al. (2004) although some focus on the meaning

of mental health and its effects on the student’s performance like the work of

Blanco, and others. The last of the topics included is non-existent due to the

previously given reason of the lack of any studies from a non-western perspective

but more importantly the Asian countries like the Philippines. But nonetheless it

would border on the topic of the effects of the culture in the propagation or

worsening of their health and its hindrance towards the treatment. How this

corresponds to the present situation is simple.

As a student, one sees and hears stories about others which may or may not

be true concerning others about their lives. It begets the question of how

extensively the students of today are being managed, handled, and safeguarded
 26

from themselves or their environments. The study explores the following research

questions:

1) What are the common mental illnesses experienced by college students?”

2) What are the available programs/ interventions provided to college students?”

3) What are the remedies/ interventions that are availed by college students? And

4) What are the alternatives that are used by psychiatrists for similar/exact

problem?

Conceptual Framework

The conceptual framework is formulated by identifying the variables and

their relationship.

This study is based on Psychosocial Theory by the idea mainly of the

psychologist Erik Erickson. In this theory, it talks about the stage of life where

people are in the stage of “Intimacy vs Isolation”. It is an evidence theory of

socialization and lifespan development that seeks to predict and explain major

causes, consequences and other correlated parts of stress that will affect the

physical and mental health of college students in school.

This is to assess the correlation between the physical and mental health of

the respondents, mainly college students. People nowadays are not aware that

stress and anxiety can affect their mental and physical well-being.

This study will also tackle the factors that may affect the health of a person,

including physical, emotional, psychological and other factors. This assessment

 27

will measure how a person responds physically and mentally to pressure, stress,

and anxiety.
 28

Conceptual Paradigm

Input Process Output

College Students
in BSU-Lipa
 age Proposed
Assessment Test
 sex Activity
 status
 program

Figure 1.
The Conceptual Paradigm in
Assessment of Physical and Mental Health of College Students

Hypothesis

After analyzing the concepts in this literature, the researchers found two

possible hypotheses that will serve as a guide to find answers in the study. With

this, the researchers hypothesized that there is a significant relation in the physical

and mental health among College Students in Batangas State University-Lipa

Campus.

Definition of Terms

These are the uncommon words used in this research. These definitions are

based on how these words are used in each statements given in this research

material.
 29

Acupuncture - a system of integrative medicine that involves pricking the skin or

tissues with needles, used to alleviate pain and to treat various physical, mental,

and emotional conditions. Originating in ancient China, acupuncture is now

widely practiced in the West.

Ambit - the scope, extent, or bounds of something.

Bipolar Disorder - Bipolar disorder, previously known as manic depression, is a

mental disorder that causes periods of depression and periods of abnormally

elevated mood. The elevated mood is significant and is known as mania or

hypomania, depending on its severity, or whether symptoms of psychosis are

present.

Cholesterol - Cholesterol is a waxy substance found in your blood. Your body

needs cholesterol to build healthy cells, but high levels of cholesterol can increase

your risk of heart disease. With high cholesterol, you can develop fatty deposits in

your blood vessels.

Chronic Stress - Chronic stress is the response to emotional pressure suffered for

a prolonged period of time in which an individual perceives they have little or no

control.

Comorbid - the simultaneous presence of two chronic diseases or conditions in a

patient.

Complementary - combining in such a way as to enhance or emphasize the

qualities of each other or another.

Constraints - a limitation or restriction.

 30

Depicting - show or represent by a drawing, painting, or other art form.

Dysfunction - abnormality or impairment in the function of a specified bodily

organ or system.

Electrolytes - Electrolytes are minerals in your body that have an electric charge.

They are in your blood, urine, tissues, and other body fluids. Electrolytes are

important because they help balance the amount of water in your body.

Extracurricular - (of an activity at a school or college) pursued in addition to the

normal course of study.

Holistic - characterized by comprehension of the parts of something as intimately

interconnected and explicable only by reference to the whole.

Indictment - a formal charge or accusation of a serious crime.

Juxtaposed - place or deal with close together for contrasting effect.

Nascent - (especially of a process or organization) just coming into existence and

beginning to display signs of future potential.

Neglect - fail to care for properly.

Perpetually - in a way that never ends or changes; constantly.

Pervasive - (especially of an unwelcome influence or physical effect) spreading

widely throughout an area or a group of people.

Prevalent - widespread in a particular area or at a particular time.

Psychotic Disorder - Psychotic disorders are severe mental disordersthat cause

abnormal thinking and perceptions. People with psychoses lose touch with reality.

Two of the main symptoms are delusions and hallucinations.

 31

Relapse - a deterioration in someone's state of health after a temporary

improvement.

Reliance - dependence on or trust in someone or something.

Reluctance - unwillingness or disinclination to do something.

Social Strata - Social stratification is a kind of social differentiation whereby a

society groups people into socioeconomic strata, based upon their occupation and

income, wealth and social status, or derived power (social and political).

Sociopathy - is a colloquial term that refers to behaviors associated with antisocial

personality disorder. Sociopathy best resembles Antisocial Personality Disorder in

the DSM-V. Sociopath are often used in place of one another but they are actually

two different things.

Somatic Symptoms - Somatic symptom disorder is characterized by an extreme

focus on physical symptoms — such as pain or fatigue — that causes major

emotional distress and problems functioning. You may or may not have another

diagnosed medical condition associated with these symptoms, but your reaction to

the symptoms is not normal.

Stereotypes - a widely held but fixed and oversimplified image or idea of a

particular type of person or thing.

Stigma - a mark of disgrace associated with a particular circumstance, quality, or

person.

Therapeutic - the branch of medicine concerned with the treatment of disease and

the action of remedial agents.

 32

Thyroid - The thyroid is a small gland in your neck that makes thyroid hormones.

Sometimes the thyroid makes too much or too little of these hormones. Too

much thyroid hormone is called hyperthyroidism and can cause many of your

body's functions to speed up. “Hyper” means the thyroid is overactive.

Underutilization - Underutilization is the state of not being used enough or not

used to full potential. An example of underutilization is when a very smart person

with a master’s degree is just working at an entry-level job in fast food.

Vis-à-vis - Vis-à-vis comes from Latin by way of French, where it means

literally "face-to-face." In English it was first used to refer to a little horse-

drawn carriage in which two people sat opposite each other. From there it

acquired various other meanings, such as "dancing partner." Today it no longer

refers to actual physical faces and bodies, but its modern meaning comes from

the fact that things that are face-to-face can easily be compared or contrasted.

So, for example, a greyhound is very tall vis-à-vis a Scottie, and one currency

may be stronger vis-à-vis another.

 33

CHAPTER III

RESEARCH METHODOLOGY

The chapter deals with the method, procedures, and research design that will be

utilize by researchers in conducting study. This chapter presents and discusses a

brief description of the subject of the study, the data gathering, and instruments to

be use, as well as the statistical treatment.

Research Design

The purpose of this study is to assess the physical and mental health of

college students that are studying in Batangas State University. The researchers

employed the quantitative method – emphasize objective measurements and the

statistical, mathematical, or numerical analysis of data collected through

questionnaire.

Quantitative methods are those research methods that use numbers as its

basis for making generalizations about a phenomenon. The data that will serve as

the basis for explaining a phenomenon, therefore, can be gathered through

surveys. Such surveys use instruments that require numerical inputs or direct

measurements of parameters that characterize the subject. Quantitative research

focuses on gathering numerical data and generalizing it across groups of people to

explain a particular phenomenon (Lehbaree, 2009). The output serves as the basis

for making the conclusions and generalizations of the study.

 34

Respondents of the Study

The respondents of the study are the students in Batangas State University-

Lipa Campus. The researchers will be using the stratified random sampling

technique for choosing its sample. This study’s participants will be chosen using

this stratified random sampling. Stratified random sampling is one of the simplest

forms of collecting data from the total population. Under random sampling, each

member of the subset carries an equal opportunity of being chosen as a part of the

sampling process. This sampling method is a part of the sampling technique in

which each sample has an equal probability of being chosen. A sample chosen

randomly is meant to be an unbiased representation of the total population.

Before the sampling proper, the researchers need to know how many

samples they need in order for their assessment research to become valid. Thus,

they used RAOSOFT application in order to figure it out. The results of the

RAOSOFT app are as follows:

Total Population = 1,720 students

Level of Confidence = 90%

Margin of Error = 10%

Sample Size = 66

According to Sugiyono (2012), Population means generalization region

consists of object or subject that has certain qualities and characteristics that

determined by the researcher to be studied and drawn the conclusions. Then, the

researcher uses simple random sampling in taking sample. Simple random

 35

sampling is the sampling technique where we select a group of subjects for study

from a larger group. Each individual is chosen entirely by chance and each

member of the population has an equal chance of being included in the sample.

Data Gathering Instrument

A. Construction of Questionnaire

In order to gather necessary data for the completion of study, the

researchers used researchers-made questionnaire as the main instrument. Similar

studies were used as references in constructing the content of the questionnaire.

The questionnaire was designed to obtain objectives answer to questions included

in the study. After the researchers constructed the questionnaire, they consulted it

to their thesis adviser.

The questionnaire was divided into three parts, the first part contained the

demographic profile of the respondents in terms of age, sex, income and

educational attainment. Then, the second part contained the level of physical and

mental state of the respondent, mechanism and socio-cultural attitudes. The third

part will focus on the questions that will give researchers the data they are looking

for. The questionnaire consists of 30 items that includes on how will the

researchers assess the relationship between physical and mental health of the

respondents.

B. Validation of Questionnaire

The assessment study used a researcher-made questionnaire. The items

developed will be shown to five experts in the field of Psychology in order for the
 36

questionnaire to become valid. For norming, the said questionnaire will undergo a

dry-run.

C. Administration of Questionnaire

The researchers asked the permission of the authorities for them to

distribute the questionnaire. After asking for permission, the test questionnaires

will be distributed to the respondents of the study and the assessment will begin.

D. Scoring of the Respondents

In order to score the responses, the researchers used the 4-point Likert Scale

to assess the totality of the mental and physical health of each respondent.

Data Gathering Procedures

Before the actual data, the researchers asked for permission of the

authorities inside the university. The researchers excused and presented the letter

approved by the College Dean. Before giving the questionnaire to the respondents,

the researchers will explain to them the purpose of the study and gave them the

instruction on how to answer the questionnaire. The leader of the research team

will give the signal for the assessment to begin. The other members will be around

as guides and patrollers to make sure that the test will run smoothly, free from any

extraneous factors that may affect the results. The entire data gathered by the

researchers were tallied, tabulated, analyzed, and interpreted according to their

scores by the use of appropriate statistical treatment. The researchers were able to

find the results of the study with the data gathered by the researchers.
 37

Statistical Treatment of Data

The data that the researchers will collect after the assessment examination shall be

tabulated, analyzed, and interpreted using some statistical procedures.

Frequency/Percentage. It will be used to determine the frequency counts and

percentages of respondents as to personal characteristics and demographics in

terms of age, sex, college year level, and civil status.

Measures of Central Tendency. Mean, Median, and Mode. A measure of central

tendency is a summary statistic that represents the center point or typical value of

a dataset. These measures indicate where most values in a distribution fall and are

also referred to as the central location of a distribution.

Z-test. It is a statistical hypothesis test used in which the z-statistic follows a

normal distribution. The z-test is best used for greater than 30 samples because

under certain limit theorem, as the number gets larger, the samples are considered

to be approximately normally distributed.

 38

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